Vhs Huron Valley Sinai Hospital v. Sentinel Insurance Company
Vhs Huron Valley Sinai Hospital v. Sentinel Insurance Company
Opinion of the Court
This case is again before us following remand from the Michigan Supreme Court.
I. FACTS AND PROCEDURAL HISTORY
In our earlier opinion we recited the relevant facts, in pertinent part, as follows:
On June 25, 2013, Charles Hendon, Jr. was involved in a motor vehicle accident when his vehicle was allegedly rear-ended by an unidentified hit and run driver, causing bodily injury. Defendant Sentinel Insurance Company is Hendon's insurer. From August 1, 2013, through October 7, 2013, plaintiff VHS Huron Valley-Sinai Hospital, doing business as DMC Surgery Hospital, provided medical services to Hendon for his care, recovery, and rehabilitation related to his injuries sustained in the automobile accident, at a cost totaling $68,569.
On September 9, 2013, Hendon commenced a cause of action against Sentinel asserting a claim for uninsured motorist benefits under his insurance policy and alleging negligence on the part of the unidentified hit and run driver involved in the accident. Hendon did not assert a claim for no-fault [personal protection insurance (PIP) ] benefits as part of his lawsuit. Thereafter, on July 15, 2014, DMC, plaintiff in the instant case, commenced a cause of action against Sentinel asserting a claim for no-fault PIP benefits for the medical services DMC provided to Hendon for injuries arising out of the accident. On October 21, 2014, Hendon and Sentinel settled Hendon's lawsuit seeking uninsured motorist benefits for $1,500 and, on October 29, 2014, that suit was dismissed, with prejudice, per stipulation of the parties.
After settling Hendon's case, Sentinel sought summary disposition of DMC's action for PIP benefits under MCR 2.116(C)(7), asserting that it was barred by res judicata. The trial court denied Sentinel's motion, concluding that res judicata did not bar DMC's claim because it could not have been resolved in Hendon's earlier action for uninsured motorist benefits given the dissimilarity in the two claims. The court then entered a stipulated order for dismissal and consent agreement, which closed the case but allowed Sentinel to appeal as of right the court's denial of its motion for summary disposition. Sentinel appeals. [
VHS Huron Valley Sinai Hosp. v. Sentinel Ins. Co ., unpublished per curiam opinion of the Court of Appeals, issued October 13, 2016 (Docket No. 328005), pp. 1-2,2016 WL 6038312 , vacated and remanded501 Mich. 857 ,900 N.W.2d 628 (2017).]
This Court concluded that the trial court properly determined that res judicata did not bar plaintiff's claim for PIP benefits and that the trial court did not err by denying defendant's motion for summary disposition under MCR 2.116(C)(7). VHS Huron Valley Sinai Hosp ., unpub. op. at 2. With regard to the second element of res judicata, this Court determined that the actions did not involve the same parties or their privies because Hendon and plaintiff were not in privity with one another. Id . at 3-4. This Court reasoned that because Hendon asserted only a claim for uninsured motorist benefits and plaintiff had no interest or right to those benefits, Hendon and plaintiff "did not share a substantial identity of interest" in those benefits, nor did plaintiff have "a mutual or successive relationship in those benefits." Id . at 4. According to this Court, plaintiff's interest in or right to the recovery of PIP benefits was not represented or protected in the earlier litigation, and Hendon had no motivation in the earlier litigation to protect plaintiff's interest in or right to recover PIP benefits. Id . Therefore, this Court affirmed the trial court's decision. Id . at 5.
On November 9, 2016, this Court denied defendant's motion for reconsideration.
VHS Huron Valley Sinai Hosp. v. Sentinel Ins. Co
., unpublished order of the Court of Appeals, entered November 9, 2016 (Docket No. 328005). On December 20, 2016, defendant filed an application for leave to appeal in the Michigan Supreme Court. On September 12, 2017, the Michigan Supreme Court vacated this Court's judgment and remanded to this Court for reconsideration in light of
Covenant
.
VHS Huron Valley Sinai Hosp.
,
II. ANALYSIS
On remand, the pivotal question is whether the Michigan Supreme Court's decision in Covenant affects this Court's prior decision concluding that summary disposition in favor of defendant was not warranted.
As an initial matter, in
Covenant
, the Michigan Supreme Court held "that healthcare providers do not possess a statutory cause of action against no-fault insurers for recovery of personal protection insurance benefits under the no-fault act."
Covenant
,
Post-
Covenant
, this Court has recognized that a healthcare provider "cannot pursue a statutory cause of action for PIP benefits directly from an insurer."
