United States District Court for the Western District of Michigan; Docket No. 4:93-CV-35;
Judge Benjamin F. Gibson; Unpublished
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
Coordination with Other Health and Accident Medical Insurance [§3109a]
Coordination with ERISA Plans [§3109a]
TOPICAL INDEXING:
Employee Retirement Income Security Act (ERISA – 29 USC Section 1001, et seq.)
CASE SUMMARY:
This written Opinion by Judge Gibson (which predates the Sixth Circuit Court of Appeals decision in Auto Owners Insurance Company v Thorn Apple Valley, Inc., Item No. 1730), also deals with priority disputes between a coordinated no-fault insurer and a coordinated ERISA health plan.
Judge Gibson noted that this area of federal law is in flux, adopted the reasoning in Lincoln Mutual Casualty v Lectron Products, Inc. (Item No. 1567), 823 F Supp 1385 (ED Mich, 1993), and held that:
"Under federal common law, the plain language, strictly construed, of the ERISA plan, not the intent of the state Legislature in statutorily regulating insurance, must prevail."
The court further noted that the plan document unambiguously subordinates its coverage as secondary to that of other coverage under other plans, even though the language used in the ERISA plan was not as concise as the coordination language used in the no-fault plan. Thus, the no-fault plan was primary and the ERISA plan secondary with no pro rata apportionment