Representative Cases

no fault insurance

Representative Result #1

Capsule Summary:
Molosky & Co. obtains over $1.5 million settlement of benefits from a no-fault insurance provider in case filed in out-of-state federal district court after the insurance company claimed our client was not entitled to any No-Fault benefits.

Expanded Description:
Our client was catastrophically injured in a motor vehicle accident in 1977. For more than 3 decades, our client and her family struggled in obtaining help from the insurance company which unjustly placed the burden of our client’s care, recovery and rehabilitation on her elderly mother. Molosky & Co. proactively assisted our client in finding and relocating to an out-of-state care facility which provided appropriate care/accommodations for her injuries and allowed her mother to reside with her. Molosky & Co. also filed a lawsuit in federal district court for the insurance company’s failure to reimburse our client all allowable No-Fault expenses, including the attendant care her mother provided. Molosky & Co. prevailed against the insurance company’s motion for summary disposition which claimed our client was never entitled to No-Fault benefits in the first place, as the alleged “owner” of an uninsured vehicle at the time of her accident (even though our client previously received No-Fault benefits for more than 3 decades!). After protecting (and confirming) our client’s entitlement to future No-Fault benefits, Molosky & Co. secured: (1) a $500,000 payment from the insurance company; (2) a fair/reasonable attendant care rate for future attendant care provided by our client’s family; and (3) a contractual commitment for our client and her family to remain at the care facility.

Representative Result #2

Capsule Summary:
Molosky & Co. obtained $1,161,000.00 in no-fault PIP benefits for a catastrophically injured person through facilitative mediation; $375,000.00 for suitable barrier-free housing modifications, and $131,000.00 annual family provided attendant care payments for the next six years.

Expanded Description:
Molosky & Co. filed a lawsuit for a catastrophically injured person who suffered a traumatic brain injury and paraplegia resulting from a single-car rollover. For several years, the client attempted to negotiate terms for suitable barrier-free housing for his incapacitated loved one. Through vigorous discovery that led to substantial negotiations during facilitative mediation, Molosky & Co. successfully negotiated a settlement for $375,000.00 to provide suitable barrier-free housing and $131,000.00 annual attendant care payments to the caregiver father for the next six years. We also preserved all current and future benefits for our client, particularly in the event of a change in the medical condition of the client.

Representative Result #3

Capsule Summary:
Molosky & Co. obtained approximately $630,000 from a no-fault insurance provider that failed to pay our client’s necessary medical benefits following a catastrophic motor vehicle accident that resulted in significant and permanent physical and mental injuries.

Expanded Description:
A catastrophic motor vehicle accident permanently injured our client in 1995. Ever since the accident, our client struggled to support herself financially, as the accident resulted in significant and permanent physical and mental injuries that precluded her from working. Defendant, a no-fault insurance provider, made receiving benefits a nightmare for our client, by constantly denying coverage and delaying reimbursement to cover medical costs. We sued for damages dating back to the date of the 1995 accident. Defendant claimed that the one-year back rule of MCL 500.3145(1) applied to this suit, but we argued that it did not apply to our client because of her inability to comprehend her rights and act on them. MCL 600.5851 allows impaired individuals to disregard the one-year back rule and claim damages from the date of the accident forward, as in our client’s situation. Defendant relented and finally settled the case in facilitation for approximately $630,000: $450,000 for past attendant care and home modifications, and $180,000 for five years of future attendant care. We also preserved payment of all future medical benefits for our client.

Representative Result #4

Capsule Summary:
Molosky & Co. obtained over $535,000 in no-fault benefits for catastrophically injured minor, including securing a $450,000 arbitration award for suitable barrier-free housing modifications.

Expanded Description:
Molosky & Co. recently filed a lawsuit against the no-fault insurer of a minor catastrophically injured/paralyzed in a 2010 auto accident. Within months of filing the lawsuit, Molosky & Co. quickly secured payment (with penalty interest) of nearly $30,000 in overdue attendant care which the insurer previously failed/refused to reimburse our client’s family. Thereafter, Molosky & Co. negotiated a retroactive rent increase of $800 per month for the partially barrier-free housing accommodations which our client’s grandparents made available to her. In total, Molosky & Co. secured nearly $55,000 in rent for our client/client’s grandparents. Thereafter, Molosky & Co. secured a $450,000 arbitration award against the no-fault insurer (after negotiating a favorable arbitration framework) to resolve our client’s remaining housing accommodation claim.

Representative Result #5

Capsule Summary:
Molosky & Co. successfully battled an insurance company and obtained over $500,000 in past due No-Fault benefits.

Expanded Description:
Molosky & Co. recently represented a man paralyzed in a 1986 auto accident. Though entitled to No-Fault benefits for his care, recovery or rehabilitation, our client struggled for many years to live independently with little to no help from the insurance company. For over twenty five years he relied on the generosity and help of family and friends. When his health took a sudden downward turn, our client could no longer be independent and needed help. He asked the insurance company for a barrier-free home to accommodate his wheelchair, attendant care due to his drastically reduced ability to care for himself, and a modified van necessary for transportation. The insurance company ignored his needs, and delayed and stalled home modifications. However, our client fought with us against the insurer and on the eve of trial, the insurance company agreed to pay not only a $350,000 payment for past due attendant care and home modifications, but also around-the-clock attendant care, temporary accommodations during construction of a new barrier-free home, and a new van.

Representative Result #6

Capsule Summary:
Molosky & Co.’s client triumphed over an insurance company and obtained over $475,000 in No-Fault benefits.

Expanded Description:
A horrific auto accident in 2003 forever altered our client’s life. A quadriplegic entitled to No-Fault benefits for his care, recovery or rehabilitation, he requested the insurance company provide a barrier-free home and a necessary modified van. The insurer failed to replace our client’s old van with a new one and let the auto policy lapse, leaving our client an isolated prisoner in a home woefully unsuitable for a person confined to a wheelchair. For over nine years, the indifferent insurance company delayed and stalled home modifications, essentially waiting for our client to die. However, our client had no such plans. Despite numerous medical issues related to his injury, subsequent hospitalizations, and harassment from the insurance company, with our help, he fought back. Our client received not only a $270,000 settlement for home modifications, but also an agreement that the insurance company pay for utilities, maintenance and repair, property taxes, and insurance for our client’s new, barrier-free home. In addition, our client received a brand new modified van ($80,000), fully insured ($10,000), attendant care, and payment of overdue medical expenses (over $97,000).

Representative Result #7

Capsule Summary:
Our quadriplegic client sues no-fault insurer for continued delay in providing home modifications and negotiates $410,000 settlement.

Expanded Description:
Molosky & Co. represented a severely injured man when his vehicle crashed into the woods. After undergoing spinal surgery and several months of rehabilitation, our client determined to return home to his wife and three sons. Unfortunately, in its current condition, his home is unsuitable. After four home evaluations and 21/2 years, the insurance company failed to provide home modifications, dragging its feet over design and cost. Molosky & Co. filed a Complaint and after a year of extensive discovery, our client received a settlement of $410,000 for home modifications.

Representative Result #8

Capsule Summary:
Molosky & Co. obtains mid-six figure third party no-fault settlement and payment of all outstanding first-party no-fault benefits.

Expanded Description:
Our clients, a modest retired couple, were on their way home when another driver lost control of his speeding vehicle and crashed into our clients’ lawfully operated vehicle. Molosky & Co. quickly ensured payment of all first party no-fault (“PIP”) benefits owed to our clients for injuries suffered in the crash (which, prior to Molosky & Co.’s involvement, the no-fault insurer refused/delayed paying). Molosky & Co. secured PIP benefits including but not limited to over $12,000 in reimbursement for attendant care, replacement services, and medical mileage provided by/to our clients in the immediate 5 months following the crash. In fact, Molosky & Co.’s persistent/professional interactions with the no-fault insurer resulted in a voluntary increase of over $2.00 per hour for all of the attendant care hours provided to/by our clients and payment of an outstanding/overdue $80,000 hospital bill. Once our clients reached their maximum expected medical recovery, Molosky & Co. expertly secured a mid-six figure settlement with the negligent driver (less than twelve months post-crash), with virtually no costs to our clients.