W. A. Foote Mem. Hosp. v. Mich. Assigned Claims Plan
,
In
W. A. Foote Mem. Hosp
.,
As in
W. A. Foote Mem. Hosp.
, the question of whether
Covenant
should be given full or limited retroactive effect is not determinative in this case, given that defendant raised plaintiff's lack of standing as an affirmative defense. Additionally, in its motion for summary disposition, defendant stated that it was "[a]ssuming for purposes of this Motion that Plaintiff has standing at all[.]" Moreover, given that it is a question of law and all the facts necessary for its resolution are present, the issue of standing is preserved and
Covenant
would apply to this case even if it were given only limited retroactivity. See
In their briefs following remand, the parties disagree on a key issue relevant to the interplay between
Covenant
and the facts of this case, that being whether defendant waived the issue of standing
This Court reviews de novo issues pertaining to the interpretation of contractual language and interprets contractual terms in accordance with their ordinary meaning when the terms are not expressly defined in the contract.
Barton-Spencer v. Farm Bureau Life Ins. Co. of Mich.
,
This Court's main goal in the interpretation of contracts is to honor the intent of the parties. The words used in the contract are the best evidence [of] the parties' intent. When contract language is clear, unambiguous, and has a definite meaning, courts do not have the ability to write a different contract for the parties, or to consider extrinsic testimony to determine the parties' intent. [ Auto-Owners Ins. Co. v. Campbell-Durocher Group Painting & Gen. Contracting, LLC ,322 Mich.App. 218 , 225,911 N.W.2d 493 (2017),2017 WL 4557612 , quoting Kyocera Corp. v Hemlock Semiconductor, LLC ,313 Mich.App. 437 , 446,886 N.W.2d 445 (2015) (quotation marks omitted).]
"A stipulation is an agreement, admission, or concession made by the parties in a legal action with regard to a matter related to the case."
In re Koch Estate
,
With regard to the issue of waiver, in
Nexteer Auto. Corp. v. Mando America Corp.
,
A waiver is an intentional relinquishment or abandonment of a known right. An affirmative expression of assent constitutes a waiver. In contrast, a failure to timely assert a right constitutes a forfeiture.
A stipulation is an agreement, admission or concession made by the parties in a legal action with regard to a matter related to the case. To waive a right, the language of a stipulation must show an intent to plainly relinquish that right . However, the use of specific key words is not required to waive a right. [Quotation marks and citations omitted; emphasis added.]
Returning to the facts of the present case, the stipulated order for dismissal and consent judgment provides, in pertinent part:
WHEREFORE, upon hearing and argument of April 24, 2015, this Court entered an Order dated May 21, 2015 denying the Motion for Summary Disposition brought by Sentinel Insurance Company ("Sentinel").
WHEREFORE, Sentinel argued that it was entitled to summary disposition on the grounds that this provider suit is barred by res judicata, the injured party (Charles Hendon) having filed his own suit against Sentinel, based upon the same accident that gave rise to this suit, which was dismissed with prejudice pursuant to a release.
WHEREFORE, Sentinel wishes to enter a final Order in this cause for the purpose of filing an appeal as of right from the court's May 21, 2015 decision, which denied Sentinel's Motion for Summary Disposition.
WHEREFORE, Sentinel and Plaintiff VHS Huron-Valley Sinai Hospital, d/b/a DMC Surgery Hospital ("DMC") have agreed to the amount that DMC would be entitled to, if Sentinel's position regarding res judcata /release [sic] is ultimately rejected by the Michigan Court of Appeals or Supreme Court.
WHEREFORE, the parties hereby agree to the entry of a judgment (subject to Sentinel's right to appeal as set forth above) against Sentinel and in favor of DMC in the amount of $61,712.18, plus taxable costs [and interest calculated under MCL 600.6013 of the Revised Judicature Act (RJA) ] consistent with Bonkowski v. Allstate [ Ins. Co. ],281 Mich.App. 154 [761 N.W.2d 784 ] (2008).
WHEREFORE, the parties further agree that, if Sentinel's position regarding res judcata /release [sic] is ultimately rejected by the Michigan Court of Appeals or Supreme Court, DMC will also be entitled to an award of interest pursuant to MCL 500.3142, to be calculated at the time the aforementioned judgment is paid to DMC based upon the following dates:
* * *
WHEREFORE, based upon the foregoing, IT IS HEREBY ORDERED that judgment is entered in favor of DMC and against Sentinel in the amount of $61,712.18, plus taxable costs and RJA interest consistent with Bonkowski v. Allstate ,281 Mich.App. 154 ,761 N.W.2d 784 (2008), plus interest pursuant to MCL 500.3142 to be calculated as indicated above at the time said judgment is satisfied.
IT IS FURTHER ORDERED that, notwithstanding anything set [forth] above, Sentinel hereby reserves its appellate rights with respect to the May 21, 2015 denial of its Motion for Summary Disposition, as it is Sentinel's intention to use this order as a final order allowing it to appeal by right from that decision.
IT IS FURTHER ORDERED that the aforementioned judgment amount shall not be recoverable until Sentinel has exhausted its appellate remedies, relative to the denial of its Motion for Summary Disposition.
IT IS FURTHER ORDERED that if, for any reason, Sentinel chooses not to further pursue its appellate remedies, this judgment shall remain in effect and shall be recoverable upon expiration of any applicable appeal period(s) relative to the denial of Sentinel's Motion for Summary Disposition.
IT IS FURTHER ORDERED that if, for any reason, an appellate court determines that this Consent Judgment is not a final order that is appealable by right, this agreement is null and void.
IT IS FURTHER ORDERED that the above-entitled cause of action be, and hereby is, dismissed with prejudice and without costs to any of the parties hereto, pursuant to the terms herein.
This is a final order that resolves the last pending claim and closes the case at the trial court level.
The Michigan Supreme Court has made it abundantly clear, following a comprehensive review of the no-fault act, MCL 500.3101
et seq
., that healthcare providers do not have standing to pursue a claim against a no-fault insurer for PIP benefits for the allowable expenses incurred by an insured.
Covenant
, 500 Mich. at 195,
While we properly base our conclusion on the plain language of the stipulated order for dismissal and consent judgment, our determination is supported by a review of the record and the procedural posture of this case as a whole. For example, as a matter of background, given the state of the law before
Covenant
was decided, defendant may have reasonably surmised that any challenges to plaintiff's standing would have been rejected by the trial court and the appellate courts. See
W. A. Foote Mem. Hosp.
,
III. CONCLUSION
Accordingly, in light of the Michigan Supreme Court's pronouncement in
Covenant
, plaintiff does not have a cause
of action against defendant.
O'Brien, J., concurred with Fort Hood, P.J.
VHS Huron Valley Sinai Hosp. v. Sentinel Ins. Co.
,
If it were not for our dissenting colleague's insistence on publication pursuant to MCR 7.215(A), this opinion would not be published because it does not meet the standards of MCR 7.215(B).
This Court is bound to follow precedent of the Michigan Supreme Court.
State Treasurer v. Sprague
,
"Whether a party has standing is a question of law that is reviewed de novo by this Court."
Coldsprings Twp. v. Kalkaska Co. Zoning Bd. of Appeals
,
There is no indication in the record that Hendon assigned his rights to "past or presently due benefits" to plaintiff.
Covenant
, 500 Mich. at 217 n. 40,
Dissenting Opinion
A release is a contract. We interpret contracts according to their plain and unambiguous terms. We do not add or ignore words. We disdain interpretative methodologies premised on "reasonableness." "A fundamental tenet of our jurisprudence is that unambiguous contracts are not open to judicial construction and must be
enforced as written
."
Rory v. Continental Ins. Co.
,
Given these well-settled rules, the majority's conclusion that the plain words of the parties' release do not mean what they say, and instead must be viewed against the backdrop of "the record and the procedural posture of this case as a whole," is nothing short of remarkable. Contrary to Rory and every rule of contract interpretation, the majority has rewritten the parties' release.
This is not a hard case, and its resolution should be as simple as the rule set out in Rory . Charles Hendon, Jr., sustained personal injuries in an accident with an uninsured vehicle. Plaintiff, VHS Huron Valley-Sinai Hospital, Inc., provided Hendon with healthcare services related to the accident. Hendon filed a first-party lawsuit against defendant, Sentinel Insurance Company, seeking uninsured motorist (UIM) benefits, but failed to include in his lawsuit a claim for no-fault personal protection insurance (PIP) benefits. Hendon and Sentinel settled Hendon's UIM claim. Huron Valley then sued Sentinel for payment of Hendon's medical expenses. Sentinel contended that its liability for Hendon's medical expenses should have been litigated in Hendon's UIM case and that res judicata barred the suit. The circuit court denied Sentinel's summary disposition motion on this ground. Sentinel and Huron Valley settled their dispute by entering into a release. The parties agreed that Sentinel would pay Huron Valley $61,712.18, plus costs and interest, "if Sentinel's position regarding res judcata /release [sic] is ultimately rejected by the Michigan Court of Appeals or Supreme Court."
At least two other paragraphs of the release addressed (and repeated) that the sole issue to be presented on appeal was "regarding res judcata /release." The 2015 release made no mention of Huron Valley's standing (or alleged lack thereof). Nor did the release reference a healthcare provider's statutory right to sue.
