COA 375649 SNM PHYSICAL THERAPY LLC V CITIZENS INSURANCE COMPANY OF THE MIDW Opinion - Per Curiam - Unpublished 7/17/2026

If this opinion indicates that it is “FOR PUBLICATION,” it is subject to
revision until final publication in the Michigan Appeals Reports.
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S T A T E O F M I C H I G A N
C O U R T O F A P P E A L S
SNM PHYSICAL THERAPY LLC,
Plaintiff-Appellant,
UNPUBLISHED
July 17, 2026
11:09 AM
v No. 375649
Wayne Circuit Court
CITIZENS INSURANCE COMPANY OF THE
MIDWEST,
LC No. 23-015596-NF
Defendant-Appellee.
Before: GADOLA, C.J., and BOONSTRA and CAMERON , JJ.
PER CURIAM.
Plaintiff, SNM Physical Therapy LLC, appeals as of right the trial court’s order granting
defendant, Citizens Insurance Company of the Midwest, summary disposition under MCR
2.116(C)(10). We affirm.
I. FACTS
Ilham Elrahazoui was involved in a motor vehicle collision on September 25, 2022, and
allegedly was injured. At the time of the collision, Elrahazoui was insured under a policy of no-
fault insurance issued by defendant. After the collision, plaintiff treated Elrahazoui with
Nervomatrix/Trigger Point Impedance Imaging (TPII). The treatment is intended to provide back
pain relief by using “Electric Hyperstimulation Analgesia to targeted myofascial trigger points
identified through a proprietary algorithm that measures skin impedance.” Elrahazoui thereby
incurred medical expenses allegedly totaling $140,300. Elrahazoui allegedly assigned her claim
for payment to plaintiff, and plaintiff submitted the claim to defendant for payment. Defendant
denied payment on the basis that plaintiff had failed to present evidence that the TPII treatment
was medically efficacious.
Plaintiff initiated this action seeking payment for the medical expenses under MCL
500.3157. Defendant moved for summary disposition under MCR 2.116(C)(10). Defendant
argued that it was not obligated to pay for the TPII services because plaintiff had not presented

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medical proof that the Nervomatrix/TPII treatments were efficacious and thus reasonably
necessary for Elrahazoui’s care as required under Krohn v Home-Owners Ins Co, 490 Mich 145;
802 NW2d 281 (2011). Defendant supported its motion with the opinion of Dr. Adil Ali who
asserted that use of the Nervomatrix device was not a generally accepted medical treatment. Dr.
Ali opined that the algorithm by which the device allegedly detects trigger points in a patient is
unknown, making it impossible to verify whether and how the device is performing its asserted
function, and that
[T]here is no definitive scientific medical basis for how the Soleve Nervomatrix
device detects trigger points and functions to provide pain relief. Finally, there is
no objective and verifiable medical evidence that the use of the Soleve Nervomatrix
device is efficacious for the treatment of acute or chronic painful neurological and
musculoskeletal conditions, particularly low back pain or painful myofascial trigger
points.
The Gorenberg study was an uncontrolled pilot study that did not demonstrate that
the Nervomatrix device is superior to placebo. . . . The Ferrandiz study
demonstrated that the Soleve Nervomatrix device does not result in a better
outcome than placebo-treatment in terms of pain, pain behavior, functioning,
central sensitization, pain catastrophizing, and health benefits.
The clinical value of the Soleve Nervomatrix device has not been established.
There is no definitive scientific medical basis for how the Soleve Nervomatrix
device detects trigger points, or that the trigger points that it identifies exist.
Therefore, there is no evidence that the Soleve Nervomatrix device treats anything
at all. The Soleve Nervomatrix device is not the accepted medical standard for
diagnosing and treating acute or chronic painful neurological and musculoskeletal
conditions, particularly low back pain or painful myofascial trigger points.
Dr. Ali further opined that the studies ostensibly establishing the efficacy of the Nervomatrix
device were funded by the manufacturer of the device, and that no other placebo-controlled study
documented the efficacy of the device. Defendant also supported its motion with a study finding
that treatment with the Nervomatrix device was not superior to placebo in a randomized clinical
trial. Defendant argued that it anticipated that plaintiff would rely on the report of Dr. William
McGee, which was based upon studies done by the manufacturer of the Nervomatrix/TPII device.
Plaintiff responded to the motion relying upon the report and affidavit of Dr. William
McGee, which in turn relied in part upon the Gorenberg and the Ferrandiz studies. Dr. McGee
described generally the algorithm by which the Nervomatrix purportedly identified trigger points
and opined that “this sophisticated algorithm allows for precise identification of MTPs, which is
crucial in developing targeted treatment strategies for low back pain. By pinpointing these specific
areas of pain generation, the device enables more focused and effective therapeutic interventions.
Dr. McGee further stated:
By targeting the underlying neurophysiological mechanism of the nervous system
in pain processing and tissue healing, this technology offers a novel approach to
pain management and rehabilitation. The device’s ability to identify and treat MTPs

