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Innocent Until Proven Guilty: The Balancing of the Equities; Reasonableness and Necessity of Charges
In Breece v Johnson, et al., the Court held that the no-fault policy at issue was fraudulently induced by material misrepresentations in the application for insurance. However, the third-party claimant (not a named insured) was found to be more innocent than the insurer. This in turn precluded rescission of the no-fault policy. To reach its conclusion on overriding innocence, the Court utilized the non-exhaustive five factors outlined in Pioneer State Mut Ins Co v Wright.
The repricing of disputed expenses alone does not establish summarily that rates charged by a medical provider are “reasonable” and “necessary” within the meaning of the No-Fault Act under MCL 500.3107(1)(a) and MCL 500.3157(1).
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