PIP (Provider Suit)

Court/Case No: Wayne County Circuit Court/15-013077-NF

Tried/Argued Before: Judge

Demand: $56,247.30

Verdict: $0 - Summary disposition granted

Name of Judge(s): Honorable Judge Leslie Kim Smith

Keys to the Case:

Plaintiff (a medical provider) claims entitlement for services rendered to two underlying claimants. Notably, these claimants had their own PIP lawsuit which was dismissed for failure to provide written notice within one year, pursuant to MCL 500.3145(1). Despite the existence of a valid court order deeming the claimants ineligible for PIP benefits arising out of the subject accident, Plaintiff refused to dismiss their case.

Defendant filed a motion for summary disposition, predicated on the fact Plaintiff did not provide written notice of the claim within one year. Plaintiff’s counsel attempted to present a representation letter to the Defendant (wherein Plaintiff’s counsel claimed to represent the underlying claimants) which was purportedly provided six months after the date of the accident. Defendant countered by submitting affidavits from the litigation and pre-suit claims adjusters who never received the claimed fax.

Notably, this purported fax document had the incorrect claim number, incorrect claimants’ names, and failed to identify the nature and extent of the injuries as required by the statute.

During oral argument, Plaintiff claimed the purported fax document was sufficient to serve as constructive notice when coupled with bills and records submitted by providers. Defendant referred to the Perkovic opinion, which notes submission of bills and records from a provider is insufficient notice under the statute.

Ultimately, the judge indicated that although there may be some question as to whether the claimed fax was sent to the Defendant, there was no question that the document was insufficient to provide written notice under MCL 500.3145(1). As such, this provider’s claim was dismissed with prejudice.

Defense SW attorney(s) Involved in Case: