In a state full of laws which are designed to protect the insurance companies, not the citizens, there has recently been a light at the end of the tunnel. In the case of Leuker v Auto Owners, an unpublished opinion, the Court of Appeals made a very pro-plaintiff decision:
The Court unequivocally stated that “an insurance medical examination cannot serve to retroactively render reasonable those delays that took place more than 30 days before the report was received.”
Why is this important? It is important because this case can be used as a sword. This case holds that even though an insurance company can rely on these “independent medical examinations” at trial, the “IME” cannot be used to defend a motion for attorney fees for any benefit incurred more than 30 days prior to the time of the IME. When adjusters admit that they have no medical training,
simultaneously, they admit to no reasonable defense to treating doctors conclusions that an individual was injured before the termination when arguing against attorney’s fees, something which can save the client tens of thousands of dollars.
Leuker is instrumental in preparing for trial. It must be used at case evaluations, facilitations and in motions. It must be used to collect No-Fault Benefits.
By way of a few examples, I have used this case as the main basis of my argument before a case evaluation panel which awarded every dime of what was outstanding, plus all of the interest and some attorney fees. It did not matter that some benefits were post-termination because the insurance company had no defense to the pre-termination bills and one overdue bill subjects the insurance company to interest and attorney fees.
I have used this case at a deposition where the adjuster admitted that she did not know Leuker, valid Michigan Law, something to be highlighted before a jury.
Lastly, I have used this in motions for summary dispositions. Even in motions for summary dispositions which have been denied, it has helped. For instance, I filed a motion for summary disposition on pre-
termination benefits and cited this case why interest and attorney fees were owed. The judge felt that a genuine issue of material fact remained but stated on the record, if we went to trial and I was successful, the defense would not be able to defend against attorney fees for over 90 percent of the bills. Needless to say, that is a huge advantage to my client!
Unfortunately, the law is not on the side of the citizens. It is on the side of the insurance companies.
However, by using the good law as a sword, I have been able to aggressively get my clients benefits which they would not have otherwise seen. These types of actions make for better settlements and stronger cases.
Joshua R. Terebelo works in the law firm’s litigation division, where he focuses on No-Fault insurance lawsuits and helps auto accident victims receive their first-party personal injury protection (PIP) benefits.