Michigan Court of Appeals; Docket No. 243859; Unpublished
Judges Cavanagh, Murphy, and Smolenski; unanimous; per curiam
Official Michigan Reporter Citation: Not applicable, Link to Opinion 
STATUTORY INDEXING:
Coordination with Other Health and Accident Medical Insurance [3109a]
TOPICAL INDEXING:
Not applicable
CASE SUMMARY:
In this unanimous unpublished per curiam opinion, the Court of Appeals upheld the defendant health insurance company’s exclusion for medical expenses incurred as a result of an automobile accident, thus requiring that those expenses be paid by the no-fault auto insurance policy.
In this case, the injured person’s no-fault auto insurer, Southern Michigan Insurance Company, argued that the health care coverage on the injured person was primarily liable for payment of the medical expenses.
Pursuant to §3109a, the no-fault insurance policy issued by Southern Michigan Insurance Company excluded coverage for medical expenses where other insurance was available. Defendant’s policy also excluded coverage where no-fault auto insurance was available and limited its coverage to expenses exceeding coverage provided by other insurance. The Court of Appeals first noted that the use of such “escape and excess clauses” such as the one in the health insurance policy at issue, are invalid and, rather than exclude or limit coverage, benefits are available, but coordinated.
Even though the escape and excess clause in the health insurance policy did not preclude coverage, the Court of Appeals nevertheless held that a separate clause “excluding coverage for medical expenses incurred as a result of an automobile accident without regard to the existence of other insurance coverage” was a valid exclusion that did preclude coverage under the health care policy. The court held that this exclusion was not rendered ambiguous by the escape clause, because each exclusion is to be read independently of other exclusions. Therefore, based upon the exclusion, the health insurance company was entitled to summary disposition.
