The Insurance Alliance of Michigan (IAM) held its annual “Insurance & the Law” Seminar for Insurance Claims Professionals on September 24th with nine Zausmer, August & Caldwell attorneys speaking on a variety of insurance topics.
James C. Wright and Michael A. Schwartz’s presentation, “Innocence Lost – The Uncertain Equities of Rescission Under Bazzi,” centered on the Michigan Supreme Court’s recent decision in Bazzi v Sentinel Ins Co, which held that rescission of an insurance policy is an equitable remedy that is left to the discretion of the trial courts. Jim and Michael used examples from currently-pending cases to demonstrate the difficulty in predicting outcomes in cases that involve a rescinded insurance policy.
Cinnamon A. Rice and Elizabeta Rumery offered a presentation entitled “Running the Bahri Bases in Court,” which reviewed the implications of Bahri v IDS Property Casualty, the 2014 Michigan Court of Appeals decision that allows insurers to use fraud exclusions to deny no-fault PIP benefits to insureds who make fraudulent statements. Cinnamon and Liz used a baseball analogy to take the conference attendees “around the bases,” describing various ways to defend a claim using the Bahri defense.
The third duo of ZAC lawyers presenting, Janetta A. Ksar and Kristina M. Macionski, presented “The Shelton Situation: Can Common Law Fraud be Asserted against Third Parties?” Janetta and Kristina explored whether fraud can bar a claim under Michigan common law, regardless of the insurance policy language.
ZAC lawyers Bryan R. Padgett and Danielle R. DePriest presented “Assignments Under Shah: An End to Uncertainty in the Covenant Era?” This program addressed the Michigan Court of Appeals’ recent decision in Jawad A. Shah, M.D., P.C. et al. v State Farm Mut Auto Ins Co, which held that held that a medical provider is entitled to pursue no-fault PIP claims against an insurer based on an assignment of rights from a patient.
The final presentation featured Jeremy M. Mullett, who presented along with a ZAC insurance client on “The CON Job: How to Use Certificates of Need to Avoid Falling Victim to Exorbitant MRI Charges.” Jeremy’s topic focused on medical providers’ Certificates of Need, with a special emphasis on MRI facility charges. Jeremy showed how the providers’ Certificates of Need, which are submitted to the State of Michigan when establishing a medical facility, typically list much lower MRI charges than what is submitted in the context of a no-fault claim.