Background
Joseph Canty alleged that he was injured in a February 2021 automobile crash caused by Michael Chester Mason. Although Canty carried no-fault insurance, he had opted out of personal protection insurance coverage because he had qualified health coverage through Medicare Parts A and B. He therefore sued Mason in tort under MCL 500.3135(3)(c) to recover medical expenses.
Mason sought partial summary disposition, asserting that Canty and his medical providers had not sought Medicare payment and that Canty instead claimed the providers’ full billed charges. Mason argued that Canty failed to mitigate his damages and that his recovery was limited by the reimbursement provisions in MCL 500.3157. The trial court rejected both arguments, but a divided Court of Appeals held that the mitigation doctrine and the statutory reimbursement limitations applied.
The Court’s Holding
The Michigan Supreme Court affirmed in part and reversed in part. It held that the common-law duty to mitigate damages applies to tort claims under MCL 500.3135(3)(c). Canty was therefore required to make reasonable efforts to obtain Medicare coverage for treatment received from Medicare-participating providers. Mason bears the burden of proving failure to mitigate as an affirmative defense, and the reasonableness of Canty’s efforts is for the fact-finder.
The Court separately held that MCL 500.3157’s reimbursement limitations do not govern Canty’s tort claim. MCL 500.3135(3)(c) incorporates the definitions in MCL 500.3107 through MCL 500.3110, not the reimbursement caps in MCL 500.3157. The latter provision applies to treatment covered by PIP insurance, while Canty sought tort damages after opting out of PIP coverage. The Court remanded the case to the trial court for further proceedings.
Key Takeaways
- A Medicare-covered plaintiff pursuing automobile-related tort damages under MCL 500.3135(3)(c) must reasonably seek Medicare payment for treatment from Medicare-participating providers.
- The defendant bears the burden of proving that the plaintiff failed to make reasonable mitigation efforts.
- MCL 500.3157’s PIP reimbursement limitations do not cap medical-expense damages in a tort action under MCL 500.3135(3)(c), although claimed allowable expenses must still be reasonable and reasonably necessary.
Why It Matters
The decision separates two limits on medical-expense recovery after a Medicare beneficiary opts out of PIP coverage. Ordinary mitigation principles remain applicable, but the no-fault act’s PIP reimbursement caps do not automatically control the tort recovery.
Justice Elizabeth M. Welch separately cautioned that this statutory result may permit different reimbursement treatment for tort damages and PIP benefits, particularly for services Medicare does not cover, and invited the Legislature to reconsider the statute. That policy concern was expressed in her concurrence, not adopted as part of the majority’s holding.