Michigan Court of Appeals; Docket #272379; Unpublished
Judges Owens, Neff, and White; 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In this unanimous unpublished per curiam opinion, the Court of Appeals determined that a no-fault insurer was not entitled to set off benefits paid by Medicare on behalf of a person injured in a 1975 motor vehicle accident where the person was insured under an uncoordinated no-fault insurance policy.
The plaintiff in this case was rendered quadriplegic in a motor vehicle accident which occurred in 1975. At the time of the accident, the plaintiff lived with his parents and was covered under their uncoordinated no-fault insurance policy with defendant Progressive Insurance. The plaintiff qualified for Social Security benefits and, eventually, Medicare. Because Rodney Grant’s accident occurred before the Medicare secondary payor provision of the Omnibus Budget Reconciliation Act of 1980 took effect, Progressive was not automatically the primary payor and Medicare paid most of Rodney Grant’s accident-related medical expenses. In 2005, plaintiffs filed an action seeking payment from Progressive for Rodney’s accident-related injuries. Progressive moved for summary disposition, arguing that under MCL 500.3109(1), which provides that “benefits provided or required to be provided under the laws of any state or the federal government shall be subtracted from the personal protection insurance benefits otherwise payable for the injury,” mandated that it be entitled to set off the Medicare benefits that were paid to the plaintiffs as a matter of law. The trial court agreed.
The Court of Appeals disagreed and reversed, based on MCL 500.3109a and the decision in LeBlanc v State Farm, 410 Mich 173 (1981) [Item No. 377], interpreting that section of the No-Fault Act. As the Court of Appeals noted, §3109a provides that, “An insurer providing personal protection insurance benefits shall offer, at appropriately reduced premium rates, deductibles and exclusions reasonably related to other health and accident coverage on the insured. The deductibles and exclusions required to be offered by this section shall be subject to prior approval by the commissioner and shall apply only to benefits payable to the person named in the policy, the spouse of the insured and any relative of either domiciled in the same household.” (emphasis in original). It then explained that in LeBlanc, the Michigan Supreme Court determined that the phrase “other health insurance” in §3109a includes Medicare benefits. Therefore, the court determined that under LeBlanc, the trial court’s decision must be reversed. In this regard, the court stated:
“The phrase ‘other health and accident coverage’ contained in §3109a contemplates benefits provided to qualified participants under the Medicare program; thus, Medicare benefits may be coordinated with no-fault personal protection insurance benefits at the option of the insured. . . . Because LeBlanc continues to govern the application of §3109(a) to Medicare benefits payable due to injuries that occurred prior to December 5, 1980, the circuit court erred in failing to follow LeBlanc, and in granting defendant summary disposition.”
