Court Dismisses Plaintiff’s Medical Expense PIP Claim Based on Tousignant

Katrina A. Murrel recently prevailed on a motion for partial summary disposition in this case for payment of PIP benefits, pursuant to Tousignant v Allstate Ins Co, 444 Mich 301, 303; 506 NW2d 844 (1993).  In this case, Plaintiff sought payment of over $60,000.00 in medical expenses from Progressive.  The Court granted a dispositive motion in Progressive’s favor, finding that there was no genuine issue of material fact that plaintiff failed to comply with the terms of the coordinated automobile insurance policy.  The court found that Plaintiff violated the terms of her health insurance policy with Health Alliance Plan by failing to submit some bills to HAP, seeking treatment outside of her network and failing to seek pre-authorizations when necessitated by the terms of her HAP policy.  Therefore, Plaintiff is precluded from seeking payment from Progressive for dates of service of bills that would have been covered by her health insurer, HAP.