July 01, 2021
Kara Peters was injured while riding as a passenger in a motor vehicle, and received treatment from Insight Physical Therapy & Neuro Rehab Center (Insight). Peters did not maintain her own no-fault policy, and therefore sought PIP benefits from the insurer of the vehicle’s owner, Auto Club. During discovery, Peters produced a copy of Insight’s bill, which reflected a “patient balance” of $0, and an “insurance balance” of $83,855.20. Auto Club thus sought partial summary disposition regarding Peters’ claim for allowable expense PIP benefits for the $83,855.20 Insight bill. Specifically, Auto Club argued that the bill established that Insight expected payment from Peters’ health insurer, not from Peters personally, and therefore that Peters could not establish that she had any “incurred” charges with Insight as required by MCL 500.3107(1)(a).
The Circuit Court agreed and dismissed Peters’ claim for PIP benefits for the Insight charges. It reasoned that Peters had failed to proffer an affidavit from anyone at Insight, or any other evidence, to establish that Insight expected payment from Peters personally instead of seeking payment solely from Peters’ health insurer.
But the Court of Appeals reversed in the unpublished decision of Peters v Auto Club Ins Ass’n. The Court held that Peters had necessarily “incurred”, or become personally liable to pay, the Insight charges when she accepted treatment. Moreover, the Court held that the fact that Insight’s bill showed a “patient balance” of $0 did not mean that Insight was not expecting payment for its services. Instead, the Court reasoned that “viewed in the light most favorable to [Peters], the billing statement suggests that Insight expected payment for the services billed, albeit from an insurer” and, therefore, that the charges remained “incurred” by Peters.