Representative Result #9

Capsule Summary:
Molosky & Co. obtained over $286,000 in no-fault benefits for client, notwithstanding client’s previously executed settlement agreement with insurance company purportedly releasing all future no-fault home modifications.

Expanded Description:
Molosky & Co. recently represented a woman paralyzed in a 1988 auto accident. Though entitled to no-fault benefits for her care, recovery or rehabilitation, the no-fault insurance company refused to reimburse our client for attendant care services at a reasonable rate even though our client actively supervised/managed her attendant care providers, at a fraction of the commercial agency rate. The no-fault insurance company also refused to make medically necessary home modifications, claiming our client was stuck with the home the insurance company paid to build back in 1990. Molosky & Co.’s aggressive handling of the case resulted in the insurance company paying $75,000 for home modifications in addition to purchasing two new lifts, valued in excess of $52,000, to service our client’s basement. Further, the insurance company agreed (contractually) to increase our client’s attendant care payments by over $22,000 per year. Molosky & Co.’s advocacy also resulted in our client obtaining a new claims adjuster.

Representative Result #10

Capsule Summary:
Our client, a test driver for a large automobile manufacturer, was severely injured in an accident at a test driving track in 1994. Despite clear evidence of a need for round-the-clock attendant care, the manufacturer and its insurers never informed our client of the benefits to which he was entitled under No Fault insurance. In October 2012, Molosky & Co. negotiated a settlement paying our client $250,000 for past due attendant care benefits, and an agreement to provide 12 hours per day of attendant care in the future.

Expanded Description:
Our client test drove vehicles for a large automobile manufacturer for 22 years. In 1994, our client crashed while traveling 100 m.p.h. on the test track. The air bag, which should have been disabled during test drives, deployed with enough force to severely whiplash our client's head, neck, and back. After the accident, our client suffered extremely debilitating and dangerous dizziness and vertigo, leaving him unable to drive, prone to walking into walls, and vulnerable to falling without warning. Our client required 8 to 16 hours per day of attendant care, primarily provided by his wife. Despite numerous, specific inquiries over the next 14 years, the auto manufacturer and its insurers never told our client he was entitled to attendant care benefits under No Fault insurance. After major surgery in 2008 to repair degenerative damage in his neck and back, our client first saw the words "attendant care" in a pamphlet at the hospital. When he inquired, the auto manufacturer and its insurers still told him he could only have such benefits for the one year prior to his current inquiry. Then he came to Molosky & Co. We took on the insurers and secured $250,000 for our client for the 18 years of past-due attendant care, and we guaranteed he will have 12 hours of paid attendant care for as long as he needs it in the future.

Representative Result #11

Capsule Summary:
Molosky & Co. triumphed after a seven day jury trial for overdue No Fault benefits securing a judgment exceeding $41,000.00. Additionally, on February 28, 2013, the Judge issued his Opinion and Order granting Plaintiff attorney fees of $187,834.25 and costs of $3,860.90, as a result of the insurance company's unreasonable delay of payment.

Expanded Description:
Our client, a barrier free residential contractor, constructed a barrier free home for a man catastrophically injured in an auto accident. Under Michigan’s No Fault Act, an insurance company is obligated to pay for the medically necessary home accommodations. Prior to completion of construction, the catastrophically injured man passed away. Under an Accord and Satisfaction agreement, the insurance company retained ownership of the home and agreed to complete the home construction. Our client completed the work and presented the insurance company with the Certificate of Occupancy and an invoice for final payment due. The insurance company refused to make full payment, presenting a short punch list of items. The additional items were taken care of, but in the meantime, severe weather and heavy rains resulted in an unexpected power outage, flooding of the property and subsequent moisture and mold damage. The insurance company further enlisted the services of our client to perform water abatement/remediation work, and once again, failed to fully compensate our client. Molosky & Co. conducted numerous depositions; prepared multiple discovery requests; reviewed thousands of pages of documents; and argued many motions, including three motions to compel (receiving Court-ordered attorney fees twice). Molosky & Co. prevailed after a seven day jury trial where eighteen witnesses testified and the Court admitted approximately ninety exhibits.

