Your right to sue the insurer directly
In 2017 the Michigan Supreme Court held in Covenant Medical Center v. State Farm that providers had no independent right to sue no-fault insurers. Providers relied on patient assignments instead. The 2019 reform reversed that: MCL 500.3112 now lets a provider make a claim and bring an action directly against the insurer for PIP benefits for treatment it provided.
Where the money is lost
| Problem | What it costs you | What we do |
|---|---|---|
| Bills denied after an insurer medical exam | The full balance from that date forward | File suit with your records and treating opinions |
| Fee-schedule miscalculation | Underpayment on every line | Recompute the amount payable under MCL 500.3157 and the DIFS bulletins |
| Claims aging past one year | The claim itself | Triage your aging report and file before balances expire |
| Priority disputes between insurers | Months of non-payment | Sue every potentially liable insurer and let the court sort priority |
| Patient settles without you | Your balance may be released | Give written notice of your claim and coordinate with patient counsel |
What overdue bills earn
A PIP bill is overdue 30 days after the insurer receives reasonable proof of the charge. From then, MCL 500.3142 adds 12% simple interest a year. If the refusal or delay was unreasonable, the court can award attorney fees under MCL 500.3148. Interest and fees change the economics of small balances that are otherwise not worth chasing.
How an engagement works
- You send an aging report and a sample of denials or explanations of review.
- We sort balances by one-year-back exposure, insurer and denial reason, and tell you what is collectable.
- We send demands and file suits in batches by insurer, which keeps costs down and gets the adjuster’s attention.
- We report status to you by claim and insurer.
Every month you wait, the oldest month of bills expires. The one-year-back rule bars recovery of charges incurred more than a year before suit unless a pending claim paused the clock. How the rule works for providers.
Every provider topic
- The fee scheduleHow MCL 500.3157 caps reimbursement and where insurers get it wrong.
- The one-year-back ruleKeeping aging balances collectable.
- Direct claims and assignmentsMCL 500.3112 claims versus patient assignments.
- Utilization review appealsAppealing overutilization denials to DIFS.
- Rescission suits that name providersWhat to do when an insurer sues you to avoid paying.
- Home care and attendant care agenciesRates, hours and the 2026 bulletin.
- Surgeons and surgery centersHigh-balance claims, IMEs and fee-schedule disputes.
- Interest and attorney fees12% interest and fee shifting on overdue bills.
- Reasonable proof and documentationWhat makes a bill payable and starts the 30-day clock.
- Priority disputes for providersGetting paid when insurers point at each other.
- Provider intake portalSend an aging report for a free claims review.
Questions people ask us
Do we need a patient assignment to sue?
Not for treatment after June 11, 2019, when the Legislature gave providers a direct cause of action in MCL 500.3112. Assignments can still be useful, for example when a claim spans the reform date, and we review your intake paperwork for both.
Does suing the insurer interfere with our patient’s own case?
It can if nobody coordinates. A patient’s settlement or release can affect a provider’s claim. We coordinate with the patient’s attorney so your balance is protected and the patient’s case is not disrupted.
How are your fees charged?
Provider collections are handled on a contingency fee, so we are paid from what we recover. The percentage is set out in a written engagement agreement before we file anything.
An insurer named us as a defendant in a rescission lawsuit. What should we do?
Respond on time and do not assume the case only concerns the patient. Insurers often name providers to avoid paying outstanding bills. Send us the complaint the day it arrives.