# Advocacy Organization for Patients & Providers v. Auto Club Insurance

> Michigan Court of Appeals · August 20, 2003 · 257 Mich. App. 365

URL: https://www.frixlaw.com/law-library/cases/9655403

## Case

- **Full name:** Advocacy Organization for Patients & Providers v. Auto Club Insurance Association
- **Court:** Michigan Court of Appeals
- **Decided:** August 20, 2003
- **Citations:** 257 Mich. App. 365; 670 N.W.2d 569
- **Precedential status:** Published
- **Opinion:** Concurrence by Fitzgerald
- **Judges:** Fitzgerald, Markey, Murray
- **Cited by:** 127 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/9655403

## How later opinions describe it (automated extraction)

- explaining that the trial court properly granted the defendants’ motion for summary disposition when the plaintiffs failed to establish that the evidence in a light most favorable to plaintiffs, we will accept for purposes of this appeal that Doyle actually made a “statement.”…
- recognizing that if a no-fault insurance carrier was required to pay a provider’s customary charge without regard to whether the charge was reasonable, it would violate the public policy of cost containment underlying the no-fault act because the provider would in effect set w…
- stating that “a claim for civil conspiracy may not exist in the air; rather, it is necessary to prove a separate, actionable tort.”
- finding that “a claim for civil conspiracy may not exist in the air; rather, it is necessary to prove a separate, actionable tort”
- explaining that a party asserting a claim of tortious interference “must establish that the interference was improper”

## Opinion text

Fitzgerald, P.J.,
(concurring). In reaching its conclusion, the majority strictly applied the plain and unambiguous language of MCL 500.3107, as they are required to do. Therefore, I agree with the analysis employed by the majority. I write separately, however, because I am bothered by the fact that the Legislature has not declared what is a “reasonable” charge for a particular product or service and has not provided statutory criteria to determine whether a charge is reasonable under § 3107.
As noted by the majority, § 3107 is subjective and requires insurers to make a determination in each instance whether a charge is reasonable. When an insurer does not pay the amount of the charge in full, doctors and physicians often sue their patients for the balance unpaid by the insurer. The unfortunate results of the failure to provide criteria for determining the reasonableness of a charge are destruction of the doctor-patient relationship when the doctor sues *386 the patient, as well as increased litigation where a trier of fact is required to determine the reasonableness of the charge. To address these problems, I would strongly recommend that legislation be enacted that requires the Commissioner of Insurance to adopt medical-fee schedules, similar to the reimbursement schedules for health-care providers that are common in connection with health-insurance policies, with respect to reimbursement of health-care providers under policies of automobile insurance. Under this scheme, no health-care provider could demand or request any payment from any person in excess of those fees permitted by the medical-fee schedules established pursuant to the act, nor would any person be liable to any health-care provider for any amount of money that resulted from the charging of fees in excess of those permitted by the medical-fee schedules.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/9655403. Public record. Not legal advice.