Michigan Court of Appeals; Docket No. 139620; Unpublished
Judges Wahls, Michael J. Kelly, and Connor; Unanimous; Per Curiam
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:
In this brief unpublished per curiam Opinion, the Court of Appeals interpreted the provisions of §3109a as it applied to an exclusion in defendant's health insurance plan under ERISA which provided for no benefits where the injuries were received in a motor vehicle accident.
The defendant refused to pay for its employee's medical expenses incurred in a motor vehicle accident on the grounds of its exclusion which precluded such benefits where the injuries were received in an accident involving a car or other motor vehicle for which there is in effect a policy of no-fault insurance. Auto Club paid the medical expenses and brought action seeking reimbursement. The trial court granted summary disposition, finding that Auto Club was entitled to reimbursement as a matter of law.
In vacating and remanding for further proceedings, the Court of Appeals acknowledged that under state law, plaintiff might have been entitled to reimbursement pursuant to the holding in Federal Kemper Insurance Company v Health Insurance Administration, Inc, 424 Mich 537 (1986). However, both parties concede that because of the United States Supreme Court's decision in FMC Corp v Holliday, 498 US 52 (1990), state law is preempted and resolution of this dispute is controlled by federal law. Therefore, the