Detroit, Michigan – Attorneys who handle No-Fault Insurance Cases – Health Care Providers' Rights

On February 15, 2002, the Michigan Court of Appeals gave some powerful legal weapons to medical providers who are not promptly paid by Michigan auto No-Fault insurance companies.  The decision is a great victory for providers and their auto accident patients, and has already helped to level the playing field in No-Fault insurance payment disputes. 

Sections 3142 and 3148

In a unanimous ruling by the Michigan Court of Appeals in 2002, medical providers were granted authority to enforce the No-Fault act against No-Fault insurance companies who do not honor their payment obligations under the statute.

The February 2002 ruling states that insurers may be held liable under Section 3142 of the statute for 12-percent interest if the payment is not made within 30 days of the insurer’s receipt of “reasonable proof of the fact and of the amount of loss sustained.”  Section 3148 of the statute renders an insurer liable for attorney fees if the insurer has “unreasonably refused to pay the claim or unreasonably delayed in making proper payment.”  Before the 2002 ruling, only auto accident patients held the right to bring a suit against a No-Fault insurance company if it did not pay claims in full and in a timely manner. 

Health Care Providers’ Rights

Medical providers who treat auto accident patients have a right to commence legal enforcement action against No-Fault insurance companies to recover payment for medical services rendered to patients insured by those companies.  If a medical provider can demonstrate that payment was overdue, the medical provider can recover 12-percent interest on the balance owing.  Likewise, if the medical provider can establish that the payment was “unreasonably refused or unreasonably delayed,” the medical provider can recover actual attorney fees from the recalcitrant insurer.

Goals of the Michigan No-Fault Insurance Act

The goal behind Sections 3142 and 3148 of the No-Fault insurance act is to give enforcement powers to medical providers, which further the purposes and goals of the No-Fault act to avoid medical payment delays.  Furthermore, such a ruling shifts the loss from providers to insurance companies, and, in the process, protects No-Fault patients.  In this regard, the court stated:

“. . . The goal of the No-Fault system was to provide victims of motor vehicle accidents assured, adequate, and prompt reparation for certain economic losses…  the No-Fault act may not be used by a No-Fault insurer as a vehicle to shift the burden of the injured person's economic loss to a health care provider…the impermissible payment behavior of an insurer has an economic impact on the injured person, both directly and indirectly, usually in the form of damaged credit ratings, difficulties in securing health care services, harassment, and lawsuits initiated by health care providers for reimbursement.  Permitting the imposition of these penalty provisions by health care providers provides a legitimate and enforceable incentive to No-Fault insurers to perform their payment obligations, imposed by operation of law, in a reasonable and prompt manner.”

The decisions of the Michigan Court of Appeals empower medical providers to fight back when Michigan No-Fault insurance companies improperly withhold payment for medical services rendered to auto accident victims. 

Statute of Limitations

It is important to keep in mind that the No-Fault statute contains a short statute of limitations which, in the case of claims brought by patients, typically will expire one year after the date an expense is incurred.  It is not clear whether this one year statute of limitations will apply to enforcement claims brought by medical providers.  However, until the Court of Appeals rules to the contrary, providers should assume that the limitation period is short and, therefore, enforcement action should not be delayed. Our Detroit, Michigan-area No-Fault insurance attorneys can help you bring legal action against an insurance company that delays payment of a claim. 

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Contact Our Michigan No-Fault Insurance Attorneys

If you or someone you love has been injured in an auto accident, or you are a health care provider and need to collect compensation for treating an accident victim, our Detroit, Michigan-area No-Fault insurance attorneys can help you.  Our skilled litigators have over 50 years of experience and are familiar with the process of pursuing payment from No-Fault insurance companies that refuse to pay benefits in a timely manner.  To discuss your specific case, don’t hesitate to contact the Sinas Dramis Law Firm today.