CHIROPRACTORS REHABILITATION GROUP, PC v STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
Docket Nos. 320288 and 322317
Court of Appeals of Michigan
October 29, 2015
313 Mich. App. 113
ELITE HEALTH CENTERS, INC v STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY; Submitted July 14, 2015, at Detroit.
Elite Health Centers, Inc., Elite Chiropractic, PC, and Horizon Imaging, LLC, brought an action against State Farm in the 46th District Court, seeking payment for services they rendered to Ricky Johnson for injuries he allegedly sustained in a motor vehicle accident. State Farm had requested that Johnson appear for an EUO, which he failed to do. When State Farm refused to pay the healthcare providers, the providers brought suit. State Farm moved for summary disposition and to amend its affirmative defenses. The court, Debra Nance, J., denied the motions. State Farm sought leave to appeal. The Oakland Circuit Court, Colleen A. O‘Brien, J., denied the application. State Farm then sought leave to appeal in the Court of Appeals. The Court of Appeals
The Court of Appeals held:
1. Under the no-fault act,
2. A healthcare provider‘s eligibility to recover medical expenses is dependent on the injured party‘s eligibility for no-fault benefits. In these cases, State Farm argued that the injured parties’ failure to cooperate with the requested ME and EUOs established that they were not entitled to no-fault coverage. Under Roberts v Farmers Ins Exch, 275 Mich App 58 (2007), a suspension of benefits is proper if a claimant repeatedly fails to comply with his or her statutory duty to submit to an ME, but a suspension of benefits does not constitute an irrevocable denial of benefits and does not mean that the claimant is not entitled to benefits. Similarly, using compliance with EUO provisions as a condition precedent to the recovery of no-fault benefits is not permissible because doing so would vitiate the insurer‘s statutory duty to pay benefits in a timely manner. Accordingly, the failure to submit to an EUO does not establish as a matter of law that an injured person is not entitled to benefits. The failure of the injured parties to submit to the ME and EUOs requested by State Farm in these cases, therefore, did not demonstrate that there is no genuine issue of material fact with regard to whether plaintiffs, as the injured parties’ healthcare providers, were entitled to no-fault benefits as a matter of law, because the injured pаrties’ failure to comply did not conclusively establish the ineligibility of the injured parties to PIP benefits. State Farm remained statutorily obligated to pay benefits in a timely manner if the injured parties complied with the requirements of the no-fault act, which included submitting to an ME if requested, demonstrating that they were eligible for benefits under a no-fault policy, and providing reasonable proof of the fact and of the amount of loss sustained. The injured parties’ failure to comply with the ME and EUOs did not establish that State Farm was entitled to summary disposition as a matter of law.
District court orders denying State Farm‘s motions for summary disposition in Dockеt Nos. 320288 and 322317 affirmed; district court order denying State Farm‘s motion to amend its affirmative defenses in Docket No. 322317 reversed; cases remanded for further proceedings.
INSURANCE - NO-FAULT AUTOMOBILE INSURANCE - FAILURE TO SUBMIT TO A MEDICAL EXAMINATION - SUSPENSION OF BENEFITS - EFFECT ON A HEALTHCARE PROVIDER‘S ELIGIBILITY TO RECOVER MEDICAL EXPENSES.
A healthcare provider‘s eligibility to recover medical expenses under the no-fault act is dependent on the injured party‘s eligibility for no-fault benefits; a suspension of benefits is proper if an injured party repeatedly fails to comply with his or her statutory duty to submit to a medical examination under
Docket No. 320288:
Andreopoulos & Hill, PLLC (by L. Louie Andreopoulos and David T. Hill), for Chiropractors Rehabilitation Group, PC.
E. Smith & Associates, PC (by Eric D. Smith and Scott W. Malott), for State Farm Mutual Automobile Insurance Company.
Docket No. 322317:
Bauer & Hunter PLLC (by Christopher C. Hunter and Richard A. Moore) for Elite Health Centers, Inc., Elite Chiropractic, PC, and Horizon Imaging, LLC.
