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Orthopedic P.C. v. Allstate Insurance Co.

United States District Court, E.D. Michigan, Southern Division

February 10, 2017

ORTHOPEDIC, P.C., Plaintiff,



         This action arises from a claim for Personal Injury Protection benefits, assigned to Defendant under Michigan law, which was submitted in connection with an August 2013 auto accident involving non-party LaDawn Jones. Plaintiff filed this action seeking reimbursement for medical expenses that it incurred in treating Jones during 2014 and 2015.

         Now before the Court is Defendant's Motion for Summary Judgment. Owing largely to a significant admission by Plaintiff that it has no evidence to support a causal connection between the accident and Jones' injuries, the Court will GRANT Defendant's Motion. The Court has determined that there is no need for oral argument and will decide the matter based on the parties' written submissions. See E.D. Mich. LR 7.1(f).

         I. BACKGROUND

         LaDawn Jones was involved in a car accident on August 25, 2013. Since there was no auto insurance policy that covered the accident, Jones made a claim with Michigan's Automobile Insurance Placement Facility, which in turn assigned her claim to Defendant. (See ECF No. 12, Def.'s Mot. Summ. J. at 3.)

         Plaintiff treated Jones on various occasions between March 2014 and March 2015. The total amount billed by Plaintiff during that period was $93, 592.93. (See ECF No. 12, Ex. B, Orthopedic PC Billing Statement at 3.) Defendant issued two payments to Plaintiff, in September and November of 2014 respectively, which totaled $676.35. (See ECF No. 12, Ex. C, Allstate Payment Letters.)

         On February 23, 2015, Plaintiff filed this four-count lawsuit in the Circuit Court of Wayne County. (ECF No. 1, Notice of Removal, Ex. A, February 23, 2015 Summons and Complaint.) The Complaint had one exhibit attached: a list of claims totaling $35, 731.00. (See Id. at 8.)

         In April and May of 2015, Defendant received bills based on treatments of Jones from a company named Computerized Joint Surgery, LLC. Some of those bills were for the same treatments on the same dates that had been billed previously by Plaintiff.[1] (See ECF No. 12, Ex. D, Computerized Joint Surgery LLC Bills; ECF No. 12, Ex. E, Orthopedic PC Bills.) Defendant points out that in some instances, they both bill for treatments occurring at different locations on the same date. (See ECF No. 12 at 4.) Dr. Muhammad Awaisi, Plaintiff's owner, testified that the duplicative billing was a mistake, likely owing to an administrative error. (ECF No. 12, Ex. F, Deposition of Muhammad Awaisi at 39:11-42:20.) Dr. Awaisi also testified that according to Plaintiff's records, Jones informed Dr. Sam Hakki-the physician employed by Plaintiff that was responsible for her treatment-that she had suffered two falls in the time between the car accident in August 2013 and the beginning of her treatment in March 2014. (Awaisi Dep. 103:15-24.)

         On June 8, 2015, Defendant received a billing statement from Plaintiff, dated May 20, 2015, which indicated the $95, 592.93 balance mentioned above. (ECF No. 1 at 2-3.) The next day, Defendant removed the action to this Court. (ECF No. 1.) Nearly six months later, on December 4, 2015, the Court issued an Order for Plaintiff to show cause as to why the case should not be dismissed for failure to prosecute. (ECF No. 2.) The Court vacated the Order a few days later (ECF No. 4), and on the same day, Defendant filed its Answer to the Complaint. (ECF No. 3.)

         According to the Scheduling Order issued on February 3, 2016, the cutoff date for fact discovery was set for August 2, 2016, and the final date for the filing of dispositive motions was set for October 31. (See ECF No. 7 at 1.) During that period, the Court issued two Stipulated Orders compelling participation in discovery by Plaintiffs: one compelling responses to Defendant's Second Interrogatories and Answers to Interrogatories and Request for Production of Documents (ECF No. 9), and another two weeks later compelling Plaintiff to produce two individuals for deposition by Defendant (ECF No. 10). That period also saw two attorney substitutions for Plaintiff: one in March (before the two discovery Orders, and about a month after the Scheduling Order) (ECF No. 8), and one in June (ECF No. 11).

         On June 2, 2016, Defendant served Plaintiff with its Third Request for Admissions and Production of Documents. (ECF No. 12, Ex. G, Defendant's Third Request for Admissions and Production of Documents.) Defendant requested five admissions, quoted in full below:

1. Admit Plaintiff has no evidence to causally relate Ms. Jones' condition to the August 2013 motor vehicle accident.
2. Admit Plaintiff has no evidence to refute the fact that Ms. Jones' condition may have been caused by superseding intervening slip and fall incidents.
3. Admit Plaintiff has no evidence that Dr. Hakki rendered any treatment or services to Ms. Jones between January 2015 and March 2015 at Plaintiffs Clinton Township office.
4. Admit Plaintiff has no evidence that Ms. Jones received any treatment or services at Greater Lakes Ambulatory Surgical Center ...

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