We decided Sentinel's appeal in Huron Valley's favor in October 2016. Not surprisingly, our decision focused exclusively on the doctrine of res judicata; after all, that was the only issue that the parties had agreed to present to us. We held that because Huron Valley and Hendon were not in privity, res judicata did not apply. We did not consider Huron Valley's standing to sue, because the issue was never raised. We did not evaluate whether healthcare providers possess a statutory cause of action against insurers, because consistent with the release it signed, Sentinel argued only that Huron Valley's claim for PIP benefits could have been resolved in Hendon's UIM action, implicating res judicata principles. Displeased with our rejection of this argument, Sentinel applied for leave to appeal in the Supreme Court.
In May 2017, the Supreme Court decided
Covenant Med. Ctr., Inc. v. State Farm Mut. Auto. Ins. Co.
,
Sentinel's argument would be compelling if it had made it in the trial court or settled the underlying case with a release reserving that issue for appeal. Instead, Sentinel elected to sign a release that carved out for appeal only a single, specific and narrow question: whether the doctrine of res judicata barred Huron Valley's claim. In other words, Sentinel waived any argument that Huron Valley lacked standing. It deliberately elected to forgo this appellate claim. If Sentinel suspected that a standing argument had legal legs, it should have identified "standing" in the release as an issue to be presented to an appellate court.
Perhaps the release did not preserve a standing claim because the parties' bargain required Sentinel to waive the issue. Perhaps Sentinel's counsel calculated incorrectly that the Supreme Court would decide Covenant differently. We need not speculate because our Supreme Court has forcefully and effectively instructed that if a contract's words are unambiguous, we look no further to ascertain the parties' intent. The words lend themselves to but one interpretation in this case: Sentinel agreed to appeal on res judicata grounds and waived its potential standing argument.
The majority makes much of the fact that Sentinel raised the issue of standing in the trial court by including it as an affirmative defense. This proves my point: Sentinel knew an important legal issue existed that might entirely preclude Huron Valley's claim. Yet Sentinel deliberately decided to forgo asserting a standing challenge when it signed a release plainly limiting its appeal to "res judicata." This is called a waiver.
The majority's reliance on the
absence
of language in the release "indicating that defendant intended to clearly and unequivocally waive its legal position with respect to plaintiff's standing" turns the law of contracts-and waiver-upside down. "[A]n unambiguous contract reflects the parties' intent as a matter of law."
In re Egbert R. Smith Trust
,
The majority ignores the law and repudiates the plain language of the release. Instead of holding Sentinel to the bargain it made, the majority tosses a lifeline, excusing Sentinel's waiver by hypothesizing that before the Supreme Court decided
Covenant
, Sentinel "may have reasonably surmised that any challenges to plaintiff's standing would have been rejected by the trial court and the appellate courts." This breathtaking and contrived exemption from the words of the contract suggests that because Sentinel reasonably expected that a standing argument would go nowhere, it could nevertheless preserve the claim without including it in the release.
Rory
forcefully condemns such reasoning: "When a court abrogates unambiguous contractual provisions based on its own independent assessment of 'reasonableness,' the court undermines the parties' freedom of contract."
Rory
,
Sentinel made a choice. It settled the claims brought by Huron Valley. As part and parcel of that settlement, Sentinel agreed in writing to limit its appeal to an argument regarding res judicata, thereby forgoing any and all other legal claims. Having made its bed, Sentinel must lie in it. Any other result violates bedrock principles of contract law and flies in the face of decades of contract jurisprudence. I would hold that based on the clear and unambiguous language of the release, Sentinel's Covenant argument comes too late, and respectfully dissent.
The majority cites
Nexteer
as authority for its holding that a waiver of a right requires language reflecting a specific intent to waive the right. In
Nexteer
,
Mando was aware of the arbitration clause in the nondisclosure agreement, and it was aware of Nexteer's general allegations in its complaint. It had the ability to apply the language of the arbitration clause to the complaint in order to decide whether it should pursue arbitration. After stipulating that the arbitration provision did not apply, Mando may not now argue that the arbitration provision does in fact apply. [ Id . at 397,886 N.W.2d 906 .]
Nexteer assuredly does not stand for the proposition that a waiver may be enlarged by reference to legal arguments not mentioned in the waiver. The majority's groundbreaking proposition that stipulated waiver language may be interpreted to mean more than it says contravenes Nexteer , Rory , and countless other cases. That is why publication is required under MCR 7.215(B)(3) ("A court opinion must be published if it ... alters, modifies, or reverses an existing rule of law[.]").
Reference
- Full Case Name
- VHS HURON VALLEY SINAI HOSPITAL, Doing Business as DMC Surgery Hospital, Plaintiff-Appellee, v. SENTINEL INSURANCE COMPANY, Defendant-Appellant.
- Cited By
- 31 cases
- Status
- Published