Scarfone & Geen, PC (by Robert J. Scarfone and Keisha L. Glenn), and James G. Gross, PLC (by James G. Gross), for State Farm Mutual Automobile Insurance Company.
Before: WILDER, P.J., and SHAPIRO and RONAYNE KRAUSE, JJ.
WILDER, P.J. These consolidated appeals are before this Court by leave granted.1 In each case, defendant, State Farm Mutual Automobile Insurance Company (State Farm), appeals a circuit court order affirming a district court order denying a motion for summary disposition. In Docket No. 322317, State Farm also
I
Plaintiffs in both cases are healthcare providers that rendered medical treatment to individuals allegedly injured in motor vehicle accidents. The medical providers brought actions in the district court, under the no-fault act,
A
In Docket No. 320288, Raynard Jackson allegedly sustained injuries on or about September 4, 2011, while a passenger in a motor vehicle owned and operated by Mohammed Abdullah. At the time, Abdullah‘s vehicle was insured under a no-fault policy issued by State Farm. Because of incomplete and conflicting police reports and medical records, there were questions regarding whether Jackson was injured in the accident. Consequently, in response to Jackson‘s claim for PIP benefits, State Farm requested that Jackson submit to a medical examination (ME) as permitted under
Sometime after the accident, Jackson sought treatment from plaintiff, Chiropractors Rehabilitation Group, PC. When State Farm failed to reimburse plaintiff for the charges associated with its treatment of Jackson, plaintiff filed a complaint alleging that, under the no-fault act, it was entitled to reimbursement from State Farm for the services it provided to Jackson. On May 10, 2013, State Farm moved for summary disposition under MCR 2.116(C)(10), arguing that it was not responsible for charges associated with plaintiff‘s treatment of Jackson. State Farm asserted that because Jackson had failed to cooperate in its investigation of the claims, he was not eligible for coverage under the policy. State Farm then reasoned that Jackson‘s ineligibility for coverage barred the claims of any healthcare provider seeking coverage on Jackson‘s behalf.
The district court denied State Farm‘s motion for summary disposition. The court held that questions of fact existed regarding whether Jackson was eligible for coverage under the no-fault act and whether Jackson‘s ineligibility would bar the provider‘s claims. The district court also denied State Farm‘s motion for reconsideration. On appeal, the circuit court affirmed the district court‘s order.
B
In Docket No. 322317, Ricky Johnson was purportedly a passenger in a vehicle involved in an accident on June 28, 2012, but the traffic report identified only
On September 19, 2012, Johnson filed a claim for PIP benefits with State Farm, which had issued a policy of no-fault insurance to Veretta Robinson, the owner of the vehicle in which Johnson was allegedly a passenger. On January 22, 2013, State Farm requested that Johnson appear for an EUO on February 4, 2013. Johnson failed to appear for this scheduled EUO and later failed to appear at EUOs rescheduled for March 20, 2013 and March 22, 2013.
On September 6, 2013, plaintiffs filed a first amended complaint seeking PIP benefits from State Farm. Plaintiffs sought reimbursement of nearly $20,000 in outstanding medical exрenses related to plaintiffs’ treatment of Johnson. On November 19, 2013, State Farm filed a motion to amend its affirmative defenses and for summary disposition. Through this motion, State Farm sought to include as an affirmative defense that plaintiffs’ suit was barred because Johnson had failed to cooperate with State Farm‘s investigation of the claim. State Farm also argued that summary disposition of plaintiffs’ claims was appropriate because Johnson‘s ineligibility for PIP benefits precluded plaintiffs from seeking such benefits. Additionally, State Farm asserted that the policy language at issue required Johnson to submit to an EUO as a condition precedent to the recovery of benefits. State Farm argued that Johnson‘s failure to
The district court denied State Farm‘s motion to amend its affirmative defenses and for summary disposition. The court ruled that State Farm had provided no legal authority to warrant an amendment to the affirmative defenses. With respect to the summary disposition motion, the court held that Johnson‘s actions did not preclude a healthcare provider‘s claim because a healthcare provider has a right to a separate cause of action.
