Credit Troll

HELP! Borrowing Statute and Medical Debt - Sevices Rendered In California But Patient Lives In Michigan

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Hello & HELP!,

I work for a medical provider and I am assisting a patient who is being harassed by a collection agency and her insurance company. 

Here is the breakdown:

Patient  had surgery in California but the Patient lives in Michigan and her Insurance company's coverage is out of Michigan. Our patient was seen and services were rendered in June 2011. We are a medical facility out of California and the patient lives and has insurance coverage out of Michigan.  Our surgical center submitted an out of network claim correctly. Shortly after submitting the claim the Insurance carrier paid out the out of network claim directly to the patient for $42k who in turn forwarded the check to our office July 2011.  The patient was then contacted about 3-6 months later demanding a $21k refund from the patient due to an error from the  insurance carrier. In 2012 our office attempted to contact the insurance company and request necessary documents so we can look at the validity of the refund request in order to consider the refund.  Months went by and the insurance carrier could not/did not provide our office with the necessary information. We fast forward to 2015 after years went by and the patient was contacted by a collection agency demanding payment. 

 

*** I am working with the patient to resole this debt. I have been researching Michigan statute laws and looking for some kind of defense or angle.  I have been in contact with the collector and have sent certified mail a written debt validation request. "which they did not respond" so I then had the patient send her own request to validate the debt demanding 30 days from 2/26/16 to respond.

I did note that we can try to use California collection laws due to the services were rendered in California.

 

QUESTION:

Can we apply the Borrowing statute law or does Michigan have a borrowing statute law that can help the patient by making the insurance carrier or collection agency adhere to California statutes/collection laws due to the services were originally rendered in California even though the insurance carrier is out of Michigan? Is there any other defenses or approach we can take?

 

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23 hours ago, Credit Troll said:

Hello & HELP!,

I work for a medical provider and I am assisting a patient who is being harassed by a collection agency and her insurance company. 

Here is the breakdown:

Patient  had surgery in California but the Patient lives in Michigan and her Insurance company's coverage is out of Michigan. Our patient was seen and services were rendered in June 2011. We are a medical facility out of California and the patient lives and has insurance coverage out of Michigan.  Our surgical center submitted an out of network claim correctly. Shortly after submitting the claim the Insurance carrier paid out the out of network claim directly to the patient for $42k who in turn forwarded the check to our office July 2011.  The patient was then contacted about 3-6 months later demanding a $21k refund from the patient due to an error from the  insurance carrier. In 2012 our office attempted to contact the insurance company and request necessary documents so we can look at the validity of the refund request in order to consider the refund.  Months went by and the insurance carrier could not/did not provide our office with the necessary information. We fast forward to 2015 after years went by and the patient was contacted by a collection agency demanding payment. 

 

*** I am working with the patient to resole this debt. I have been researching Michigan statute laws and looking for some kind of defense or angle.  I have been in contact with the collector and have sent certified mail a written debt validation request. "which they did not respond" so I then had the patient send her own request to validate the debt demanding 30 days from 2/26/16 to respond.

I did note that we can try to use California collection laws due to the services were rendered in California.

 

QUESTION:

Can we apply the Borrowing statute law or does Michigan have a borrowing statute law that can help the patient by making the insurance carrier or collection agency adhere to California statutes/collection laws due to the services were originally rendered in California even though the insurance carrier is out of Michigan? Is there any other defenses or approach we can take?

 

@Credit Troll

I am not a lawyer.  Yes, Michigan has a borrowing statute. If the insurance company is a "resident" of Michigan, I don't believe (IANAL) the borrowing statute will help. If the insurance company is registered in another state, and as a foreign entity in Michigan, you might be able to make a case that the economic injury occured in its state of incorporation. I urge you/your client to consult with an attorney. A lawsuit has not been filed, only attempts to collect a debt, correct? 

MCL 600.5861 Cause of action accruing without state; limitation on commencement of action.
An action based upon a cause of action accruing without this state shall not be commenced after the expiration of the statute of limitations of either this state or the place without this state where the cause of action accrued, except that where the cause of action accrued in favor of a resident of this state the statute of limitations of this state shall apply. This amendatory act shall be effective as to all actions hereinafter commenced and all actions heretofor commenced now pending in the trial or appellate courts. http://legislature.mi.gov/doc.aspx?mcl-600-5861

Here's a Michigan case that explains the analysis:

https://scholar.google.com/scholar_case?q=SCHERER+v.+HELLSTROM&hl=en&as_sdt=4,23&case=13097926001928955789&scilh=0

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On 3/17/2016 at 11:59 AM, Credit Troll said:

QUESTION:

Can we apply the Borrowing statute law or does Michigan have a borrowing statute law that can help the patient by making the insurance carrier or collection agency adhere to California statutes/collection laws due to the services were originally rendered in California even though the insurance carrier is out of Michigan?

Unfortunately, No.  The policy is out of Michigan and the issue is between the insured and the carrier not the provider.  It is wonderful that you are helping the patient with this but it is not an issue with the provider per se.

Sadly many patients make this mistake of simply ignoring the issue until it reaches a satisfactory conclusion. 

1 hour ago, Brotherskeeper said:

I did note that we can try to use California collection laws due to the services were rendered in California.

That would matter if YOU the provider were in need of payment from the patient.  It doesn't help that the crux of the issue is the insurer is stating that coverage was limited in the amount due to being out of network.

1 hour ago, Brotherskeeper said:

Is there any other defenses or approach we can take?

Yes, EVERY state has an Insurance Commissioner and the patient should immediately open a case with them. This is figuratively the CFPB of the insurance industry for consumers.

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1 minute ago, nascar said:

Start by researching Michigan's voluntary payment doctrine.

Durant v. ServiceMaster Co., 159 F. Supp. 2d 977 (E.D. Mich. 2001).

 

That may go a long way to resolving the issue. I would argue that insurance carrier is out of luck.

 

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