Representative Result #12

Capsule Summary:
Insurance company refused payment after driver is in an automobile accident and left with a closed head injury.

Expanded Description:
An automobile accident left our client with a closed head injury. Prior to the accident our client was a successful, self-employed, highly motivated, business owner. After filing the lawsuit and conducting discovery, the insurance company acquiesced that our client suffered a closed head injury. This was due to Molosky & Company’s extensive discovery and perseverance in pursuing the insurance company for no-fault benefits payable to the client. Our client received approximately $200,000 for unpaid PIP benefits, attorney fees, and penalty interest.

Representative Result #13

Capsule Summary:
Molosky & Co obtains $200,000 settlement for client who was injured when home-improvement retailer neglected to properly load flatbed cart and assist customer in maneuvering cart.

Expanded Description:
Our client, a successful business owner, entered a home-improvement retail store to purchase, just that, home improvement supplies. Our client sought out a cart and loaded it with those supplies within reach. A store employee finished loading the cart with inaccessible items. The employee stacked all 640 pounds of building supplies against the cart handrail and proceeded to pull the cart to the checkout line. At this point, the employee left our female client to maneuver/pull the overloaded cart through the checkout process. Mimicking the store employee, our client attempted to pull the cart forward. Due to the imbalanced load, the cart buckled and the cart and supplies cascaded down onto our client’s right leg, pinning her to the ground. Molosky & Co. filed suit for economic and non-economic damages suffered as a consequence of the retail store’s negligence. The retailer paid our client $200,000 for pain and suffering.

Representative Result #14

Capsule Summary:
A driver disregarded a stop sign and crashed into a successful business owner who was traveling at approximately 50 mph.

Expanded Description:
Our client, a successful entrepreneur, was traveling through an intersection at 50 mph when the driver of another vehicle failed to stop at the posted stop sign and a classic T-bone collision of two vehicles occurred. Our client was unable to work in or manage her own business. Molosky & Co. filed suit to aid our client in collecting the economic and non-economic damages she suffered as a result of the other driver’s negligence. After conducting extensive discovery and tirelessly pursuing the driver and the owner of the vehicle, Molosky & Co was able to reach an agreement, in which, our client received $185,000 for loss of income and pain and suffering.

Representative Result #15

Capsule Summary:
Our health care provider client received over $175,000 in full payment for treatment of a young man involved in a severe automobile accident.

Expanded Description:
Our client provided treatment to a young man left paralyzed from an automobile accident. Upon invoicing the man’s health insurance, payment was received in full. Shortly thereafter, the same insurance company recalled the payment citing the automobile insurance to be the primary payer. Both insurance companies cited each other as the responsible party from which to seek payment. Molosky and Co. filed suit against the no-fault insurance company because as a no-fault insurance carrier, an individual is entitled to benefits for care, recovery, or rehabilitation resulting from an injury in an automobile accident. Upon our filing the Complaint against the insurance company, our client received full payment, together with penalty interest and our attorney fees of over $175,000 for the care that was provided.

Representative Result #16

Capsule Summary:
Our healthcare provider client received payment of $170,000 from no-fault insurance company for care of automobile accident victim.

Expanded Description:
Our client, a health care provider, sued a no-fault insurance company for non-payment of services provided to a severely injured man in an automobile accident. After exhaustive discovery by Molosky & Co., the health care provider received payment of $170,000 for no-fault benefits improperly withheld for attendant care provided for their patient.

Representative Result #17

Capsule Summary:
Molosky & Co. sues no-fault insurance company and negotiates payment for services performed by health care client.

Expanded Description:
Molosky & Co. recently filed suit on behalf of our health care client for nonpayment of invoices for services provided to an automobile accident victim. The no-fault insurance company unsuccessfully argued that the injuries of the accident victim were pre-existing and therefore, not responsible. Molosky & Co. was able to obtain a favorable settlement for its client.

Representative Result #18

Capsule Summary:
An insurance company refused payment for the medical expenses of a homeless woman hit by a semi.

