Oakland Circuit Court. LC No. 2013-009983-AV. Oakland Circuit
Court. LC No. 2014-139132-AV.
CHIROPRACTORS REHABILITATION GROUP PC, Plaintiff-Appellee:
LOUIE L. ANDREOPOULOS, ROYAL OAK, MI.
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY,
Defendant-Appellant: ERIC D. SMITH, NORTHVILLE, MI.
WILDER, P.J., and SHAPIRO and RONAYNE KRAUSE, JJ.
Mich.App. 116] Kurtis T. Wilder, P.J.
consolidated appeals are before this Court by leave
granted. 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 [313 Mich.App. 117] challenges the district
court's order denying leave to amend its affirmative
defenses. We affirm in part and reverse in part.
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, MCL 500.3101 et
seq., seeking reimbursement for medical expenses related
to the treatment rendered. State Farm, the no-fault insurer
allegedly responsible for payment of personal protection
insurance (PIP) benefits under the no-fault act, filed
motions for summary disposition in which it argued, among
other things, that the injured parties were not eligible for
the payment of PIP benefits and, therefore, the healthcare
providers were similarly precluded from seeking such
benefits. The district courts denied State Farm's motion
for summary disposition in each case.
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 MCL 500.3151
and an examination under oath (EUO). Jackson failed to appear
for two ME appointments [313 Mich.App. 118] scheduled in
February and March 2012. He similarly failed to attend the
EUO. In April 2012, State Farm advised Jackson, through his
legal counsel, that because of Jackson's failure to
cooperate with its investigation of the claim, State Farm was
suspending his claim for benefits.
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.
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.
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 [313 Mich.App. 119] "
Qutrel Monteque" as a passenger. Johnson purportedly
gave the police a false name at the time of the accident. On
August 23, 2012, Johnson sought treatment from plaintiff
Elite Health Centers, Inc. Johnson complained of neck and
back pain that he attributed to injuries sustained in the
accident. Johnson also sought treatment from plaintiff
Horizon Imaging, LLC, in September 2012, where he underwent
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.
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
expenses 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 [313 Mich.App. 120] cooperate made it impossible
to establish whether a loss occurred or whether it was first
in priority to provide no-fault coverage to Johnson. State
Farm, therefore, reasoned that summary disposition was
appropriate under MCR 2.116(C)(10). In response, plaintiffs
argued that because EUO provisions in insurance contracts may
not act as a condition precedent to the recovery of PIP
benefits, State Farm was not entitled to summary disposition.
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.
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 only the injured party could
pursue such a claim. On February 4, 2014, the district court
denied State Farm's motion for reconsideration.
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.
appeals, State Farm argues that the lower courts erred by
denying its motions for summary [313 Mich.App. 121]
disposition. We review de novo a trial court's decision
on a motion for summary disposition, Gorman v American
Honda Motor Co, Inc, 302 Mich.App. 113, 115; 839 N.W.2d
223 (2013), as well as a circuit court's affirmance of a
district court's decision on a motion for summary
disposition, First of Am Bank v Thompson, 217
Mich.App. 581, 583; 552 N.W.2d 516 (1996). When reviewing a
motion for summary disposition brought under MCR
2.116(C)(10), this Court must consider, in the light most
favorable to the party opposing the motion, " the
'affidavits, together with the pleadings, depositions,
admissions, and documentary evidence then filed in the action
or submitted by the parties' . . . ." Calhoun Co
v Blue Cross Blue Shield Michigan, 297 Mich.App. 1, 11;
824 N.W.2d 202 (2012), quoting MCR 2.116(G)(5). "
Summary disposition is appropriate under MCR 2.116(C)(10) if
there is no genuine issue regarding any material fact and the
moving party is entitled to judgment as a matter of
law." Dillard v Schlussel, 308 Mich.App. 429,
444-45, 865 N.W.2d 648 (2014) (quotation marks and citation
omitted). " There is a genuine issue of material fact
when reasonable minds could differ on an issue after viewing
the record in the light most favorable to the nonmoving
party," Allison v AEW Capital Mgt, LLP, 481
Mich. 419, 425; 751 N.W.2d 8 (2008), or " when the
evidence submitted 'might permit inferences contrary to
the facts as asserted by the movant,'"
Dillard, 308 Mich.App. at 445, quoting Opdyke
Investment Co v Norris Grain Co, 413 Mich. 354, 360; 320
N.W.2d 836 (1982).
Farm first argues in Docket No. 322317 that healthcare
providers do not have standing under the [313 Mich.App. 122]
no-fault act to bring an action against an insurer to obtain
no-fault PIP benefits. We disagree.
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
Michigan, 284 Mich.App. 513, 519; 773 N.W.2d 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