Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

VHS Huron Valley Sinai Hospital v. Sentinel Insurance Co.

Court of Appeals of Michigan

January 23, 2018

VHS HURON VALLEY SINAI HOSPITAL, doing business as DMC SURGERY HOSPITAL, Plaintiff-Appellee,
v.
SENTINEL INSURANCE COMPANY, Defendant-Appellant.

         Wayne Circuit Court LC No. 14-009084-NF

          Before: Fort Hood, P.J., and Gleicher and O'Brien, JJ.

          ON REMAND

          FORT HOOD, P.JUDGE.

         This case is again before us following remand from the Michigan Supreme Court.[1] In our earlier opinion, we concluded that the trial court properly determined that res judicata did not operate to bar plaintiff's claims against defendant. However, the Michigan Supreme Court has remanded this case to our Court to reconsider our initial disposition of this case in light of the Michigan Supreme Court's decision in Covenant Med Ctr, Inc v State Farm Mut Auto Ins Co, 500 Mich. 191; 895 N.W.2d 490 (2017). For the reasons set forth below, we vacate the trial court's stipulated order for dismissal and consent judgment, reverse the trial court's order denying defendant's motion for summary disposition and remand for entry of judgment in favor of defendant.[2]

         I. FACTS AND PROCEDURAL HISTORY

         In our earlier opinion we recited the relevant facts, in pertinent part, as follows:

On June 25, 2013, Charles Hendon, Jr. was involved in a motor vehicle accident when his vehicle was allegedly rear-ended by an unidentified hit and run driver, causing bodily injury. Defendant Sentinel Insurance Company is Hendon's insurer. From August 1, 2013, through October 7, 2013, plaintiff VHS Huron Valley-Sinai Hospital, doing business as DMC Surgery Hospital, provided medical services to Hendon for his care, recovery, and rehabilitation related to his injuries sustained in the automobile accident, at a cost totaling $68, 569.
On September 9, 2013, Hendon commenced a cause of action against Sentinel asserting a claim for uninsured motorist benefits under his insurance policy and alleging negligence on the part of the unidentified hit and run driver involved in the accident. Hendon did not assert a claim for no-fault PIP benefits as part of his lawsuit. Thereafter, on July 15, 2014, DMC, plaintiff in the instant case, commenced a cause of action against Sentinel asserting a claim for no-fault PIP benefits for the medical services DMC provided to Hendon for injuries arising out of the accident. On October 21, 2014, Hendon and Sentinel settled Hendon's lawsuit seeking uninsured motorist benefits for $1, 500 and, on October 29, 2014, that suit was dismissed, with prejudice, per stipulation of the parties.
After settling Hendon's case, Sentinel sought summary disposition of DMC's action for PIP benefits under MCR 2.116(C)(7), asserting that it was barred by res judicata. The trial court denied Sentinel's motion, concluding that res judicata did not bar DMC's claim because it could not have been resolved in Hendon's earlier action for uninsured motorist benefits given the dissimilarity in the two claims. The court then entered a stipulated order for dismissal and consent agreement, which closed the case but allowed Sentinel to appeal as of right the court's denial of its motion for summary disposition. Sentinel appeals. [VHS Huron Valley Sinai Hosp v Sentinel Ins Co, unpublished opinion per curiam of the Court of Appeals, issued October 13, 2016 (Docket No. 328005), pp 1-2 (footnotes omitted), vacated and remanded 501 Mich. 857; 900 N.W.2d 628 (2017).]

         This Court concluded that the trial court properly determined that res judicata did not bar plaintiff's claim for personal protection insurance [PIP] benefits, and that the trial court did not err by denying defendant's motion for summary disposition under MCR 2.116(C)(7). VHS Huron Valley Sinai Hosp, unpub op at 2. With regard to the second element of res judicata, this Court determined that the actions did not involve the same parties or their privies because Hendon and plaintiff were not in privity with one another. Id. at 3-5. This Court reasoned that because Hendon asserted only a claim for uninsured motorist benefits, and plaintiff had no interest or right to those benefits, Hendon and plaintiff "did not share a substantial identity of interest" in those benefits, nor did plaintiff have "a mutual or successive relationship in those benefits." Id. at 4. According to this Court, plaintiff's interest in or right to the recovery of PIP benefits was not represented or protected in the earlier litigation, and Hendon had no motivation in the earlier litigation to protect plaintiff's interest in or right to recover PIP benefits. Id. Thus, this Court affirmed the trial court's decision. Id. at 5.

