She Had Back Surgery. The Insurer Refused to Pay.

Auto-Owners stopped paying a woman's no-fault medical benefits in May 2023 after a car crash. The company said it was not sure her injuries came from the accident. She already had a long history of back pain. She later had spinal surgery, and her lawyer says the unpaid bills left her with medical debt. She had already prevailed at trial. Her lawyer tells the judge the jury awarded the $123,792 she requested for medical benefits, plus $14,855.04 in penalty interest, and that the verdict form matches those figures. The insurer argues it had a real reason to stop paying: a minor crash, 30 years of earlier back treatment, and a flare she reported to her chiropractor days before the accident. Her lawyer says those were guesses, and that the company did not investigate in time to justify the May 2023 cutoff. Judge Rossi finds the denial unreasonable. He says the insurer did not investigate promptly, and that the outside doctors it relied on were not enough once the jury rejected their opinions. He points to the spinal surgery as a reason to doubt that she was simply exaggerating pain. Lawyer fees can be awarded. Time runs out before any fee number is set, so the amount, along with court costs, is left for a later hearing. Proceeding: Motion for Taxable Costs, No-Fault Attorney Fees, and Judgment Interest Court: 17th Circuit Court, Kent County, MI Date: See source Chapters: 00:00 She asks the judge to make the insurer pay her lawyer 01:31 The jury already treated the benefits as overdue 03:05 Auto-Owners stopped paying in May 2023 04:56 She has spinal surgery before the insurer gets a surgeon's opinion 08:35 Her lawyer says the cutoff left her in medical debt 12:47 The insurer points to a minor crash and old back pain 14:15 The judge asks why she would have surgery if she were only exaggerating 19:22 The fight over a back flare days before the crash 24:43 Her lawyer says the jury matched every dollar she requested 26:43 The judge finds the denial unreasonable 35:05 Lawyer fees can be awarded, and the amount waits Participants: • Judge Rossi — presiding judge, 17th Circuit Court, Kent County, Michigan. • Ann Mabbott — attorney for the insured, seeking costs and no-fault lawyer fees. • Jim Wright — attorney for Auto-Owners Insurance Company. • The insured — counter-plaintiff whose medical benefits were stopped after a car crash, and whose benefit claim a jury later awarded. Legal terms: • No-fault medical benefits: Michigan auto coverage that pays an injured person's medical bills through their own insurer after a crash. • Overdue benefits: Benefits not paid within 30 days after the insurer receives reasonable proof of the loss. Penalty interest can follow. • Lawyer fees for an unreasonable denial: When benefits were overdue, the court can award the injured person's lawyer fees if the insurer had no real, timely reason to refuse payment. The dollar amount is set separately. Keywords: Auto-Owners insurance denial, no-fault medical benefits, car accident insurance, attorney fees hearing, Judge Rossi, 17th Circuit Court, Kent County Michigan, spinal surgery insurance claim, real court hearing Official source:    • Видео   This is legal commentary for educational purposes only. Not legal advice. #RealCourt #InsuranceDenial #CourtHearing