Expanded Description:
A homeless woman was hit by a semi while crossing the highway and suffered serious injuries. The hospitals where she was treated were not paid by the insurance company responsible for the expenses. Molosky & Company filed suit on behalf of the hospitals for their past due medical services unpaid by the no-fault insurance provider. Due to Molosky & Company’s efforts, the entire past due hospital bills, approximately $102,000, was obtained in payment of past due no-fault benefits.

Representative Result #19

Capsule Summary:
No-fault insurance company refuses payment to health care provider citing insured’s lack of Michigan domicile.

Expanded Description:
Our health care client provided services to the victim of an automobile crash. The no-fault insurance company refused payment arguing that the insured did not maintain a domicile in the state of Michigan. Molosky & Co. filed suit on behalf of our client to collect payment for the unpaid medical bills. The Court granted our Motion for Summary Disposition and the insured immediately paid the entire $83,000 past due account to our client.

Representative Result #20

Capsule Summary:
An insurance company refused to pay our client’s no fault benefits, including medical and immediately needed surgery expenses, wages lost, replacement services, and attendant care. Molosky & Co. filed a complaint against the insurance company on several counts and ultimately settled out of court for a mid-five-figure sum.

Expanded Description:
Our client was involved in a rear-end motor vehicle accident that caused severe and debilitating injuries, specifically to his back, shoulders, neck, arms and head. These injuries hampered our client’s ability to continue his career in professional boxing and his ability to perform even simple motions such as lifting and bending. For nearly two years, our client’s insurance company denied our client’s claim for benefits. Our client needed immediate shoulder surgery, so Molosky & Co. sued the insurance company for our client’s no-fault benefits and negotiated an immediate payment for the surgery, all future medical benefits, and a significant five-figure payment for all past due benefits, including all of our attorney fees and costs.

Representative Result #21

Capsule Summary:
Rider on horseback injured when horse struck by emergency vehicle. Insurance company sought to manipulate benefits.

Expanded Description:
Our client was severely injured when, a driver of a vehicle in a medical emergency struck the horse she was riding, killing the horse, and causing extensive injuries to the client including paralysis. The insurance company attempted to force our client into accepting less attendant care in exchange for paying for overages caused by the contractor for her home modifications. Molosky & Co. filed suit for denied/unpaid attendant care monies. As a result of aggressive action by Molosky & Co., a facilitation settlement resulted in $45,000 for back attendant care and an agreement to choose a mutual occupational therapist to assess our client’s home. The insurance company also agreed to pay for 4 hours of daily attendant care until completion of the assessment.

Representative Result #22

Capsule Summary:
Durable medical equipment supplier receives payment of over $35,000 from no-fault insurance company.

Expanded Description:
A wheel-chair bound man with cerebral palsy was injured after falling from his vehicle lift. As a result of the accident, certain durable medical equipment became necessary. Our client, a DME supplier met those needs by providing the prescribed equipment. When invoiced by our client, the no-fault insurance company denied and delayed payment for the equipment citing the items were not related to the accident. With the intervention of Molosky & Co., our client received over $35,000 in payment for the equipment provided.

Representative Result #23

Capsule Summary:
No-fault insurance company pays durable medical equipment provider approximately $34,000 in denied payments.

Expanded Description:
As the result of an automobile accident, a woman suffered accidental bodily injuries. Due to no insurance being available, the accident victim was assigned to a no-fault insurance company through the Michigan Assigned Claims Facility. Under this assumption, our DME client provided the necessary medical products, services and accommodations to its client. Upon invoicing the insurance company, payment was improperly withheld. Molosky & Co. filed suit against the no-fault insurance company and collected payment, including penalty interest and attorney fees over $34,000.

Representative Result #24

Capsule Summary:
Molosky & Co. sues no-fault insurance company for denied benefits and collects approximately $33,000 for client.

