PIP Provider

Court/Case No: Oakland County Circuit Court/19-173296-NF

Tried/Argued Before: Judge

Demand: $37,442.64

Verdict: $0 – Motion for Summary Disposition granted

Name of Judge(s): Honorable Hala Jarbou

Keys to the Case:

The cause of action was brought by two entities alleging that they were legally related and to be treated as one for purposes of the assignment it received from the underlying insured. This case arises out of an underlying suit the claimant filed in Wayne County Circuit Court to recover benefits under No-Fault. Ultimately, the underlying insured signed a Release and settled its claims with our client, thus disposing the case.

We first argued that since the underlying insured settled and released all claims with our client, the Plaintiff provider in this case is estopped from bringing the cause of action. Specifically, since the Release language indicated that it relieves the Defendant of all past, present and future claims, the Defendant cannot be held liable for outstanding bills resulting from the alleged treatment to the underlying insured. Moreover, the provision in the Release specifically carved out only one of the legal entities, while excluding the other. Lastly, it was the Defendant’s position that if the excluded Plaintiff is to recover for the alleged treatment it rendered, the appropriate party to pursue is the underlying insured.

Most importantly, we argued that the second legal entity did not have standing as the assignment clearly did not include them as a party to the Assignment of Benefits. Plaintiff’s counsel attempted to argue they were legally the same entity, but the Plaintiff failed to substantiate that assertion with any evidence.

Ultimately, the Court granted our Motion. Judge Jarbou indicated on the record that she based her decision on the fact that since the underlying insured signed a Release in her underlying PIP suit that specifically extinguished all past, present and future claims, as well as, carved out the first entity within a provision of the Release, the second excluded entity did not have a cause of action against Defendant. Plaintiff provider was estopped from bringing the cause of action as a result of the Release. The Judge agreed that Plaintiff failed to substantiate its claim that the first and second provider were legally the same entity, and thus, the second entity was not a party to the assignment and does not have standing.

As a result, the first entity’s claim was dismissed from the Oakland County Circuit Court for a lack of jurisdiction as its bills fell well below the $25,000 jurisdiction threshold. The second provider’s claim was completely dismissed based on the language in the Release and it not being a party to the Assignment it relied on.

Defense SW attorney(s) Involved in Case: