[ Opinion Index ] [ Return ] To Previous Page The following opinion is presented on-line for informational use only and does not replace the official version. (Mich Dept of Attorney General Web Site - www.ag.state.mi.us) STATE OF MICHIGAN FRANK J. KELLEY, ATTORNEY GENERAL Opinion No. 5622 January 10, 1980 NO-FAULT MOTOR VEHICLE INSURANCE: Charges for preparation of medical report PHYSICIANS AND SURGEONS: Charges for preparation of medical report pursuant to no-fault motor vehicle insurance law INSURANCE: Charges for preparation of medical report pursuant to no-fault motor vehicle insurance law A physician may charge a fee for preparing a medical report pursuant to Michigan No-Fault Motor Vehicle Insurance law. An insurer is required to reimburse claimants for the cost of obtaining a medical report required by the insurer pursuant to the Michigan No-Fault Motor Vehicle Insurance law whether the report is provided directly by the physician to the insurer or is furnished to the insurer through the claimant. William F. McLaughlin, Director Department of Commerce Lansing, Michigan You have requested my opinion regarding the interpretation of certain sections of the Michigan no fault motor vehicle insurance act, 1956 PA 281, ch 31 as added by 1972 PA 294; MCLA 500.3101 et seq; MSA 24.13101 et seq. Your questions are: 1. May a physician charge a fee for preparing a medical report required pursuant to 1956 PA 218, supra, Sec. 3158(2)? 2. Is the insurer required to reimburse claimants for the cost of obtaining such reports? 1956 PA 218, supra, Sec. 3158(2) states: 'A physician, hospital, clinic or other medical institution providing, before or after an accidental bodily injury upon which a claim for personal protection insurance benefits is based, any product, service or accommodation in relation to that or any other injury, or in relation to a condition claimed to be connected with that or any other injury, if requested to do so by the insurer against whom the claim has been made, (a) shall furnish forthwith a written report of the history, condition, treatment and dates and costs of treatment of the injured person and (b) shall produce forthwith and permit inspection and copying of its records regarding the history, condition, treatment and dates and costs of treatment.' (emphasis added) Thus, the insurer against whom a claim is made may require the physician who provided medical services to the claimant to submit reports and records to the insurer pertaining to treatment of the insured. 1956 PA 218, supra, Sec. 3157 provides: 'A physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for an accidental bodily injury covered by personal protection insurance, and a person or institution providing rehabilitative occupational training following the injury, may charge a reasonable amount for the products, services, and accommodations rendered. The charge shall not exceed the amount the person or institution customarily charges for like products, services and accommodations in cases not involving insurance.' Thus, the statute provides that treating physician may charge a reasonable amount for the products and services rendered in connection with treatment of the injured person, but not exceeding the customary charge in cases not involving insurance. When expense is incurred as a result of the insurance company exercising its rights to the records of the health care provider, it is my opinion that the cost of preparing the report should be borne by the insurance company making the inquiry. Thus, it is my opinion that a physician may impose reasonable and customary charges for preparation of such reports. In answer to the second question, in Shavers v Attorney General, 402 Mich 554, 578-579, 267 NW2d 72 (1978), the Michigan Supreme Court stated: '. . . The goal of the no-fault insurance system was to provide victims of motor vehicle accidents assured, adequate, and prompt reparation for certain economic losses. The Legislature believed this goal could be most effectively achieved through a system of compulsory insurance, . . .' It would therefore be contrary to the above-stated purpose of the Michigan No Fault Law to require victims of accidents to pay for the preparation of reports required by the insurer prior to paying their claims. The doctor's charge is part of the insurer's claims adjustment expense and is incurred because the insurer chose to require a report rather than examining the files and records as authorized by 1956 PA 218, Sec. 3158(2), supra. Thus, it is my opinion that the insurer is required to reimburse claimants for the cost of obtaining a medical report required by the insurer pursuant to 1956 PA 218, Sec. 3158(2), whether the report is provided directly by the physician to the insurer or is furnished to the insurer through the claimant. Frank J. Kelley Attorney General
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