On January 30, 2014, State Farm moved for reconsideration of the district court‘s order denying leave to amend its affirmative defenses. In this motion, State Farm argued that healthcare providers lacked standing to pursue a claim for PIP benefits, asserting that оnly the injured party could pursue such a claim. On February 4, 2014, the district court denied State Farm‘s motion for reconsideration.
The circuit court denied State Farm‘s application for leave to appeal, finding that State Farm had failed to show that it would suffer substantial harm by awaiting final judgment. This Court thereafter granted leave to appeal.
II
In both appeals, State Farm argues that the lower courts erred by denying its motions for summary
A
State Farm first argues in Docket No. 322317 that healthcare providers do not have standing under the
This issue is not properly preserved because State Farm raised this argument for the first time in a motion for reconsideration. Vushaj v Farm Bureau Gen Ins Co of Mich, 284 Mich App 513, 519; 773 NW2d 758 (2009). However, we will review this issue because it is an issue of law and all of the relevant facts are available. Id.
Whether a party has standing to bring an action is a question of law reviewed de novo on appeal. Gyarmati v Bielfield, 245 Mich App 602, 604; 629 NW2d 93 (2001).
[A] litigant has standing whenever there is a legal cause of action.... Where а cause of action is not provided at law, then a court should, in its discretion, determine whether a litigant has standing. A litigant may have standing in this context if the litigant has a special injury or right, or substantial interest, that will be detrimentally affected in a manner different from the citizenry at large or if the statutory scheme implies that the Legislature intended to confer standing on the litigant. [Lansing Sch Ed Ass‘n v Lansing Bd of Ed, 487 Mich 349, 372; 792 NW2d 686 (2010) (emphasis added).]
This Court has frequently restated the following principles of statutory construction:
The primary goal of statutory interpretation is to ascertain and give effect to the intent of the Legislature in enacting a provision. Statutory language should be construed reasonably, keeping in mind the purpose of the statute. The first criterion in determining intent is the specific language of the statute. If the statutory language is clear and unambiguous, judicial construction is neither required nor permitted, and courts must apply the statute as written. However, if reasonable minds can differ regarding the meaning of a statute, judicial construction is
appropriate. [CG Automation & Fixture, Inc v Autoform, Inc, 291 Mich App 333, 338; 804 NW2d 781 (2011) (quotation marks and citation omitted).]
Courts should give effect to every word and phrase in a statute and avoid an interpretation that renders any part of a statute surplusage or nugatory. Dep‘t of Environmental Quality v Worth Twp, 491 Mich 227, 238; 814 NW2d 646 (2012).
In Munson Med Ctr v Auto Club Ins Ass‘n, 218 Mich App 375, 381-381; 554 NW2d 49 (1996), this Court previously recognized that medical service providers have the “right to be paid for the injureds’ no-fault medical expenses... pursuant to
This conclusion is consistent with other opinions issued by this Court that have acknowledged the viability of first-party claims brought by healthcare
B
Next, State Farm argues in both appeals that the healthcare providers’ ability to seek no-fault PIP benefits is dependent on whether the injured party would be eligible to receivе those PIP benefits. Accordingly, State Farm contends that the trial courts erred by denying its motions for summary disposition because the medical providers’ claims were barred because Jackson and Johnson were ineligible for benefits given that they had failed to submit to the MEs and EUOs that State Farm had requested and, consequently, failed to provide reasonable proof of a compensable loss. We agree with State Farm‘s general statement of the law, but disagree that the medical providers’ claims are barred as a matter of law at this stage of the proceedings.