Expanded Description:
Our client’s three year old granddaughter sustained catastrophic injuries while riding in the backseat of her grandparents’ car. As a result of the accident, the victim requires barrier-free accommodations for care, recovery, and rehabilitation. To provide this care for her granddaughter, our client moved out of her home and into an apartment. Our client then submitted invoices for rent expense, an allowable benefit under the no-fault act, to the insurance company. The insurance company denied payment for the rent expense as invoiced, quoting our client a much lower rate. However, the insurance company failed to reimburse our client at this new rate. Molosky & Co. filed suit, aggressively pursuing the insurance company collecting approximately $33,000 in unpaid benefits, attorney fees, and penalty interest for its client.

Representative Result #25

Capsule Summary:
Molosky & Co. collects $25,000 from no-fault insurer in payment for services provided by health care provider client.

Expanded Description:
A man was severely injured and suffered paralysis in a motor vehicle accident. Prior to the accident, the man was an avid outdoorsman, hunter, and fisherman. Our client, a medical supply company, provided the man with power wheelchairs, including an all-terrain outdoor power wheelchair which allowed the man to safely return to his pre-accident activities. Upon billing for these services, the no-fault insurance company made a partial payment to our client (alleging the full amount our client charged for this medically necessary equipment was unreasonable), leaving an outstanding balance of approximately $15,000. Molosky & Co. successfully recouped the $15,000 balance and also negotiated an additional $10,000 in attorney fees as part of the settlement with the no-fault insurance company.

Representative Result #26

Capsule Summary:
Durable medical equipment provider receives payment of over $21,000 from no-fault insurance company.

Expanded Description:
Our client, a durable medical equipment supplier, sued a no-fault insurance company for non-payment of supplies provided to an automobile accident victim. After filing suit, Molosky & Co. collected over $21,000 in payment of improperly withheld no-fault benefits for its client.

Representative Result #27

Capsule Summary:
Automobile accident victim receives policy limit from third-party no-fault insurance company.

Expanded Description:
Our client was stopped at a traffic light when a distracted driver crashed into the vehicle behind our client. The momentum from the impact of the crash drove this vehicle into our client’s vehicle causing our client to sustain multiple injuries. After several months of Molosky & Co.’s pursuit of the third-party no-fault insurance company, our client received payment of the wrongful driver’s full insurance policy available.

Representative Result #28

Capsule Summary:
Hospital sues no-fault insurance company and collects for services provided.

Expanded Description:
Our health care provider client performed surgery on an automobile accident victim. Since the patient informed our client that the injuries were the result of a motor vehicle accident, our client billed the no-fault insurance carrier. The insurance company denied payment asserting the patient had redeemed Worker’s Compensation benefits relieving the insurance company’s obligation to pay no-fault benefits. Under the Workers’ Disability Compensation Act, if an injured worker redeems the WDCA case, the no-fault insurer is entitled to offset all workers’ compensation benefits available, regardless of the redemption amount. However, the no-fault insurer is still responsible for any benefits in excess of worker’s compensation requisite payments. Molosky & Co. relentlessly pursued the insurance company and collected payment for services rendered by our client.

Representative Result #29

Capsule Summary:
Healthcare provider sued no-fault insurance company for unpaid services to company’s policyholder.

Expanded Description:
Our health care provider client sued a no-fault insurance company for non-payment of services provided to permanently injured man following an automobile accident. The no-fault insurance company failed to pay for attendant care services rendered to a catastrophically injured man. Molosky & Co. successfully sued and collected payment, including penalty interest and attorney fees of approximately $14,000.

Representative Result #30

Capsule Summary:
Molosky & Co. sued a no-fault insurance company for withholding payment of services provided by our health care provider client to a man left paralyzed after an automobile accident.

Expanded Description:
Molosky & Co. recently represented a health care provider that rendered services to a victim of an automobile accident. Upon providing reasonably necessary services to this severely injured man, our client invoiced the no-fault insurance company. Although the insurance company knew the injuries were a result of the automobile accident, it withheld payment to our client. Molosky and Co. filed suit against the insurance company and was able to award our client with full payment, together with penalty interest and our attorney fees of approximately $14,000.

Representative Result #31

Capsule Summary:
Molosky & Co. obtains full resolution of No-Fault providers’ claims for reimbursement against No-Fault insurance carrier which improperly delayed/denied tens of thousands of dollars in payment for over 9 months.