         On November 9, 2016, this Court denied defendant's motion for reconsideration. VHS Huron Valley Sinai Hosp v Sentinel Ins Co, unpublished order of the Court of Appeals, entered November 9, 2016 (Docket No. 328005). On December 20, 2016, defendant filed an application for leave to appeal to the Michigan Supreme Court. On September 12, 2017, the Michigan Supreme Court vacated this Court's judgment and remanded to this Court for reconsideration in light of Covenant. VHS Huron Valley Sinai Hosp v Sentinel Ins Co, 501 Mich. 857; 900 N.W.2d 628');">900 N.W.2d 628 (2017). On remand to this Court, defendant filed a motion for peremptory reversal, arguing that Covenant compels the dismissal of plaintiff's claims. In its answer to the motion, plaintiff argued that Covenant is inapplicable because defendant waived the issue of standing by entering into the stipulated order and consent judgment, which permitted it to appeal the issue of res judicata only. On October 26, 2017, this Court denied defendant's motion for peremptory reversal "for failure to persuade the Court of the existence of manifest error requiring reversal and warranting peremptory relief without argument or formal submission." VHS Huron Valley Sinai Hosp v Sentinel Ins Co, unpublished order of the Court of Appeals, entered October 26, 2017 (Docket No. 328005). After receiving leave from this Court to do so, defendant filed a supplemental brief, and plaintiff filed a brief in response.

         II. ANALYSIS

         On remand, the pivotal question is whether the Michigan Supreme Court's decision in Covenant impacts this Court's prior decision concluding that summary disposition in favor of defendant was not warranted.

         As an initial matter, in Covenant, the Michigan Supreme Court held "that healthcare providers do not possess a statutory cause of action against no-fault insurers for recovery of personal protection insurance benefits under the no-fault act." Covenant, 500 Mich. at 196. In so ruling, the Covenant Court declined to "follow the long line of cases from the Court of Appeals recognizing that a healthcare provider may sue a no-fault insurer to recover PIP benefits under the no-fault act." Id. at 200. Instead, it relied "on the language of the no-fault act to conclude that a healthcare provider possesses no statutory cause of action against a no-fault insurer for recovery of PIP benefits." Id. at 200.[3]

         Post-Covenant, this Court has recognized that a healthcare provider, "cannot pursue a statutory cause of action for PIP benefits directly from an insurer." W A Foote Mem Hosp v Mich. Assigned Claims Plan, ___Mich App___, ___; ___N.W.2d ___(2017) (Docket No. 333360); slip op at 6. In W A Foote Mem Hosp, ___Mich App at ___; slip op at 6, this Court considered whether Covenant should apply retroactively to cases pending on appeal when it was decided, or apply prospectively only. This Court concluded that it was required to apply the Michigan Supreme Court's decision in Spectrum Health Hosps v Farm Bureau Mut Ins Co of Mich, 492 Mich. 503; 821 N.W.2d 117 (2012), which "essentially adopted the rationale" of the United States Supreme Court's decision in Harper v Virginia Dep't of Taxation, 509 U.S. 86, 97; 113 S.Ct. 2510; 125 L.Ed.2d 74 (1993), holding that judicial decisions concerning statutory interpretation apply retroactively to all cases pending on direct review when the rule is announced. W A Foote Mem Hosp, ___Mich App at ___; slip op at 14-17.

         In W A Foote Mem Hosp, ___Mich App at ___; slip op at 3, 6-7, 19, this Court applied Covenant retroactively where the issue whether the plaintiff possessed a statutory cause of action was preserved and the case was pending on direct review when Covenant was issued. Because the issue whether the plaintiff possessed a statutory cause of action was preserved, this Court stated that it was not necessary to decide whether full or limited retroactivity should apply. Id. at ___; slip op at 7 n 9. As this Court explained, "a judicial decision with full retroactivity would apply to all cases then pending, whereas with limited retroactivity it would apply in pending cases in which the issued [sic] had been raised or preserved." Id. at ___; slip op at 7 n 9 (citation omitted). Finally, this Court concluded that, even if it were to consider the "threshold question" and the "three-factor test" that are often stated in Michigan caselaw, it would not "find a level of exigency that would justify contravening the general rule of full retroactivity." Id. at; slip op at 17-19.

         As in W A Foote Mem Hosp, the question of whether Covenant should be given full or limited retroactive effect is not determinative in this case, given that defendant raised plaintiff's lack of standing as an affirmative defense. Additionally, in its motion for summary disposition, defendant stated that it was "[a]ssuming for purposes of this Motion that Plaintiff has standing at all[.]" Moreover, given that it is a question of law and all of the facts necessary for its resolution are present, the issue of standing is preserved and Covenant applies to this case even if it were given only limited retroactivity. See W A Foote Mem Hosp, ___Mich App at ___; slip op at 7.

         In their briefs following remand, the parties disagree on a key issue relevant to the interplay between Covenant and the facts of this case, that being whether defendant waived the issue of standing[4] by entering into a stipulated order for dismissal and consent judgment in the trial court.

         This Court will review issues pertaining to the interpretation of contractual language de novo, and will interpret contractual terms in accordance with their ordinary meaning when such terms are not expressly defined in the contract. Barton-Spencer v Farm Bureau Life Ins Co of Mich, 500 Mich. 32, 39; 892 N.W.2d 794 (2017). The Michigan Supreme Court has also recently instructed that we are to "construe contracts 'so as to give effect to every word or phrase as far ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.