Roughly three people a day suffer catastrophic injuries in car crashes in Michigan.
But many have been unable to get long-term care at home after the state Legislature passed a new no-fault law in 2019.
Laura Haynes is president and CEO of the Michigan Home Care and Hospice Association. She said since the law was passed, insurers have been paying home care companies less than it costs to provide the care.
So they've had to turn many people away.
“You can't take on a case that you're going to lose money on. No other business would be subjected to that,” Haynes said. “And it’s hard when you have to turn them down.”
In the most recent case, the Court of Appeals agreed with a lower court that insurance companies have been using the wrong section of the no-fault law to justify the low reimbursements. The ruling said providers should be able to bill under a different section of the law that provides for higher reimbursements.
“[The Court of Appeals] is a published case, so it is binding law in the state of Michigan,” said Steve Hulst. He represented West Michigan Home Care Services (doing business as First Light Home Care) in a lawsuit against Meemic Insurance Company. “That has to be followed, it should protect all home care providers in the state.”
What has not yet been decided is what the actual rate of reimbursement for home care should be. That will be decided in later trial verdicts.
“We just need reasonable reimbursement. That’s all the providers wanted. That’s all these accident victims need so they can get the care they deserve,” Hulst said.
No-fault attorney Wayne Miller said he is now “cautiously optimistic,” that the legal tide has turned.
“I have had to advise my own home care clients that until this point, if you want to have some kind of certainty of getting paid enough to cover your expenses, I can’t guarantee that. Now with these [recent] cases, it’s changed my thinking a little bit. I’m now telling them, this makes it a good enough risk that you might want to begin accepting these cases once again.”
Meemic Insurance Company has not yet said if it will appeal the Court of Appeals ruling to the Michigan Supreme Court.
Erin McDonough is executive director of the Insurance Alliance of Michigan, which represents car insurance companies. In a statement, she said “We are reviewing the full impact of the cases.”
She added, “It is clear that bipartisan reforms passed in 2019 have helped consumers and small businesses across Michigan by reducing fraud, lowering costs, and increasing choices and competition in the market.”