A review of relevant Michigan caselaw indicates that a healthcare provider‘s eligibility to recover medical expenses is dependent on the injured party‘s eligibility for no-fault benefits under the insurance policy. Our decision in TBCI, PC v State Farm Mut Auto Ins Co, 289 Mich App 39; 795 NW2d 229 (2010), is instructive. In that case, the healthcare provider brought suit seeking payment of PIP benefits under the no-fault act. Id. at 40. The plaintiff had provided medical treatment to Eric Afful, who was allegedly injured in a motor vehicle accident. Id. at 40-41. State Farm, however, had refused to pay Afful‘s claim, contending that the claims were fraudulent. Id. at 40. Afful filed suit
Here, there is no serious dispute whether the judgment in the first case was a final judgment on the merits. The jury determined that Afful had submitted a fraudulent claim for benefits, and a judgment pursuant to the verdict was entered on June 3, 2008. Further, there is no question whether plaintiff‘s claims were, or could have been, resolved in the first lawsuit. This is because the essential evidence presented in the first case sustained dismissal of both actions. See Eaton Co Rd Comm‘rs v Schultz, 205 Mich App 371, 375; 521 NW2d 847 (1994). Plaintiff, by seeking coverage under the policy, is now essentially standing in the shoes of Afful. Being in such a position, there is also no question that plaintiff, although not a party to the first case, was a “privy” of Afful. “A privy of a party includes a person so identified in interest with another that he represents the same legal right....” Begin v Mich Bell Tel Co, 284 Mich App 581, 599; 773 NW2d 271 (2009).6 As noted, the jury determined that Afful submitted a fraudulent claim. The result under the plain language of the exclusion provision interpreted in the first action is that Afful and his privies were not entitled to coverage under the policy. Plaintiff is simply attempting to relitigate precisely the same issue in order to obtain coverage under the policy. The trial court properly dismissed plaintiff‘s suit to the extent that it found its claim was barred by res judicata. For this reason, plaintiff‘s claim of appeal fails. [TBCI, 289 Mich App at 43-44.]
Similarly, in Bahri v IDS Prop Cas Ins Co, 308 Mich App 420, 424-425; 864 NW2d 609 (2014), this Court held that the healthcare providers’ claims for PIP
In Mich Head & Spine Institute v State Farm Mut Auto Ins Co, 299 Mich App 442; 830 NW2d 781 (2013), this Court also acknowledged the interdependence between the claims of a healthcare provider and an injured party. In that case, the healthcare provider rendered services and accommodations to Pellumbesha Biba and brought an action against Biba‘s no-fault insurer, State Farm, seeking to recover payment for those services. Id. at 445-446. In exchange for $35,000 and in settlement of ongoing litigation with State Farm, Biba executed a contract that released State Farm from liability for no-fault benefits incurred to date or which might be incurred in the future. Id. at 444-445. Six months after signing the release, Biba began treatment with the plaintiff, Michigan Head & Spine. Id. at 445. In reliance on the release, State Farm refused to pay Michigan Head & Spine for its treatment of Biba. Id. at 445. State Farm appealed an order granting summary disposition in favor of Michigan Head & Spine, and this Court had to determine “whether an insured‘s release bars a healthcare provider‘s claim for payment for medical services rendered to the insured after the release was executed.” Id. at 448. Applying contract principles, this Court held that the plain language of the release “demonstrate[d] that, in exchange for defendant‘s payment of $35,000, the parties intended to discharge [State Farm‘s] liability
Additionally, in Detroit Med Ctr v Progressive Mich Ins Co, 302 Mich App 392; 838 NW2d 910 (2013), this Court implicitly recognized that a healthcare provider‘s claim is dependent on the injured party‘s entitlement to benefits under a no-fault insurance policy, although it did not directly rule on the issue. The case was initiated by the plaintiff healthcare provider that treated the injuries of a motorcyclist who was insured by the defendant insurance company. Id. at 394. The trial court entered judgment in favor of the healthcare provider based on its conclusion that the motor vehicle associated with the incident was sufficiently involved in the accident for the plaintiff healthcare provider to recover no-fault benefits. Id. at 394. This Court held that summary disposition should have been granted in favor of the defendant insurance company because the motorcyclist was not entitled to personal protection insurance benefits pursuant to the no-fault act under the facts of the case. Id. at 399.8
State Farm argues that the district courts’ focus on whether Jackson and Johnson were involved in the accidents or sustained injuries related thereto was misplaced. Instead, according to State Farm, the courts should have focused on the undisputed fact that the injured parties failed to submit to the requested MEs and EUOs. State Farm contends that this failure
In order to resolve this issue, a brief review of the statutes and caselaw addressing MEs and EUOs is warranted. Beginning with MEs,
(a) An order that the mental or physical condition of the disobedient person shall be taken to be established for the purposes of the claim in accordance with the contention of the party obtaining the order.
