Michigan Court of Appeals; Docket No. 249249; Unpublished
Judges Hoekstra, O’Connell and Donofrio; unanimous; per curiam
Official Michigan Reporter Citation: Not applicable, Link to Opinion 
STATUTORY INDEXING:
Not applicable
TOPICAL INDEXING:
Employee Retirement Income Security Act (ERISA – 29 USC Section 1001, Et Seq.)
CASE SUMMARY:
In this unanimous unpublished per curiam opinion, the Court of Appeals upheld the trial court determination that an ERISA health insurance plan properly denied plaintiff’s no-fault benefit claims, where plaintiff had no-fault automobile insurance which was required to be coordinated with the health insurance plans under the language of the policy.
Plaintiff’s father had health insurance coverage for himself and his family under and ERISA health insurance plan. The plan language provided that the plan “coordinates its benefits with other health plans under which an individual may be covered.” Health plans were defined in the ERISA plan as “group insurance or other coverage for a group of individuals” and “coverage under any individual no-fault auto insurance, by whatever name called.”
The plan denied claims that were paid or payable by the auto insurance policy on the basis that the auto insurance policy provided primary coverage. The Court of Appeals upheld the denial of the plaintiff’s claims under the ERISA plan’s coordination language and held that the plan’s plain language prevented plaintiff from “receiving double the amount of her medical expenses.”
The court rejected the plaintiff’s argument that the ERISA Act was superceded by a choice of law clause in the policy of health insurance which made the contract “subject to and interpreted under the laws of the state of Michigan.” The court held that a choice of law clause in the ERISA plan did not displace the application of ERISA when the contract is plainly an employee benefit plan that otherwise falls under the Act’s scope.
