Michigan Court of Appeals; Docket No. 104934 and 104935; Unpublished
Judges Maher, Holbrook, and Noble; Unanimous; Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion 
STATUTORY INDEXING:
Duplicate Recovery [§3109a]
Prohibition Against Assigning Future Right to Benefits [§3143]
TOPICAL INDEXING:
Private Contract (Meaning and Intent)
CASE SUMMARY:
In this unanimous per curiam Opinion, the Court of Appeals held that Blue Cross was entitled to enforce a subrogation clause in its health insurance policy and recover medical expenses it paid on behalf of a plaintiff who had those same expenses reimbursed by an automobile no-fault insurer as a result of a motorcycle/automobile accident. The plaintiff motorcyclist recovered his no-fault benefits from the insurer of the striking vehicle. The plaintiff also recovered health insurance benefits under a group health insurance policy issued by Blue Cross. The policy contained a coordination of benefits clause and a subrogation clause, both of which gave Blue Cross the right to be reimbursed "except against insurers on policies of insurance issued to and in the name of such enrollee." In this case, the plaintiff did not recover his no-fault benefits under any policy issued to him. Rather, the benefits were payable from the insurer of the striking vehicle. Therefore, the language of the policy gave Blue Cross the right to coordinate/subrogate.
The court also held that the subrogation language in the health insurance policy did not violate the no-fault statute's prohibition against assignment of benefits (see, §3143). The court drew a distinction between "assignments" and "subrogation." The court found that the subrogation clause did not constitute an assignment of future benefits, and therefore, was valid.
The court also held that Blue Cross should not be held to have waived its enforcement of the subrogation clause, for the reason that plaintiff did not detrimentally rely upon the Blue Cross payment. In fact, the bulk of the money paid by Blue Cross had been held in a trust account set up by plaintiffs attorney until the resolution of this case.