(b) An order refusing to allow the disobedient person to support or oppose designated claims or defenses, or prohibiting him from introducing evidence of mental or physical condition.
(c) An order rendering judgment by default against the disobedient person as to his entire claim or a designated part of it.
(d) An order requiring the disobedient person to reimburse the insurer for reasonable attorneys’ fees and expenses incurred in defense against the claim.
(e) An order requiring delivery of a report, in conformity with section 3152, on such terms as are just, and if a physician fails or refuses to make the report a court may exclude his testimony if offered at trial. [
MCL 500.3153 .]
Thus, under
This Court‘s decision in Roberts v Farmers Ins Exch, 275 Mich App 58; 737 NW2d 332 (2007), is instructive. Roberts indicates that a suspension of benefits is proper if a claimant repeatedly fails to comply with his or her statutory duty to submit to MEs. Id. at 69. In Roberts, after the insured, Brittany Underwood, repeatedly missed scheduled MEs and failed to pay cancellation fees, the insurer discontinued first-party no-fault benefits. Id. at 61. This Court, in reviewing the propriety of the insurer‘s actions, held:
Underwood repeatedly failed or refused to attend the physical and psychological [MEs]. Underwood therefore breached her statutory duty to “submit to mental or physical examination by physicians.”
MCL 500.3151 . Farmers did not conclude that because of Underwood‘s breach, benefits were irrevocably denied; rather, it merely suspended those benefits until Underwood (1) paid the $1,000 cancellation fee and (2) submitted to a psychological [ME]. Because Underwood had breached her statutory duty to submit to [MEs], Farmers had a legitimate statutory question, namely, whether a claimant, upon breach of her statutory duty to submit to [MEs], remains entitled to continuing PIP benefits. The statute provides no penalty for a claimant‘s breach of his or her duty to submit to [MEs]; therefore, Farmers raises a legitimate statutory question regarding the appropriate consequence of Underwood‘s breach of her statutory duty. Because Farmers had a legitimate question of statutory construction, its suspension of benefits to Underwood was reasonable. McCarthy [v Auto Club Ins Ass‘n, 208 Mich App 97, 103; 527 NW2d 524 (1994)]. We hold that where a claimant repeatedly breaches his or her statutory duty to submit to [MEs], an insurer may properly suspend benefits pending completion of any requisite [ME]. Otherwise, an insured could breach with impunity his or her duty to submit to [MEs], and theinsurer would have no way of investigating whether the injury claims were legitimate. In addition to the statutory duty to submit to [MEs], Farmers’ no-fault policy imposes on a person claiming coverage under the policy a duty to “[s]ubmit to physical examinations at our expense by doctors we select as often as we may reasonably require.” The policy does not articulate the remedy for breach of this duty. The general rule is that a remedy for breach of contract should make the nonbreaching party whole or “place the nonbreaching party in as good a position as if the contract had been fully performed.” Corl v Huron Castings, Inc, 450 Mich 620, 625-626; 544 NW2d 278 (1996). Allowing Farmers to suspend benefits places Farmers in as good a position as if Underwood had submitted to a neuropsychological [ME] because it puts Farmers in the same position as it would be had the [ME] shown that Underwood lacked a brain injury caused by the accident. Whether viewed as a remedy for breach of the statutory duty to submit to [MEs] or as a remedy for breach of a contractual duty to submit to [MEs], the proper remedy is for the insurer to suspend performance of its duties. [Id. at 68-70 (emphasis added).]
