Michigan Supreme Court; Docket No. 80378; Published
Unanimous; Per Curiam
Official Michigan Reporter Citation: 431 Mich 663; Link to Opinion
STATUTORY INDEXING:
Standards for Deductibility of State and Federal Governmental Benefits [§3109(1)]
Veterans / Military Benefits [§3109(1)]
Coordination with Other Health and Accident Medical Insurance [§3109a]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
In this unanimous per curiam Opinion, the Supreme Court held that medical benefits paid by the federal government to a member of the Armed Services pursuant to 10 USC 1071, et seq, for injuries suffered in an automobile accident constitute both "other health and accident coverage" under §3109a of the No-Fault Act, as well as "governmental benefits" under §3109(1). The serviceman apparently had purchased a non-coordinated no-fault insurance policy. The court held that where such benefits fall within both §3109a and §3109(1), an insurer must offer an insured the option to purchase a coordinated no-fault policy as a condition precedent to being able to setoff the government medical benefit under §3109(1) of the Act. In reaching its conclusion, the court reaffirmed the analysis employed in its earlier decision in LaBlanc v State Farm (Item No. 377), wherein the court held that Medicare benefits were "other health and accident coverage" under §3109a and could not be set off unless the insured had purchased coordinated coverage. In expressing its holding, the court made the following statement:
"In short, pursuant to §3109(1), plaintiff’s military medical benefits normally must be subtracted from his no-fault insurance benefits. Further, our resolution of Nyquist and our decision in LaBlanc require the conclusion that plaintiff's military medical benefits constitute 'other health and accident coverage' pursuant to §3109a requiring defendant to offer plaintiff a coordinated no-fault policy. The defendant has conceded that this did not occur. Therefore, as in LaBlanc, the set off mandated by §3109(1) may not be employed... We do not suggest that insurers must sell uncoordinated policies to parties who are eligible for § 3109(1) type governmental benefits. However, §3109a does modify §3109(1) to the extent that the policy offered by insurers to such parties must be coordinated in the same manner as coordinated policies are offered to other purchasers who may have overlapping benefits."
The Court distinguished its earlier opinion in Crowley v DAIIE (Item No. 1022) on the basis that "Crowley was limited to the question of whether benefits paid pursuant to 10 USC 1071, et seq, were subject to set off under §3109(1) when the injured party was not the owner of the vehicle subject to coverage under the No-Fault Act. Thus, our decision in Crowley was not dispositive of the issues raised in this appeal." In other words, the plaintiff in Crowley was not in that class of insureds that could have been offered a coordinated no-fault policy. This is contrary to the case at bar where Mr. Tatum was the owner of the vehicle involved in the accident, and thus, within the class of persons to whom a coordinated policy should have been offered.