Court Opinion

ID: 9378345
Source: CourtListenerOpinion
Date Created: 2023-03-10 06:05:15.487404+00
Date Added: 2024-06-11T17:17:20.497029
License: Public Domain

If this opinion indicates that it is “FOR PUBLICATION,” it is subject to
                 revision until final publication in the Michigan Appeals Reports.

                          STATE OF MICHIGAN

                            COURT OF APPEALS

PROGRESSIVE MICHIGAN INSURANCE                                       UNPUBLISHED
COMPANY,                                                             March 9, 2023

               Plaintiff/Counterdefendant-Appellee,

v                                                                    No. 359555
                                                                     Oakland Circuit Court
CENTRIA HOME REHABILITATION, LLC,                                    LC No. 2019-177415-NF

               Defendant/Counterplaintiff-Appellant.

Before: K. F. KELLY, P.J., and MURRAY and SWARTZLE, JJ.

PER CURIAM.

        Defendant/counterplaintiff, Centria Home Rehabilitation, LLC, appeals by leave granted1
the trial court’s order granting summary disposition in favor of plaintiff/counterdefendant,
Progressive Michigan Insurance Company. Because the trial court erred when it granted summary
disposition in plaintiff’s favor, we reverse and remand for further proceedings consistent with this
opinion.

                      I. BASIC FACTS AND PROCEDURAL HISTORY

        On December 31, 2016, Samantha Calhoun was injured in a motor vehicle accident. She
was covered by a policy of no-fault insurance issued by plaintiff and received in-home attendant
care services from defendant, which were performed by Samantha’s mother, her brother, and other
home health aides. Between February 7, 2017, and June 30, 2021, plaintiff paid defendant a total
of $582,722.40 for attendant care services, which was $233,462.53 less than what defendant had
billed for its services.

      On June 21, 2019, plaintiff filed a complaint alleging that it had mistakenly issued two
payments to defendant and had overpaid defendant in the amount of $8,375. Defendant answered

1
 Progressive Mich Ins Co v Centria Home Rehab, LLC, unpublished order of the Court of Appeals,
entered April 13, 2022 (Docket No. 359555).

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and asserted a counterclaim against plaintiff, alleging that plaintiff failed to pay to it all of the
personal protection insurance (PIP) benefits required under the no-fault act. Plaintiff subsequently
moved for summary disposition regarding defendant’s counterclaim, arguing that defendant had
no right under the no-fault act to seek payment of the balance due, i.e., the difference between
what defendant billed and what plaintiff paid. The trial court agreed and entered an order granting
the motion for summary disposition on defendant’s counterclaim “for the reasons set forth by
Plaintiff/Counter-Defendant.” This appealed followed.

                                          II. ANALYSIS

        On appeal, defendant contends that the trial court erred when it granted summary
disposition in plaintiff’s favor because the outcome of this case is controlled by Mich Institute of
Pain & Headache, PC v State Farm Mutual Auto Ins Co, unpublished per curiam opinion of the
Court of Appeals, issued June 24, 2021 (Docket No. 353033). In that case, we concluded that the
plaintiff health care provider could maintain a cause of action to seek recovery of the billed
difference, distinguishing McGill v Auto Ass’n of Mich, 207 Mich App 402; 526 NW2d 12 (1994),
and LaMothe v Auto Club Ins Ass’n, 214 Mich App 577; 543 NW2d 42 (1995). Mich Institute of
Pain, unpub op at 3-4. For its part, plaintiff argues that this Court is bound by McGill and
LaMothe, both cases in which this Court stated that the proper method for challenging the
reasonableness of an insurer’s payments to a health care provider is through a lawsuit brought by
the provider against the insured.

        For the reasons stated in Centria Home Rehab, LLC v Philadelphia Indemnity Ins Co, ___
Mich App ___; ___ NW2d ___ (2023) (Docket No. 359371), a case that presents the same legal
question presented in this case, we reverse the trial court’s order granting summary disposition in
plaintiff’s favor. As we stated there: “When a health care provider, acting under an assignment of
rights from an insured or under a direct cause of action under MCL 500.3112, seeks to recover the
balance due for PIP benefits from an insurer and there is a dispute over the reasonableness of the
charges, the health care provider has standing to bring such a claim directly against the insurer.”
Centria, ___ Mich App ___, ___; ___ NW2d ___ (2013) (Docket No. 359371), slip op at 10.
Accordingly, the trial court erred when it granted plaintiff’s motion for summary disposition.

        Reversed and remanded for further proceedings consistent with this opinion. We do not
retain jurisdiction. Defendant, as the prevailing party, may tax costs. MCR 7.219(A).

                                                              /s/ Kirsten Frank Kelly
                                                              /s/ Christopher M. Murray
                                                              /s/ Brock A. Swartzle

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