Therefore, under Roberts, State Farm may reasonably suspend claims by the injured parties due to a failure to submit to MEs, and a suspension of benefits is not an irrevocable denial of benefits; the eligibility for PIP benefits is simply suspended until compliance with the ME. Likewise, we conclude that evidence that an injured party failed to submit to an ME that later results in a suspension of the claim is not tantamount to dispositive evidence that the injured person is not entitled to PIP benefits.
With regard to the effect of an injured party‘s failure to submit to an EUO, the Supreme Court‘s decision in Cruz v State Farm Mut Auto Ins Co, 466 Mich 588; 648 NW2d 591 (2002), is instructive. In Cruz, the Court held that EUO provisions may be included in no-fault
State Farm contends, inter alia, that the injured parties are ineligible for PIP benefits because they failed to submit to EUOs. However, taken to its logical extension, State Farm‘s argument, that the failure to submit to an EUO is alone sufficient to render the injured person ineligible for PIP benefits, would cause compliance with EUO provisions to effectively operate as a condition precedent to State Farm‘s duty to pay no-fault benefits.10 However, using compliance with EUO provisions as a condition precedent to the recovery of no-fault benefits is precluded by Cruz, which held that аn insurance company and its insured are not permitted to contract in a manner that vitiates the insurance company‘s “duty to pay benefits in a timely fashion as required by the statute. Once ‘reasonable
In these cases, it is apparent that an irrevocable denial11 of benefits had not been issued by State Farm in either case: State Farm had only suspended Jackson‘s claim for benefits because of its inability to determine whether Jackson was eligible for outstanding or future benefits, and there is no indication that State Farm took any action following Johnson‘s failure to appear at the EUOs. Therefore, we conclude that the injured parties’ failure to submit to the MEs and EUOs requested by State Farm did not demonstrate that there is no genuine issue of material fact as to whether plaintiffs, as the injured parties’ healthcare providers, were entitled to no-fault benefits as a matter of law, because the injured parties’ failure to comply does not conclusively establish the ineligibility of the injured parties to PIP benefits and plaintiffs’ related inability to recover payment for services from State Farm. State Farm remained statutorily obligated to pay benefits in a timely manner if the injured parties complied with the requirements of the no-fault act, which includes submitting to an ME if requested,12 demonstrating that they were eligible for benefits under the policy,13 and providing “reasonable proof of the fact and of the
Our conclusion here is consistent with the public policy goals of the no-fault act. As discussed by this Court in Wyoming Chiropractic, 308 Mich App at 401:
[t]he goal of the no-fault act is “to provide victims of motor vehicle accidents with assured, adequate, and prompt reparation for certain economic losses.” The no-
“injuries [arose] out of or [were] caused by the ownership, operation, maintenance or use of a motor vehicle“) (citation and quotation marks omitted).
See also Shavers v Attorney General, 402 Mich 554, 621-623; 267 NW2d 72 (1978) (describing operational deficiencies in the previous tort system and the corresponding changes enacted under the no-fault personal injury protection system). However, “[i]t is clear that the Legislature did not intend for no-fault insurers to pay all claims submitted without reviewing the claims for lack of coverage, excessiveness, or fraud.” Advocacy Org for Patients & Providers v Auto Club Ins Ass‘n, 257 Mich App 365, 378; 670 NW2d 569 (2003) (quotation marks, citation, and emphasis omitted). Although it is evident that the no-fault аct balances injured parties’ interests in assured payment with insurance providers’ interests in ensuring that they do not pay ineligible, excessive, or fraudulent claims, the statutory scheme and public policy goals of the act demonstrate a significant emphasis on assured, adequate, and prompt reparation for the victims of motor vehicle accidents and, correspondingly, those who may claim benefits “for the benefit of an injured person,” i.e., healthcare providers.
