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September 14, 2015

COA: Medical bill and records do not constitute notice that would toll the statute of limitations on action to recover personal protection insurance benefits

In Perkovic v. Zurich American Insurance Company, No. 321531, the Court of Appeals concluded that a medical bill and records mailed by a medical provider to an insurance company did not provide sufficient notice under MCL 500.3145(1), the statute of limitations for personal injury protection benefits, because they did not indicate the insured’s intent to file a claim.  As such, the insured’s action to recover personal protection insurance benefits filed more than one year after the accidental injury was barred by the statute of limitations.
 
Plaintiff was the driver and owner of a semi-truck, which he leased to E.L. Hollingsworth and Company (“Hollingsworth”). Hollingsworth had an automobile insurance policy with defendant that covered the equipment and vehicles it leased.  On February 28, 2009, plaintiff swerved to avoid another vehicle and drove his truck into a wall. Plaintiff subsequently received emergency medical treatment at The Nebraska Medical Center.  On April 30, 2009, The Nebraska Medical Center mailed to defendant a medical bill for services performed on plaintiff and plaintiff’s medical records.  On May 19, 2009, defendant sent notice to The Nebraska Medical Center that it was denying payment for the services rendered to plaintiff because it had “[n]o injury report on file for this person.”  It was not until March 25, 2010, more than a year after the accident, that plaintiff added defendant in his Second Amended Complaint.  Although defendant was ultimately deemed the highest priority insurer, it argued “that the medical records sent to it” were “insufficient notice because nothing from the medical records indicated that plaintiff intends to make a claim for personal protection insurance benefits.”  The trial court agreed and dismissed plaintiff’s claim because it was barred by the statute of limitations set forth in MCL 500.3145.  Plaintiff appealed.
 
The Court of Appeals affirmed.  MCL 500.3145(1) provide, in part, as follows:

An action for recovery of personal protection insurance benefits payable . . . for accidental bodily injury may not be commenced later than 1 year after the date of the accident causing the injury unless written notice of injury as provided herein has been given to the insurer within 1 year after the accident. . . . The notice of injury . . . may be given to the insurer or any of its authorized agents by a person claiming to be entitled to benefits therefor, or by someone in his behalf.

According to the Court of Appeals, the notice must clearly inform the insurance provider of the insured’s intent to file a claim.  Here, the medical bill and medical records were sent to defendant without any indication of a possible claim. Instead, the bill and records were sent for the purpose of obtaining payment. This notice of injury, which was unrelated to a possible claim for no-fault benefits, did not trigger defendant’s investigative procedures or advise defendant of the need to appropriate funds for settlement.  Although sufficient in content, the medical bill and medical records did not fulfill the purposes of the statute.  Accordingly, plaintiff did not provide sufficient notice to toll the statute of limitations under MCL 500.3145(1), and the trial court properly granted summary disposition in favor of defendant.

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