The one-year-back rule, for providers

The rule

MCL 500.3145 bars recovery of PIP benefits for any part of a loss incurred more than one year before the date the lawsuit is filed. The rule applies to providers just as it applies to patients.

Tolling after the 2019 reform

The amended statute pauses the one-year period from the date a specific claim for payment is made to the insurer until the insurer formally denies that claim. Two practical consequences follow:

• A bill that was submitted properly and never formally denied may be more collectable than its date suggests.
• A formal denial starts the clock running again from where it paused, so denials need to be tracked by date, not filed away. Tolling also requires the claim to be pursued with reasonable diligence.

Assignments and the clock

A provider that sues on a patient assignment generally takes only the rights the patient had on the date of the assignment, and an assignment covers benefits that were already incurred, not future treatment. For treatment after June 11, 2019, the provider’s direct claim under MCL 500.3112 is usually the cleaner route, but the timing rules still apply to it.

Keeping balances collectable

1. Submit every bill with the records the insurer needs to treat it as reasonable proof.
2. Log every formal denial with its date.
3. Review your no-fault aging monthly, by date of service, not date of billing.
4. File suit before the oldest open dates of service reach twelve months, net of any tolling.