Zausmer attorneys break down how Canty v Mason reaffirms that no-fault caps, fee schedules, and offsets limit excess medical expense claims.
Shareholder Stephanie Strycharz and associate Christopher Best co-authored this month’s Journal of Insurance & Indemnity Law article, “The Current State of MCL 500.3135(3)(c) – A Further Look at the Michigan Court of Appeals Holding in Canty v Mason.” Drawing on the Michigan Court of Appeals’ October 2024 opinion, they clarify that “without limit” merely lifts the personal-protection insurance cap–it does not erase every statutory boundary.
First, excess allowable expenses remain tethered to the fee schedules in MCL 500.3157. If a provider bills above the state’s set reimbursement rates, only the published fee schedule amount qualifies for recovery in a tort suit. Second, plaintiffs must present medical charges to Medicare before seeking any unpaid balance from a tortfeasor, as mandated by MCL 500.3109(1) and common-law mitigation rules. Third, by incorporating MCL 500.3107, the court signaled that every limitation in Chapter 31, including disqualifiers found in MCL 500.3113, can bar or reduce an excess claim.
This broad interpretation closes loopholes that some believed would allow unlimited tort recovery simply by calling expenses “excess”. Litigators on both sides must now account for statutory offsets, reimbursement ceilings, and mitigation duties when shaping strategy. Defense counsel can press fee schedules and offset credits. Plaintiffs’ firms must ensure medical bills comply with Medicare billing rules before filing suit. An application for leave to appeal to the Michigan Supreme Court is pending, but until the high court decides, Canty v Mason sets the rule of the road.
Read the full article in the Journal of Insurance & Indemnity Law here.
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