III
Finally, State Farm argues in Docket No. 322317 that the district court abused its discretion when it failed to grant State Farm‘s request for leave to amend its affirmative defenses to include an allegation that Johnson‘s ineligibility for no-fault benefits barred plaintiffs’ claims. We agree.
This Court reviews for an abuse of discretion a trial court‘s ruling on a motion for leave to amend a pleading. Titan Ins Co v North Pointe Ins Co, 270 Mich App 339, 346; 715 NW2d 324 (2006). “An abuse of discretion occurs when the trial court‘s decision is outside the range of reasonable and principled outcomes.” Brown v Home-Owners Ins Co, 298 Mich App 678, 690; 828 NW2d 400 (2012) (quotation marks and citation omitted).
MCR 2.111(F)(3) requires that a party state its affirmative defenses in the party‘s responsive pleading, either as originally filed or as amended under MCR 2.118. Specifically, pursuant to MCR 2.111(F)(3)(b), a pаrty must state the facts constituting “a defense that
A motion to amend ordinarily should be granted, and should be denied only for the following particularized reasons:
[1] undue delay, [2] bad faith or dilatory motive on the part of the movant, [3] repeated failure to cure deficiencies by amendments previously allowed, [4] undue prejudice to the opposing party by virtue of allowance of the amendment, [and 5] futility.... [Weymers v Khera, 454 Mich 639, 658; 563 NW2d 647 (1997) (quotation marks and citation omitted; alterations in original).]
In Johnson‘s case, the trial court denied State Farm‘s motion to amend on the basis that it failed to make a legal argument or cite any caselaw indicating that justice required an amendment of State Farm‘s affirmative defenses. The trial cоurt‘s reasoning was equivalent to a finding that the amendment would be futile. “An amendment is futile where, ignoring the substantive merits of the claim, it is legally insufficient on its face.” Gonyea v Motor Parts Fed Credit Union, 192 Mich App 74, 78; 480 NW2d 297 (1991). While futility may warrant denying a motion to amend a pleading, Weymers, 454 Mich at 658, in Johnson‘s case, the proposed amendment was not necessarily futile. As we explained in Part II(B), a healthcare provider‘s ability to recover medical expenses under the no-fault act depends on whether the injured party is eligible for no-fault benefits. Accordingly, if it were established that Johnson is not eligible for no-fault benefits, the providers’ cause of action would be precluded. In its brief in support of its motion to amend its affirmative
We affirm the district court orders denying State Farm‘s motions for summary disposition in Docket Nos. 320288 and 322317, reverse the order denying State Farm‘s motion to amend its affirmative defenses in Docket No. 322317, and remand for further proceedings consistent with this opinion in both appeals. As the prevailing party in Docket No. 320288, Chiropractors Rehabilitation Group may tax costs pursuant to MCR 7.219. No taxable costs in Docket No. 322317, none of the parties having prevailed in full. We do not retain jurisdiction.
SHAPIRO and RONAYNE KRAUSE, JJ., concurred with WILDER, P.J.
Notes
(1) Except as provided in subsection (2), personal protection insurance benefits are payable for the following:
(a) Allowable expenses consisting of all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person‘s care, recovery, or rehabilitation.
Finally,A physician, hospital, clinic or other person or institution lawfully rendering treatment to an injured person for an accidental bodily injury covered by personal protection insurance, and a person or institution providing rehabilitative occupational training following the injury, may charge a reasonable amount for the products, services and accommodations rendered. The charge shall not exceed the amount the person or institution customarily charges for like products, services and accommodations in cases not involving insurance.