The No-Fault Act; The one-year-back rule; MCL 500.3145(2); Tolling; Devillers v Auto Club Ins Ass’n; Richards v American Fellowship Mut Ins Co; Lewis v Detroit Auto Inter-Ins Exch; McNeel v Farm Bureau Gen Ins Co of MI; MCL 500.3415(3); When is a claim denied; Explanations of review (EORs); Effect of a general disclaimer

Noting that no published opinion had yet addressed the interplay of the 2019 amendments to MCL 500.3145 with pre-Devillers case law, the court held that the amendments, “particularly the addition of Subsection (3), act to supersede our Supreme Court’s ruling in Devillers and return the state of law to that provided in Lewis and its progeny.” Because defendant-Citizens Insurance never formally denied plaintiff-Encompass Healthcare’s “requests for reimbursement, the application of the one-year-back rule remained tolled until” Encompass filed this action. Encompass sought no-fault benefits from Citizens for treatment provided to a nonparty injured in an auto accident. The trial court partially granted Citizens’ summary disposition motion, concluding the insurer’s EORs served as formal denials under MCL 500.3145(3) because Citizens denied portions of Encompass’s claims. The court noted that Michigan courts had for decades “equitably tolled the one-year damage-limiting provision until the date the insurer formally and explicitly denied liability.” Then the Supreme Court overruled those cases in Devillers, holding “that former MCL 500.3145 must be strictly applied as written, without any tolling provision.” The court reviewed the pre- and post-amendment versions of MCL 500.3145 and noted the main difference was “the insertion of the phrase ‘until the date the insurer formally denies the claim.’” It further noted that MCL 500.3145(3)’s tolling provision was “identical to that embraced in the cases overruled, demonstrating the Legislature’s intent to impose a tolling exception to the one-year-back rule in the form it existed before Devillers.” Resolving this appeal turned on whether “Citizens’ EORs serve as formal denials of Encompass’s reimbursement claims.” The court readopted the “explanation of ‘formal denial’ detailed in the pre-Devillers line of cases.” And it concluded “that Citizens’ EORs did not provide the explicit and unequivocal expression of finality required to constitute formal denials under our pre-Devillers jurisprudence.” As a result, tolling was “in effect under MCL 500.3145(3) until Encompass filed its [11/4/19] complaint, and its reimbursement claims were not time-barred by the one-year-back rule.” Reversed and remanded.