Oakland County Courts Flooded With Lawsuits

To understand why Oakland County has seen a resurgence of lawsuits, we must look north.

Less than two weeks after Harper's accident, the Michigan Supreme Court made a major decision in a no-fault trial involving Covenant Medical Center of Saginaw and State Farm Mutual Insurance Co.

The Supreme Court's decision limited the right of health care providers to overtake their patients and sue an insurer for non-payment or underpayment of the services of an injured motorist.

The personal injury lawyers said the decision had pushed them to start new lawsuits in Oakland and Macomb counties, rather than Wayne County, which had seen a 30% drop between 2016 and 2018. Oakland County (1,901) between 2016 and 2018 is almost identical to the decline in the number of lawsuits filed in Wayne County (1,926).

Most Wayne County judges interpreted the Covenant's decision strictly and began mass filing lawsuits against medical providers, Anthony said.

However, several judges in Oakland and Macomb counties have taken a different view of the procedures that must be followed by providers to obtain standing, forcing lawyers to deal with more cases in the north of the country. 39, Eigh Mile Road.

The number of lawsuits in Oakland County has skyrocketed from 644 to 1,085 in 2017 and 2,545 in 2018, while the number of Macomb County cases has increased 64% over the past year. this period, according to court records.

"There was a big change at that time," Anthony said after the Covenant's decision.

A Crain 's analysis of the 2,545 self insurance lawsuits initiated in Oakland County last year shows that 56% of them were brought by 25 medical providers including neurosurgeons, orthopedic surgeons, spine and back specialists, pain clinics and rehabilitation clinics.

In Oakland County, the Advanced Surgery Center, based in Dearborn, was the most frequent litigator last year. At least 155 lawsuits were filed against 32 different auto insurance companies (more lawsuits than in the 61 rural counties of Michigan combined last year), court analysis by Crain. recordings shows. Representatives of the Center for Advanced Surgery did not return telephone messages.

Another frequent litigator in Oakland County Courts last year was neurosurgeon Flint Jawad Shah, who has taken 30 lawsuits against 14 different auto insurance companies, according to the archives.

One of the many lawsuits filed by Shah against State Farm involved the insurer's way of incorporating into its plans clauses prohibiting injured motorists from transferring their no-fault benefits to their doctors or providers, which gave them the right to sue. The clauses were added discreetly to no-fault policies while State Farm was fighting up to the Supreme Court with Covenant, according to several plaintiffs' lawyers.

"They tried to get rid of the work of providers completely," said Anthony, whose law firm works for orthopedic surgeons, MRI clinics, physical therapists and anesthesiologists.

Last year, a Michigan Court of Appeals panel ruled that State Farm's "anti-surrender clause" was inapplicable, overturning a Genesee County judge.

But even with the decision of the Court of Appeal, which was appealed to the Supreme Court, plaintiffs' lawyers choose to stay out of Wayne County because of the legal uncertainty created by the following court rulings, said Anthony.

Andrews, who is pleading primarily for attendant care benefits for quadriplegics and motorists with brain damage to the brain, said the Oakland County Court was a prime venue for the complex types of business that took place. He confronts.

"What I've found, at least in Oakland County, is that the judges seem to understand the problems – they give you a shock, a fair enough reading," Andrews said.

But insurance representatives say the commercial patterns of plaintiffs' lawyers have changed.

"The reality may be that these personal injury lawyers are beginning to look for solutions in Wayne County," said Tricia Kinley, executive director of the Insurance Alliance of Michigan, the lobbying branch of the company. industry. "At some point, you start moving to different markets."

Kinley called the peak of lawsuits in Oakland and Macomb counties "shocking, but not surprising."

"It's a really unfortunate accusation about the system that is really getting weaker every day," she said.

Undue Judgment of Benefits Advocates argue that vendor lawsuits are triggered by the business tactics of auto insurers who operate without supervision or regulation by the state.

Mendelson Kornblum Orthopedic & Spine Specialists, an orthopedic surgery center with offices in Livonia and Warren, is suing auto insurance companies after carriers' doctors – known as independent medical examiners or EMIs – say that their patient can not get medical treatment. the clinic's lawyer.

"They are filing numerous lawsuits because there are so many IMEs that are unjustified," said Bruce Pazner, a Grosse Pointe Park lawyer representing the Mendelson Clinic, who has engaged at least 56 lawsuits in the US. Oakland County last year.

Mr. Pazner said the Legislature should strengthen the regulatory oversight of doctors who perform independent medical exams "who give the same opinion again and again" in favor of the insurance company that pays them.

Insurance executives have argued that medical providers, in conjunction with personal injury lawyers, are ordering unnecessary tests and rehabilitation services that inflate the cost of care, as Michigan law did not provide for any lifetime limits. for bodily injury benefits.

"In reality, the more we have litigation, the higher the premiums, because it is only an additional cost to the system," Kinley said.

But all unpaid medical bills do not end up in dispute. Outside Detroit, many small providers, such as chiropractors, will interrupt patient care when auto insurance companies begin to deny requests for continued treatment, Anthony said.

"Insurance companies usually have an unexpected benefit because many providers do not fight them," said Anthony.

Ian Vedder, co-owner of Soteria Home Health LLC, a Grand Blanc-based attendant care agency, said it was not uncommon for insurance companies to send payment checks representing between 50 % and 70% of what he had billed to nurse aides. home care for injured motorists who can not walk, swim or eat.

"Sitting there and saying that providers can charge what they want is a completely false story," Vedder said. "I can charge what I want, but that does not mean that they will pay what I want."

"What are my options, be A, plead it or B, accept it," he added.

In most cases, said Vedder, he eats his losses and is preparing for the next insurance expert to get out the door.

"It's absolutely miserable to try to deal with an adjustment expert," he said.