Expanded Description:
Our clients are 3 No-Fault medical service providers (Attendant Care Agency, Case Manager, and Occupational Therapist) who provided services to a No-Fault insured for her care, recovery, and/or rehabilitation. The No-Fault insurance carrier abruptly stopped paying for all No-Fault benefits, purportedly based on the insurance adjustor’s “hunch” the underlying medical diagnosis supporting the claim was invalid. Thereafter, the No-Fault insurance adjustor refused to reimburse our clients for their services pending the scheduling and completion of an independent medical evaluation of the insured, which still had not been completed 9 months later. Within 1 week of receipt of Molosky & Co.’s demand letters, the No-Fault insurance carrier agreed to pay our demand in full, without any further expense or inconvenience to our clients.

Representative Result #32

Capsule Summary:
Durable medical equipment provider receives payment of over $13,000 in denied no-fault payments.

Expanded Description:
As the result of an automobile accident, a man sustained bodily injuries. Our DME supplier client provided the necessary medical products, services and accommodations to its client. Upon invoicing the no-fault insurance company, payment in full was denied. Molosky & Co. filed suit against the no-fault insurance company and negotiated payment in full of over $13,000 for its client.

Representative Result #33

Capsule Summary:
Molosky & Co. collects $13,000 from no-fault insurer in payment for services provided by health care provider client.

Expanded Description:
A 15 years old boy was struck by a car while riding a bicycle. The boy suffered lifelong catastrophic injuries as a result, including quadriplegia. Our client, a medical supply company, provided the now-man with medically necessary products and services related to his auto accident injuries. Upon billing the man’s no-fault insurance company for these products and services, the insurance company made a partial payment to our client, denying the balance for reasons including that our client provided products and services which were allegedly “not reasonable and necessary for the injured-man’s care, recovery, or rehabilitation,” as required under Michigan’s No-Fault Insurance Act. After filing a lawsuit on our client’s behalf, the no-fault insurance company initially offered $0.00 during a Court ordered facilitation. However, Molosky & Co. was persistent and aggressive, ultimately collecting $13,000 from the no-fault insurance company for our client’s services.

Representative Result #34

Capsule Summary:
Molosky & Co. sues no-fault insurance company for denied payment to its health care provider client and collects over $10,000.

Expanded Description:
Our client provided case management services to the victim of a motor vehicle accident. At this time, the no-fault insurance company confirmed with our client that it would be responsible for the payment of claims. Four months after the automobile accident, the no-fault insurance company, in writing, still confirmed that it would be the administrator for the claims. However, when our client submitted invoices for payment of services, the insurance company refused payment citing the policyholder had discontinued coverage four days prior to the accident. Molosky & Co. filed suit against the no-fault insurance company for misrepresentation and has collected over $10,000 in payment for our client.

Representative Result #35

Capsule Summary:
Health care provider collects over $9,000 from no-fault insurance company.

Expanded Description:
Our health care provider client sued a no-fault insurance company for non-payment of services provided to a woman severely injured in an automobile accident. The no-fault insurance company failed to pay for the medically necessary/prescribed services rendered to this catastrophically injured woman. Molosky & Co. successfully collected payment in full of over $9,000 for its client.

Representative Result #36

Capsule Summary:
Molosky & Co. collects $8,500 from no-fault insurer in payment for services provided by health care provider client.

Expanded Description:
A woman was severely injured when the driver of a semi-truck jack-knifed, crossed into the oncoming lane and smashed into her car. After spending five weeks in a coma and another eight months in a neurological rehabilitation center, attendant care and case management services were prescribed. Our client provided the necessary case management services to its client. Upon billing for these services, the no-fault insurance company refused payment to our client alleging case management services were not necessary and disputing the amount billed by our client. At the request of the insurance company, two different independent medical examinations were completed. Both physicians supported the current treatment of case management services. As to overbilling, our client’s rates are similar to those in area. With the assistance of Molosky & Co., our client sued the no-fault insurance company and collected $8,500 for its services.

Representative Result #37

Capsule Summary:
With assistance from Molosky & Co., our health care provider client sued a no-fault insurance company for receipt of denied services.

