Most people assume that once a medical bill is paid out of a personal injury settlement, it’s over. The case is closed, the check is signed, the file is done.
In some cases in Michigan, that assumption costs real money.
Personal injury settlements in Michigan — whether from a car accident in Grand Rapids, a slip and fall in Lansing, or a medical injury in Detroit — often involve a final step that gets very little attention: resolving outstanding medical bills. Hospitals, providers, and sometimes third-party debt collection agencies assert claims against the settlement. Those claims get paid to close the case. Most people never look back.
But federal law and Michigan law both set limits on what medical providers can legally collect from a patient. When those limits aren’t applied — and they often aren’t at the end of a case — money that should have stayed in a client’s pocket ends up somewhere else.
“In Michigan, medical bills are resolved at the end of cases every day, and most of the time the process works. But sometimes charges are paid without a full evaluation of whether they were lawful. The goal is simple: make sure people — and their lawyers — do not pay more for medical bills than the law allows.”
— Rob Buchanan, Buchanan Firm
Rob has handled serious personal injury and medical malpractice cases across Michigan since 1995. The quote above isn’t theoretical — it comes from three decades of watching how settlements actually close, and what gets missed when everyone is focused on distributing funds and ending the file.
How Medical Bills End Up in Your Settlement — The Mechanics Most Clients Never See
By the time a personal injury case settles, most clients are focused on one thing: receiving what they’ve earned after months or years of waiting. That’s exactly when medical billing gets the least scrutiny — and when the most goes unexamined.
Here’s how it typically works.
A hospital or provider treats you after an injury. They bill your health insurance or Medicaid and receive a partial payment. If the provider believes a balance remains, they have two options: continue billing you directly, or assign — or outright sell — the account to a third-party debt collection agency.
That collection agency then asserts a claim against your pending personal injury settlement. At closing, when everyone is focused on distributing funds and ending the file, that claim gets paid to clear the case.
The names on those collection letters are often the same ones appearing in Michigan settlements across the state: DCM Services, Revco Solutions, United Collection Bureau, The Rawlings Company. If you’ve received a letter from any of these companies in connection with a personal injury case, you’re seeing this process in action.
What rarely gets examined in that closing window is whether the amount being claimed was ever legally owed.
Leslie Caliguri, Senior Paralegal at Buchanan Firm, has guided clients through settlement distributions for years. She describes what that moment actually looks like from the inside:
“When a case resolves, clients are often asking, ‘What do I do with this money?’ There’s a lot going on at that stage. A lot of times it’s people who have never had money and now have a lot of money. We try to make sure they’re set up.”
That’s the window. Client attention is on receiving funds and figuring out what comes next. The billing audit — whether each charge actually complied with federal and Michigan law — is the thing that gets skipped. Not out of negligence, but because closing pressure is real and nobody flags it as a step.
What Federal and Michigan Law Actually Limit — And Why It Matters for Your Settlement
Most content about the No Surprises Act frames it as a consumer protection. For personal injury settlements, it functions as something more specific: a legal ceiling on what a provider can claim against your settlement funds.
The law took effect in January 2022 and covers the situations where patient choice is removed — emergency treatment, care from out-of-network providers at in-network facilities, and air ambulance transport. In all of these situations the rule is direct: a provider cannot bill you beyond what your health insurer paid. Your financial responsibility ends there, and so does their legal claim against your settlement.
The NSA does not cover elective procedures, scheduled out-of-network care, or most outpatient situations where you had a meaningful opportunity to choose your provider. If your treatment falls into one of those categories, a different analysis applies.
Michigan then adds a sharper edge through Public Act 234 of 2020. Under PA 234, before charging anything above what your insurer paid, a Michigan provider must obtain written patient consent — before care is delivered. Not in discharge paperwork. Not after the fact. Before.
If that consent was never obtained, the charge above the insurer rate is legally unenforceable. And when that debt gets sold to a collection agency, the agency inherits whatever legal authority the original provider had.
If the provider never cleared the consent requirement, the collection agency isn’t pursuing a disputed bill. They’re pursuing one the law never permitted.
That distinction almost never gets examined at case closing. In Michigan emergency rooms from Grand Rapids to Detroit, the treatment that triggers a personal injury claim is almost always exactly the kind of no-choice care both laws were written to protect.
When a Collection Agency Takes From Your Michigan Settlement
What the collection agency cannot do is collect more than the original provider was legally entitled to collect. If the underlying charge violated the No Surprises Act or Michigan PA 234 — because it exceeded what insurance paid, or because the required pre-service written consent was never obtained — the collection agency inherited a claim the law never permitted.
Under the Fair Debt Collection Practices Act, attempting to collect a debt that isn’t legally owed is a federal violation. That layer of protection applies regardless of whether the original provider or a third-party collector is pursuing the balance.
“When someone shares a story, I have an immediate feeling if something sounds ‘off’ and needs further investigation. We determine not only whether something went wrong but whether what’s being claimed actually holds up.”
— Leslie Caliguri, Senior Paralegal, Buchanan Firm
That instinct applies directly here. A collection letter arriving at settlement looks routine. It almost always gets paid without question. The compliance review — whether the charge ever cleared federal and state law — is the step that gets skipped.
Unjust Enrichment: The Legal Theory That May Let You Get Money Back
If a payment was made on a charge that wasn’t legally owed, Michigan law may provide a path to recover it.
The legal theory is called unjust enrichment. In plain terms: if someone received money they were not legally entitled to keep, a court may require them to return it. Michigan courts recognize these claims where retaining the payment would be inequitable — where the money changed hands without a lawful basis for the transfer.
Applied to medical billing in a personal injury settlement, the analysis is straightforward in structure: was the charge lawful under federal and Michigan law? Was the payment made without a full evaluation of whether the charge complied? If yes to both, the question of recovery is worth examining.
