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Appellate court sides with crash survivors, but groups urge caution

Some auto insurance companies could be using a tactic called "price optimization" to charge loyal customers a higher premium.
iStockphoto
Some auto insurance companies could be using a tactic called "price optimization" to charge loyal customers a higher premium.

Some severely injured car crash survivors are cautiously celebrating a decision from the Michigan Court of Appeals.

Many survivors say 2019 changes to the state’s auto no-fault law cost them medical care because of cuts to providers’ reimbursement rates. The changes also limited the maximum number of billable hours of care that family members and friends could submit for reimbursement.

Now, a split appellate court says making the new law apply to those hurt before the law took effect last year would violate the state constitution.

Attorney Mark Granzotto argued the case for clients who lost their care retroactively under the law. He said the decision means insurance companies will have to make good on policies they issued before the law changed.

“For those people who are catastrophically injured, who require long-term medical care, as my clients do, their benefits under the No-Fault Act, going forward, will be exactly the same as they have had, in one of our client’s cases, for years and years,” Granzotto said.

Various lawmakers have issued statements celebrating the decision since it came out Thursday morning.

But the state is urging caution before everything in the legal fight is completely said and done.

Anita Fox is the director of the state Department of Insurance and Financial Services. She said the debate over the 2019 changes deal is more about the cost of treatment than access to it.

Fox maintains survivors shouldn’t have lost access to care to begin with.

“For right now, the opinion itself doesn’t have an impact on anybody’s care. We’ll have to see what happens later. And, in any event, nothing should change about what an accident victim’s entitled to,” Fox said.

Erin McDonough leads the industry group Insurance Alliance of Michigan. She said the law saves people money on car insurance, and the decision could threaten that.

“The medical fee schedule established by these bipartisan auto no-fault reforms is absolutely critical because it reins in overcharging by medical providers and brings fairness, common sense and transparency to the costs of medical care,” she said.

McDonough is pledging an appeal to the state Supreme Court.

On the patient and provider side, the legal uncertainty is leading to warnings about premature celebration.

The Facebook group We Can’t Wait has spent months pressing lawmakers to fix problems with the 2019 law -- Public Act 21, or PA21 -- that it claims have driven several providers out of business and cost lives.

“[W]e are hesitant to uncork the champaign until we learn more from our legal counsel. We believe this is a positive first step in fixing PA21 but are worried it won’t happen automatically,” a statement from the group read after the appellate court’s decision.