Expanded Description:
A passenger of a vehicle was left in critical condition following the collision of two vehicles. As a result of the no-fault insurance carried by the vehicle owner, he is entitled to reasonably necessary products, services and accommodations for his care, recovery, or rehabilitation. Our client, who offers these types of services to injured individuals, provided the man with such care and billed the no-fault insurance company for payment. The insurance company, in turn, made a partial payment to our client for its services and denied the balance. Molosky & Co. was persistent in its pursuit of the insurance company and was able to acquire full payment of $8,500 for our client.

Representative Result #38

Capsule Summary:
Molosky & Co. collects $6,500 from no-fault insurer in payment for services provided by health care provider client.

Expanded Description:
Our client is a Northern Michigan-based case management services company which provides state-wide case management services for catastrophically injured no-fault patients. Our client invoiced a no-fault insurance company approximately $7,900 for case management services (including travel time and mileage) for services provided to a patient in Southeastern Michigan. The no-fault insurance company originally refused to reimburse any amount of our client’s invoices claiming they were neither reasonable nor necessary, and were allegedly exorbitant. However, after filing a lawsuit on our client’s behalf and taking a pro-active aggressive posture throughout the pre-trial stage of the lawsuit, Molosky & Co. quickly secured a $6,500 settlement payment from the insurance company, saving our client from the time/expense/uncertainty of a jury trial.

Representative Result #39

Capsule Summary:
Molosky & Co. successfully represented our catastrophically injured client after his insurer refused to pay No Fault benefits.

Expanded Description:
Molosky & Co. served as co-counsel in a No Fault lawsuit filed on behalf of our client, a young man who was catastrophically injured (quadriplegic with significant closed head injury) in an auto accident. Our client's insurer denied coverage based on a technicality in his father's insurance contract that was irrelevant to the accident. This young man needed tens of thousands of dollars for hospitalization and critical care, but the insurance company weaseled their way out of paying our client the claim money he deserved as an insured individual. We sued for breach of contract, common law fraud and misrepresentation, fraudulent concealment, common law silent fraud, violation of Michigan Consumer Protection Act, estoppel, violation of Unfair Trade Practices Act, conspiracy and fraud, and exemplary damages. Molosky & Co. helped our client receive all the money needed to pay for his hospitalization and care through the recovery and rehabilitation process.

Representative Result #40

Capsule Summary:
In wake of the Admire decision, Molosky & Co. successfully negotiates Transportation Purchase Agreement with No-Fault insurance carrier for “base” purchase price of van plus the cost of aftermarket modifications.

Expanded Description:
Our client is a catastrophically injured auto accident victim who suffers from paraplegia. She previously obtained a modified van through her No-Fault insurance carrier years before Admire v Auto-Owners Insurance Co, 494 Mich 10 (2013) was decided. Notwithstanding the Michigan Supreme Court’s Admire decision (which held a No-Fault insurance carrier not responsible for reimbursing the base cost of a to-be modified vehicle), Molosky & Co. secured No-Fault reimbursement for the purchase of our client’s van, plus the cost of after-market modifications specific to our client’s injuries. Molosky & Co. further negotiated language in our client’s Transportation Purchase Agreement preserving her claims for additional transportation benefits beyond the operational lifespan of the new, modified van.

Representative Result #41

Capsule Summary:
Molosky & Co. prevailed at trial in recovering amounts due to our client under Michigan's No Fault Act after an insurance company refused to pay for transportation services our client provided to its catastrophically injured insured.

Expanded Description:
Our client operates a transportation company serving catastrophically injured individuals. After providing transportation services related to the care, recovery and rehabilitation for an individual who was catastrophically injured in a motor vehicle accident and qualified for Personal Injury Protection benefits through a no fault insurance policy, our client submitted its invoices to the insured's insurance company. Asserting an array of inconsistent positions ranging from the payment was already made through a prior settlement to the transportation services were not compensable under the No Fault Act, the insurer refused to pay our client. Molosky & Co. sued the insurer on behalf of our client and following a two-day jury trial our client prevailed on all counts.

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