Prism Lab LLC v. Allstate Insurance Company
Court
Michigan Court of Appeals
Decided
June 17, 2025
Jurisdiction
SA
Importance
46%
Case Summary
If this opinion indicates that it is “FOR PUBLICATION,” it is subject to revision until final publication in the Michigan Appeals Reports. STATE OF MICHIGAN COURT OF APPEALS PRISM LAB LLC, UNPUBLISHED June 17, 2025 Plaintiff, 3:17 PM and FLINT REGION ASC LLC, Intervening Plaintiff-Appellant, and MICHIGAN CLINIC NEUROSURGERY PLLC, Intervening Plaintiff, v No. 369636 Wayne Circuit Court ALLSTATE INSURANCE COMPANY, LC No. 21-014505-NF Defendant-Appellant. Before: MALDONADO, P.J., and M. J. KELLY and RIORDAN, JJ. PER CURIAM. In this action to recover personal protection insurance (“PIP”) benefits under the no-fault act, MCL 500.3101 et seq., intervening plaintiff, Flint Region ASC LLC (“Flint Region”), appeals by right from the stipulated dismissal order as to intervening plaintiff, Michigan Clinic Neurosurgery PLLC (“MCN”), to challenge an earlier order granting summary disposition under MCR 2.116(C)(10) (no genuine issue of material fact) in favor of defendant, Allstate Insurance Company (“Allstate”), dismissing Flint Region’s claims to recover no-fault benefits for medical services provided to Allstate’s insured, Tauneesah Polk. We reverse and remand for further proceedings. -1- I. BACKGROUND This case arises from a motor vehicle accident involving Polk on April 16, 2020. When Polk was riding a bicycle, a city of Detroit bus collided with Polk’s left shoulder. Polk fell to the ground and sustained injuries. Polk was insured under a no-fault insurance policy with Allstate. Polk received treatment from Henry Ford Health System, as well as C-Spine Orthopedics, beginning in April 2020. Polk received medical treatment from plaintiff, Prism Lab LLC (“Prism”), from about October 15, 2020, until April 15, 2021.1 On March 24, 2021, Polk underwent a 360 Lumbar Fusion L5-S1 (hereinafter, “lumbar spinal fusion” or “surgery”), performed by a neurologic surgeon at MCN. The surgery was performed at Flint Region’s ambulatory surgical center. The surgeon was a consultant for C-Spine Orthopedics. Allstate refused to pay for the surgery. As to the expenses, Flint Region posited the incurred medical expenses totaled $473,899.76. Adding the total amount of alleged interest, $56,867.97, as well as alleged attorney’s fees, $176,922.58, Flint Region sought $707,690.31 from Allstate. A health insurance claim form dated April 1, 2021, listed the “total charges” as $788,620. An invoice dated February 2, 2022, from Flint Region showed the total balance for the surgery was $464,011.01. According to an audited bill review by Tami Rockholt, RN, BSN, a nurse consultant for Allstate, Flint Region billed $624,529.64 for the surgery. According to a review of Flint Region’s billing by Rockholt, there were “numerous charges dated [March 24, 2021] from Flint Region ASC for various components of a surgical procedure,” but “no records . . . available for review.” By way of background, Polk filed suit against Allstate seeking no-fault benefits. The matter was assigned Case Number 20-014951-NI and assigned to a judge (“the underlying action”). Polk’s complaint included claims against the city of Detroit and city bus driver, Vernon Turner.2 Prism, an assignee of Polk, also filed suit against Allstate to recover no-fault benefits for medical services. This matter was assigned Case Number 21-014505-NF and assigned to the same judge (“the instant action”).3 Flint Region and MCN moved to intervene in the instant action, contending they were owed payment by Allstate for medical services provided to Polk. The trial court granted the motion and ordered that the filing of an intervening complaint include “all pertinent records, bills, and their Initial Disclosures.” Flint Region and MCN4 filed their complaint against Allstate, alleging breach of contract and seeking declaratory relief for payment of no-fault benefits totaling $475,000 plus interest. Allstate answered and filed affirmative defenses. 1 Polk assigned her right to payment of these services to Prism. Allstate did not pay for the services. 2 Polk’s claims as to the city of Detroit and Turner were dismissed without prejudice by stipulation. 3 Prism’s claims against Allstate were dismissed without prejudice. 4 MCN’s claims against Allstate were dismissed with prejudice. -2- Allstate moved to consolidate the underl
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Decided
Date Decided
June 17, 2025
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SA
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federal
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If this opinion indicates that it is “FOR PUBLICATION,” it is subject to revision until final publication in the Michigan Appeals Reports.
