October 23, 2026
Michigan Courts are currently busy trying to work out the kinks that are quickly developing with limited PIP policies under the No-Fault Amendments. Most recently, the Court of Appeals was asked to determine when a claimant’s limited benefits were considered to be exhausted and whether the insurer’s liability had been discharged under MCL 500.3112. The Court’s unpublished opinion in Central Home Health Care Services v CURE reiterates the guidance put forth in Phase One Rehab, LLC v Allstate Prop & Cas Ins Co, ____ Mich App ____; ____ NW2d _____ (2025).
Daniel Wilson was injured in a motor vehicle accident in 2022. He maintained PIP coverage with $250,000 limits through Defendant Citizens United Reciprocal Exchange (“CURE”). Following the collision, Wilson underwent various medical treatment and incurred expenses for attendant care and replacement services. All told, the outstanding claims exceeded the available coverage and Wilson, CURE, and several of Wilson’s medical providers facilitated the claims in an effort to resolve them. The facilitation was not successful but the parties continued working to come up with an agreement as to how to distribute the remaining proceeds amongst them. During these negotiations, other additional providers surfaced and were brought into the discussions with the exception of one. A month after the facilitation, Plaintiff Central Home Health Care submitted its claims to CURE and received explanations of benefits denying the claims for various reasons, none of which included the exhaustion of benefits. While the negotiations continued with Wilson and the other providers, Central Home was never involved and ultimately, the parties reached a resolution that excluded Central Home from the disbursement.
Relying heavily upon its previously-published decision in Phase One Rehab, the Court reiterated that when an insurer asserts that it issued a good faith payment and is discharged from liability under MCL 500.3112, it is the insurer’s burden to produce sufficient evidence supporting that assertion. CURE’s evidence showed that the parties facilitated the matter prior to having received Plaintiff’s claim and that it ultimately paid out a total of $250,000 in benefits on Wilson’s behalf. However, these proofs also showed that there was no resolution at the facilitation, that negotiations were in process when Central Home’s claim was received, and that the remaining benefits were paid out after it had received written notice of that claim. CURE argued that as of the date of the facilitation, the remaining proceeds had been offered to those participating providers and that benefits were exhausted at that time—seeming to infer that even though they hadn’t been paid out, the money was already otherwise accounted for. The Court was not swayed by this argument and took note of the fact that additional providers who were unknown at the time of the facilitation but later asserted claims while the negotiations were continued were included in the ultimate distribution.
The Court determined that benefits had not been exhausted at the time Central’s claim was received because no settlement agreements had been entered into and negotiations were ongoing. Any payments issued after the receipt of the claim, did not constitute a “good faith” payment discharging the insurer’s liability to Central Home because CURE had written notice of Central Home’s claim.