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).

To access the full article: https://bit.ly/3jGChUe