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Farm Bureau required to pay fees and costs after unreasonable failure to pay PIP benefits.

Elvia Esterhal was rear-ended by a semi in 1988.  She endured a great deal of back pain and two surgical fusions in the lumbar and cervical region.  Farm Bureau refused to pay for the cervical fusion, however, citing it's hired consultant neurosurgeon, Dr. Lou Jacobs, who found "no connection" between the collision and the surgery.  Three treating doctors disagreed, however, and the jury ruled in Esterhal's favor, finding that the fusion was caused, in part, by the car accident.   Esterhal had also submitted bills for periodic foot care because with her fused spine she could not properly care for her feet.  Her doctor had prescribed care by a podriatist, but Farm Bureau rejected the bills.

The Court of Appeals ruled that Farm Bureau was required to pay attorneys fees for the podiatric care because there was no reasonable basis to object to the medical necessity for the care and it was clearly related to Esterhal's fused spine.  It ruled, however, that Esterhal could not collect fees for the spinal surgery because her attorney never placed into evidence the date on which Farm Bureau was provided with the surgeon's report confiming the causal relationship between the accident and the surgery.  Since that date was never established at trial, Esterhal could not prove the date when Farm Bureau's refusal to pay became unreasonable.
Thompson O’Neil, P.C.
309 East Front Street
Traverse City, Michigan 49684
Toll Free: 1-800-678-1307
Fax: 231-929-7262