Over the course of two (2) days, two separate courts granted two Motions for Summary Disposition on issues related to coordinated PIP policies.

In the first case, a surgery center was seeking payment of $118,625.12 without first submitting its bill to the insured’s health care insurance as required by the policy and case law. At the hearing for the motion, the surgery center argued that the health care carrier later denied payment for the bill but, when the surgery center was unable to explain why payment was denied, the Court granted the motion. This case underscores the importance of a medical provider investigating, when a patient seeks treatment for injuries arising from a motor vehicle accident, whether the patient has elected to coordinate medical benefits on their PIP policy. If the medical provider is uncertain if their patient has a coordinated policy, it is always better to err on the side of caution and bill the health insurance carrier as that is a prerequisite to seeking payment from the PIP carrier on a coordinated policy.

In the second case, a lab sought payment of $10,455 in balance billing for treatment for injuries arising out of a motor vehicle accident. In that case, the lab had properly submitted its bills to the health care insurer and the insurer had issued partial payments to the lab. The lab thereafter sought payment for the balance bills from the PIP carrier. The Court granted our Motion for Summary Disposition as the lab was bound by the payments made by the health care insurer and is not able to balance bill on a coordinated policy.

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Kitch PIP Team Wins Two Motions For Summary Disposition

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