Michigan Court of Appeals; Docket #222219; Unpublished
Judges Holbrook, Jr., Hood and Griffin; unanimous; per curiam
Official Michigan Reporter Citation: Not applicable, Link to Opinion 
STATUTORY INDEXING:
Standards for Deductibility of State and Federal Governmental Benefits [3109(1)]
TOPICAL INDEXING:
Not applicable
CASE SUMMARY:
In this unanimous unpublished per curiam opinion, the Court of Appeals upheld the trial court order that defendant Citizens reimburse plaintiff for medical expense payments that plaintiff was obligated to reimburse to plaintiff’s federal health insurance plan.
Plaintiff’s son was injured in an automobile accident, and his medical expenses were paid pursuant to a health insurance policy issued by the Mail Handlers Benefit Plan, a federal health insurance plan. The insurance policy contained a subrogation provision requiring that plaintiff reimburse medical expenses paid by the health insurance plan from any recovery obtained in a third-party lawsuit against the driver of the at-fault motor vehicle. The third-party claim was settled for $100,000 and the Mail Handlers sought and received reimbursement in the amount of $52,999.96, representing medical expenses it had paid. Plaintiff then sought to have Citizens, its no-fault insurance company, reimburse plaintiff for the amount it was required to repay to Mail Handlers.
Plaintiff claimed in its lawsuit that Citizens was elevated to the role of primary carrier when benefits were paid by a federal insurance plan and reimbursement was requested. In upholding the trial court decision in plaintiff’s favor, the court relied upon the Supreme Court decision in Sibley v DAIIE, 431 Mich 164 (1988) [Item No. 1146], which held that in order to prevent a worker injured in an automobile accident from, in effect, paying for his own work loss/medical benefits, the no-fault insurance company is obligated to repay the benefits required to be reimbursed pursuant to federal law. The Court of Appeals rejected the argument that the Sibley decision should be limited to the statutory section at issue, 3109(1), and should not be applied to a case where federal coordinated benefits were at issue. Citing Gunsell v Ryan, 236 Mich App 204 (1999) [Item No. 2064], the Court of Appeals held that the rationale underlying the Sibley decision was not limited to the statutory provision it addressed. “Where the federal government requires repayment from a beneficiary, the no-fault insurer must pay personal insurance protection benefits to the extent restitution is required.”
Further, the Court of Appeals held that the plaintiff’s claim was not governed by the one-year back provision of 3145(1).