STATE OF MICHIGAN
COURT OF APPEALS
PRISM LAB LLC, UNPUBLISHED June 17, 2025 Plaintiff, 3:17 PM
and
FLINT REGION ASC LLC,
Intervening Plaintiff-Appellant,
and
MICHIGAN CLINIC NEUROSURGERY PLLC,
Intervening Plaintiff,
v No. 369636 Wayne Circuit Court ALLSTATE INSURANCE COMPANY, LC No. 21-014505-NF
Defendant-Appellant.
Before: MALDONADO, P.J., and M. J. KELLY and RIORDAN, JJ.
PER CURIAM.
In this action to recover personal protection insurance (“PIP”) benefits under the no-fault
act, MCL 500.3101 et seq., intervening plaintiff, Flint Region ASC LLC (“Flint Region”), appeals by right from the stipulated dismissal order as to intervening plaintiff, Michigan Clinic Neurosurgery PLLC (“MCN”), to challenge an earlier order granting summary disposition under MCR 2.116(C)(10) (no genuine issue of material fact) in favor of defendant, Allstate Insurance Company (“Allstate”), dismissing Flint Region’s claims to recover no-fault benefits for medical services provided to Allstate’s insured, Tauneesah Polk. We reverse and remand for further proceedings.
-1-
I. BACKGROUND
This case arises from a motor vehicle accident involving Polk on April 16, 2020. When
Polk was riding a bicycle, a city of Detroit bus collided with Polk’s left shoulder. Polk fell to the ground and sustained injuries. Polk was insured under a no-fault insurance policy with Allstate. Polk received treatment from Henry Ford Health System, as well as C-Spine Orthopedics, beginning in April 2020. Polk received medical treatment from plaintiff, Prism Lab LLC (“Prism”), from about October 15, 2020, until April 15, 2021.1 On March 24, 2021, Polk underwent a 360 Lumbar Fusion L5-S1 (hereinafter, “lumbar spinal fusion” or “surgery”), performed by a neurologic surgeon at MCN. The surgery was performed at Flint Region’s ambulatory surgical center. The surgeon was a consultant for C-Spine Orthopedics. Allstate refused to pay for the surgery.
As to the expenses, Flint Region posited the incurred medical expenses totaled
$473,899.76. Adding the total amount of alleged interest, $56,867.97, as well as alleged attorney’s fees, $176,922.58, Flint Region sought $707,690.31 from Allstate. A health insurance claim form dated April 1, 2021, listed the “total charges” as $788,620. An invoice dated February 2, 2022, from Flint Region showed the total balance for the surgery was $464,011.01. According to an audited bill review by Tami Rockholt, RN, BSN, a nurse consultant for Allstate, Flint Region billed $624,529.64 for the surgery. According to a review of Flint Region’s billing by Rockholt, there were “numerous charges dated [March 24, 2021] from Flint Region ASC for various components of a surgical procedure,” but “no records . . . available for review.”
By way of background, Polk filed suit against Allstate seeking no-fault benefits. The
matter was assigned Case Number 20-014951-NI and assigned to a judge (“the underlying action”). Polk’s complaint included claims against the city of Detroit and city bus driver, Vernon Turner.2 Prism, an assignee of Polk, also filed suit against Allstate to recover no-fault benefits for medical services. This matter was assigned Case Number 21-014505-NF and assigned to the same judge (“the instant action”).3 Flint Region and MCN moved to intervene in the instant action, contending they were owed payment by Allstate for medical services provided to Polk. The trial court granted the motion and ordered that the filing of an intervening complaint include “all pertinent records, bills, and their Initial Disclosures.” Flint Region and MCN4 filed their complaint against Allstate, alleging breach of contract and seeking declaratory relief for payment of no-fault benefits totaling $475,000 plus interest. Allstate answered and filed affirmative defenses.
1 Polk assigned her right to payment of these services to Prism. Allstate did not pay for the services. 2 Polk’s claims as to the city of Detroit and Turner were dismissed without prejudice by stipulation. 3 Prism’s claims against Allstate were dismissed without prejudice. 4 MCN’s claims against Allstate were dismissed with prejudice.
-2-
Allstate moved to consolidate the underl
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Case Details
Legal case information
Status
Decided
Date Decided
June 17, 2025
Jurisdiction
SA
Court Type
federal
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Metadata
Additional information
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