Citizens Insurance Company of America v Stiles; (COA-PUB, 6/13/1990; RB #1384)

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Michigan Court of Appeals; Docket No. 114379; Published  
Judges Holbrook, McDonald, and Jansen; Unanimous; Per Curiam 
Official Michigan Reporter Citation:  185 Mich App 140; Link to Opinion alt  


STATUTORY INDEXING:  
Coordination with Other Health and Accident Medical Insurance [§3109a] 
Duplicate Recovery [§3109a]

TOPICAL INDEXING: 
Private Contract (Meaning and Intent)   


CASE SUMMARY:  
In this published unanimous per curiam opinion, the Court of Appeals held that the specific language used in a Blue Care Network health insurance policy precluded plaintiff from "double dipping" under the health insurance policy after having drawn uncoordinated no-fault benefits under a no-fault policy issued to a third party. The BCN health policy stated, "benefits under this certificate will not be reduced because of the existence or coverage under a member's non-coordinated no-fault automobile policy." The court held that this language would entitle the insured to collect under the health insurance policy where the insured drew uncoordinated no-fault benefits under a member's policy. However, because the uncoordinated no-fault benefits were paid under a third party's no-fault policy, this language did not permit duplication. Other language in the policy dealing with non-duplication and subrogation clearly and unambiguously prohibited the insured from duplicating coverages under the BCN policy where similar coverages had been paid by other insurers.