A potential “trap” that medical care providers and injured people (and their families) should be aware of is the “lawfully rendered treatment” language of MCL 500.3157, which has been effectively developed as an additional limitation on no-fault benefits by no-fault insurers in appellate litigation. No-fault insurers have successfully challenged in litigation the technical adequacy of care providers’ legal licensing status and have avoided payment of no-fault benefits, where they have successfully argued that certain elements of care were not within the scope of the license held by the care provider (or where the care provider did not have an appropriate license in place at the time the care was provided). In a recent case, the court of appeals decided a group home providing attendant care to a pedestrian who suffered a traumatic brain injury was not entitled to recover any of the over $200,000 in attendant care it was awarded in a jury verdict, because it was not properly licensed as an adult foster care home, and the court found that the care provided was within the scope of an adult foster care home licensing requirements. This line of cases means that injured people, their families, and their medical care providers will need to look carefully at the adequacy of the technical licensing held by their care providers, which may be very difficult or impossible for laypeople and family members, especially given the extraordinary complexity of technical licensing in the modern regulatory state. The decision is Riverview Macomb Home and Attendant Care LLC v State Farm Mutual Automobile Ins Co and Group One Home Inc, unpublished Michigan Court of Appeals case 327030, decided October 20, 2016.
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