Michigan Court of Appeals; Docket No. 220424; Published
Judges Gage, Cavanagh and Wilder; unanimous
Official Michigan Reporter Citation: 247 Mich. App. 536, Link to Opinion 
STATUTORY INDEXING:
Allowable Expenses: Incurred Expense Requirement [3107(1)(a)]
TOPICAL INDEXING:
Not applicable
CASE SUMMARY:
In this unanimous published opinion by Judge Gage, the Court of Appeals interpreted the meaning of “incurred” in 3107 of the no-fault statute, where plaintiff claimed that he was entitled to receive uncoordinated personal protection benefits in the amount actually charged by the medical providers, not the reduced amount actually paid by his Blue Cross and Blue Shield health insurance policy.
Plaintiff received injuries as a motorcyclist while stopped at a traffic signal and struck from behind by a motor vehicle. Plaintiff had a Blue Cross and Blue Shield health insurance policy which paid for his medical expenses in the amounts established in that policy. Plaintiff sought reimbursement of the same medical expenses, claiming that under 3105(1) and 3114(5), he was entitled to uncoordinated personal protection benefits from Auto Club. Plaintiff claimed that under 3107(1)(a), he was entitled to receive from Auto Club the reasonable amounts his health care providers charged for medical care, not the irrelevant, reduced amounts the health care providers accepted as full payment for the charges pursuant to their agreements with Blue Cross and Blue Shield.
The trial court granted Auto Club’s motion for summary disposition limiting plaintiff’s recovery to the amounts Blue Cross and Blue Shield paid plaintiff’s health care providers, citing its earlier opinion in Dean v ACIA [Item No. 791] and Shanafelt v Allstate Insurance Company [Item No. 1864]. Referring to Random House Webster’s College Dictionary (1995), the court interpreted the meaning of the phrase “incur” as “to become liable for.” Since plaintiff’s medical expenses had already been paid by his health insurance policy in the amounts provided for in the Blue Cross and Blue Shield policy, the court determined that plaintiff was no longer “liable for” the full medical service amounts initially charged by his health care providers. Therefore, he had not “incurred” these full charges.
Further, the court held that adopting plaintiff’s interpretation of the meaning of “incurred charges” would frustrate the legislative purpose underlying the No-Fault Act to check skyrocketing health care costs and would afford plaintiff a windfall above his entitlement to uncoordinated, double benefits. Therefore, the court concluded that plaintiff’s entitlement to reimbursement under 3107(1)(a) did not encompass any amounts exceeding those that plaintiff’s health insurer actually paid in satisfaction of plaintiff’s medical bills and for which plaintiff no longer bears legal responsibility.