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with precision addresses a critical aspect of low back pain that is often overlooked
in conventional treatments. . . . Additional research and larger clinical trials are
recommended to further establish the device’s efficacy and integration into
standard therapeutic protocols for soft tissue lesions to define the full potential of
the Nervomatrix technology and its integration into clinical practice.
The trial court granted defendant’s motion for the reasons stated in defendant’s motion and
supporting brief. Plaintiff now appeals.
II. DISCUSSION
Plaintiff contends that the trial court erred by granting defendant summary disposition of
plaintiff’s claim. Plaintiff argues that the Nervomatrix/TPII treatment is not experimental and also
that it presented objective evidence that the Nervomatrix/TPII treatment was efficacious and
thereby created a genuine issue of material fact. We disagree that the trial court erred.
We review de novo the trial court’s order granting summary disposition. Jostock v
Mayfield Twp, 513 Mich 360, 368; 15 NW3d 552 (2024). A motion for summary disposition under
MCR 2.116(C)(10) tests the factual sufficiency of the claim and is warranted when there is no
genuine issue of any material fact. El-Khalil, Inc v Oakwood Healthcare, Inc, 504 Mich 152, 160;
934 NW2d 665 (2019). In considering the trial court’s grant or denial of a motion for summary
disposition under MCR 2.116(C)(10), we consider the documentary evidence submitted by the
parties and view it in the light most favorable to the non-moving party. We will find a genuine
issue of material fact if the record leaves open an issue on which reasonable minds might disagree.
Id. We also review de novo the application and interpretation of statutes, which are questions of
law. Krohn, 490 Mich at 155.
Under the no-fault act, MCL 500.3101 et seq, personal protection insurance benefits are
payable for “[a]llowable expenses consisting of reasonable charges incurred for reasonably
necessary products, services and accommodations for an injured person’s care, recovery, or
rehabilitation.” MCL 500.3107(1)(a). The services for which payment of benefits is sought must
be both (1) objectively reasonable and (2) necessary for an insured’s care, recovery or
rehabilitation. Krohn, 490 Mich at 163. A treatment that is experimental and not generally
accepted in the medical community is not reasonable or necessary under the no-fault act unless it
is demonstrated to be efficacious. Id. at 148. In Krohn, our Supreme Court explained that
[I]f a medical treatment is experimental and not generally accepted within the
medical community, an insured seeking reimbursement for this treatment must, at
a minimum, present objective and verifiable medical evidence establishing that the
treatment is efficacious. A treatment or procedure that has not been shown to be
efficacious cannot be reasonable or necessary under the no-fault act. An insured’s
subjective belief that medical treatment is efficacious, reasonable, and necessary is
not enough to create a question of fact. [Krohn, 490 Mich at 148.]
The Supreme Court in Krohn further explained that “the term ‘reasonably’ must be
determined under an objective perspective.” Krohn, 490 Mich at 160. If a plaintiff fails to
demonstrate that an expense was incurred for a reasonably necessary product or service, a court

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may not find that an insurer breached its duty to pay that expense. Nasser v Auto Club Ins Ass’n,
435 Mich 33, 50; 457 NW2d 637 (1990).
Generally, it is a question of fact whether the services or products provided were reasonably
necessary. Krohn, 490 Mich at 157-158. However, in some cases, it may be possible for the trial
court to decide the reasonableness or necessity of an expense as a matter of law. Id. at 158. A
procedure or treatment accepted by the medical community is more likely to be presumed
necessary than a treatment that is either experimental or otherwise not generally accepted by the
medical community. See id. In either scenario, the question is whether the treatment in question
was reasonably necessary for the patient’s care, recovery or rehabilitation. Id. at 159. And in
either scenario, the burden of proving that a service is reasonably necessary lies with the plaintiff.
See Nasser, 435 Mich at 50. To summarize, when a treatment is experimental the plaintiff must
demonstrate the reasonableness of the treatment by demonstrating that the treatment is efficacious,
and the efficacy must be demonstrated by objective and verifiable medical evidence. Krohn, 490
Mich at 163-164. We also note that when reviewing a trial court’s decision regarding a motion for
summary disposition under MCR 2.116(C)(10), we consider the substantively admissible evidence
actually proffered in opposition to the motion rather than considering the mere possibility that a
claim might be supported by evidence if the case were to proceed to trial. Maiden v Rozwood, 461
Mich 109, 121; 597 NW2d 817 (1999).
In this case, plaintiff sought payment from defendant for Nervomatrix/TPII treatments that
Elrahazoui received from plaintiff. Plaintiff asserts that the treatment is accepted in the medical
community and that its claim was supported by the report of Dr. McGee. While supporting the
use of the Nervomatrix, however, Dr. McGee also described the Nervomatrix treatment as “novel,”
as an addition to “conventional” treatments, and as requiring additional research to ascertain its
efficacy. Defendant presented evidence that certain of the studies upon which Dr. McGee’s report
relied were conducted by the manufacturer of the Nervomatrix device and that the studies do not
demonstrate that treatments with the Nervomatrix device produced better results than placebo
treatment. Plaintiff in response did not demonstrate before the trial court that the treatment was
accepted in the medical community, nor did plaintiff demonstrate the efficacy of the treatment.
The trial court therefore did not err by determining that plaintiff did not create an issue of fact
regarding whether the treatment was objectively reasonable and necessary.
Whether an expense is “reasonably necessary” is assessed by an objective standard.
Krohn, 490 Mich at 178. Based on the record before us, the trial court was within its authority to
determine as a matter of law that plaintiff failed to present evidence that the Nervomatrix/TPII
treatment administered to Elrahazoui was efficacious and thus failed to demonstrate that the
treatment was objectively reasonable or necessary. The trial court therefore did not err by granting
defendant summary disposition of plaintiff’s claim.
Affirmed.
/s/ Michael F. Gadola
/s/ Mark T. Boonstra
/s/ Thomas C. Cameron

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