This is not a blanket argument that every paid medical bill is recoverable. Most are not. The legal requirements are specific, the facts matter, and not every situation clears the bar.
“In order to do plaintiff’s work, you really have to be able to establish all the requirements. Otherwise, it doesn’t make sense to take the case.”
— Rob Buchanan, Buchanan Firm
The same framework applies here. Liability, causation, damages — if the elements aren’t there, the analysis ends. The goal is orientation, not alarm. But in the right circumstances, the question is worth asking before assuming the payment was final.
What to Check Before Assuming Your Settlement Was Final
If any of the following apply to your Michigan personal injury settlement, the billing compliance question was likely never asked.
- The treatment involved emergency care or an out-of-network provider at an in-network facility — the exact situations the No Surprises Act was written to cover.
- The amount paid to the provider or collection agency was significantly higher than what your health insurer paid or was billed.
- A third-party collection agency — not the original hospital or provider — was the one asserting the claim at settlement.
- No written pre-service consent was ever obtained authorizing charges above your insurer's rate, as required under Michigan PA 234.
- The bill was paid under time pressure at the end of the case, without a line-by-line review of whether each charge complied with federal and state law.
None of these factors mean something was done wrong. They mean the question hasn’t been fully answered yet.
“Our entire review process is completely free. Even if we review the medical records and we ultimately don’t take on your case, it’s still no charge to you.”
— Caiti Hill, Intake Coordinator, Buchanan Firm
There’s no cost to asking. That matters for people who settled a case months or years ago and aren’t sure whether re-engaging an attorney makes sense.
How Buchanan Firm Approaches These Questions
Buchanan Firm reviews complex medical records and billing in serious personal injury, vehicle accidents and medical malpractice cases across Michigan. The same analytical approach — the same evaluation of whether a claim holds up legally — applies when the question involves what was paid at settlement and whether it was ever legally required.
Most medical bills paid at the end of a personal injury case are resolved appropriately. Some aren’t. The cases worth examining are specific, and the analysis is case-by-case.
If you settled a personal injury case in Michigan — in Grand Rapids, Detroit, Lansing, Kalamazoo, or anywhere else in the state — and a medical bill or collection agency claim was paid from your settlement, the question Rob Buchanan has been asking for three decades still applies:
Was that amount actually owed?
Leslie Caliguri has worked alongside Rob at Buchanan Firm for years, guiding clients from intake through settlement and beyond. Her description of how the firm operates after a case closes is the most direct answer to the question this blog started with:
“I refer to myself as a problem solver. Even after a case closes, I’m still here. That’s just how we operate.”
— Leslie Caliguri, Senior Paralegal, Buchanan Firm
Frequently Asked Questions
Can I get money back after a medical bill has already been paid from my settlement?
In some circumstances, yes. If the charge didn’t comply with the No Surprises Act or Michigan PA 234 — and money was paid on it anyway — Michigan’s unjust enrichment doctrine may provide a path to recover it. Not every situation qualifies. The facts of the billing, the type of treatment, and whether proper consent procedures were followed all matter. The first step is understanding whether the charge was ever legally collectible.
Does the No Surprises Act apply to my Michigan personal injury case?
It depends on the type of treatment. If your care involved an emergency, an out-of-network provider at an in-network facility, or air ambulance transport, the NSA likely applies and caps what the provider can legally claim from your settlement. If your treatment was elective or scheduled with a known out-of-network provider, a different analysis is required.
What is Michigan PA 234 and how does it affect my medical bills?
Public Act 234 of 2020 is Michigan’s state-level surprise billing protection. It requires providers to obtain written patient consent before charging anything above what your insurer paid — and that consent must happen before care is delivered. If a Michigan provider never obtained that consent, the excess charge is legally unenforceable, regardless of whether a collection agency is now pursuing it.
A collection agency is claiming money from my settlement. Do I have to pay it?
Not automatically. A collection agency can only collect what the original provider was legally entitled to collect. If the underlying charge violated federal or Michigan law, the agency inherited an invalid claim. Under the Fair Debt Collection Practices Act, attempting to collect a debt that isn’t legally owed is a federal violation.
How do I know if a collection agency like DCM Services or The Rawlings Company had a valid claim against my settlement?
The starting point is understanding whether the original treatment falls under NSA or PA 234 protections, whether pre-service consent was obtained, and whether the amount claimed exceeded what insurance paid. If a third-party collector was involved and the charge was never reviewed for legal compliance, those are the questions worth asking.
How long do I have to raise these issues in Michigan?
Statutes of limitations vary depending on the specific legal theory and facts involved. If you believe a billing claim paid from your settlement may not have been legally owed, it’s worth raising the question sooner rather than later. Time limits can foreclose otherwise valid claims.
Does it cost anything to have Buchanan Firm review my situation?
As Caiti Hill, the firm’s intake coordinator, puts it: “Our entire review process is completely free. Even if we review the medical records and we ultimately don’t take on your case, it’s still no charge to you.”
Tell Us Your Story
If a medical bill or collection agency claim was paid from your Michigan personal injury settlement — and you’re not sure whether that amount was ever legally owed — we want to hear what happened.
You don’t need a complete picture to reach out. You don’t need to know whether the No Surprises Act applies, whether PA 234 was followed, or whether a collection agency had a valid claim. That’s the review process. Your job is to share what you experienced.
Tell us the basics: the type of injury, where treatment happened, which companies or agencies were involved at settlement, and what felt off — if anything did. Leslie and the team will take it from there.
There’s no charge to have your situation reviewed. No obligation. No pressure. If the question is worth pursuing, we’ll tell you. If it isn’t, we’ll tell you that too.