United States District Court, E.D. Michigan, Southern Division
ADVANCED SURGERY CENTER, LLC, And SOUTHEAST MICHIGAN ANESTHESIA GROUP, PLLC, as Assignees of Terry Minor, Plaintiffs,
ALLSTATE INSURANCE CO., Defendant.
OPINION AND ORDER GRANTING IN PART AND DENYING IN
PART DEFENDANT'S MOTION TO DISMISS [DOC. 2]
CARAM STEEH UNITED STATES DISTRICT JUDGE.
a claim for Michigan No-Fault benefits stemming from a
September 16, 2016 motor vehicle collision wherein Terry
Minor sustained multiple accidental injuries. Plaintiff
Advanced Surgery Center is an ambulatory surgical center that
provided the situs for reasonably necessary medical treatment
that was rendered to Mr. Minor. Plaintiff Southeast Michigan
Anesthesia Group provided anesthesia services for one of the
procedures that was performed at Advanced Surgery Center.
responsible no-fault insurer could be identified, so
plaintiffs initially filed a lawsuit on April 28, 2017
against the Michigan Automobile Insurance Placement Facility
(“MAIPF”) to compel it to name a servicing
insurer that would act as Mr. Minor's no-fault insurance
carrier. This lawsuit was filed in Macomb County Circuit
Court and was subsequently voluntarily dismissed after
plaintiffs' counsel learned that MAIPF had named Allstate
Insurance Company to act as Mr. Minor's insurer.
Plaintiffs then filed the present action against defendant
Allstate, as the servicing insurer, in Oakland County Circuit
Court on July 18, 2017. The complaint alleges two counts: a
Personal Injury Protection (“PIP”) claim and
breach of contract. Allstate removed the matter to federal
court based on diversity jurisdiction. The matter is before
the court on Allstate's Rule 12(b)(6) motion to dismiss
for failure to state a claim upon which relief can be
FOR SUMMARY JUDGMENT
12(b)(6) allows the Court to make an assessment as to whether
the plaintiff has stated a claim upon which relief may be
granted. Under the Supreme Court's articulation of the
Rule 12(b)(6) standard in Bell Atlantic Corp. v.
Twombly, 550 U.S. 544, 554-56 (2007), the Court must
construe the complaint in favor of the plaintiff, accept the
allegations of the complaint as true, and determine whether
plaintiff's factual allegations present plausible claims.
'''[N]aked assertion[s]' devoid of
'further factual enhancement''' are
insufficient to ''state a claim to relief that is
plausible on its face''. Ashcroft v. Iqbal,
556 U.S. 662, 678 (2009) (quoting Twombly, 550 U.S.
at 557, 570). To survive a Rule 12(b)(6) motion to dismiss,
plaintiff's pleading for relief must provide
''more than labels and conclusions, and a formulaic
recitation of the elements of a cause of action will not
do.'' D'Ambrosio v. Marino, 747 F.3d
378, 383 (6th Cir. 2014) (quoting Twombly, 550 U.S.
at 555) (other citations omitted). Even though the complaint
need not contain ''detailed'' factual
allegations, its ''factual allegations must be enough
to raise a right to relief above the speculative level on the
assumption that all the allegations in the complaint are
true.'' New Albany Tractor, Inc. v. Louisville
Tractor, Inc., 650 F.3d 1046, 1051 (6th Cir. 2011)
(citing Twombly, 550 U.S. at 555).
No Statutory Right to Sue No-Fault Insurers for
Michigan Supreme Court recently held that healthcare
providers do not have a statutory right to sue a No-Fault
insurer to recover No-Fault PIP benefits incurred by an
injured person. Covenant Med. Ctr., Inc. v. State Farm
Mut. Auto. Ins. Co., ___ Mich. ___; 895 N.W.2d 490
(2017). The court specifically limited its holding to whether
the No-Fault Act conferred an independent statutory cause of
action to healthcare providers, noting that its decision was
“not intended to alter an insured's ability to
assign his or her right to past or presently due benefits to
a healthcare provider.” Id., slip op. at 24
Michigan Court of Appeals reiterated post-Covenant
that “providers have always been able to seek . . .
assignment of an injured party's rights to past or
presently due benefits . . . .” W. A. Foote
Memorial Hosp. v. MACP and MAIPF, Docket No. 333360,
(August 31, 2017), slip op. at 19-20. The decision emphasized
that it was not intended to alter the ability of the injured
person to assign his or her right to pursue an action for
medical bills owed to the medical provider that provided the
services, in accordance with MCL 500.3134, which only
prohibits the assignment of a right to a future benefit.
extent that plaintiffs rely on the No-Fault Act itself to
recover under their PIP Claim alleged in Count I, they do not
have such a statutory claim. For example, in paragraph 18 of
the complaint plaintiffs allege:
Pursuant to MCL 500.3157, Plaintiffs are entitled to recover
the outstanding balance for the products, services and/or
accommodations to the injured party from Defendant.
MCL 500.3157 provides that a health care provider may charge
a reasonable amount for medical services rendered to a person
insured by a no-fault insurance carrier and such charges may
not exceed the amount customarily charged for like services.
Of course this statute, along with the others cited by
plaintiffs in Count I, do not provide a basis for recovery,
but they do provide the categories of recovery plaintiffs may
seek to recover from defendant Allstate.
paragraph 24 of the complaint, plaintiffs allege:
Plaintiffs, as assignees of the injured party, are the real
parties of interest and as such Plaintiffs have the right to
prosecute this action against ...