Michigan Court of Appeals; Docket No 100505; Unpublished
Judges Murphy, Weaver, and McDonald; 2-1; (Judge Murphy Dissenting)
Official Michigan Reporter Citation: Not Applicable; Link to Opinion 
STATUTORY INDEXING:
Coordination with Other Health and Accident Medical Insurance [§3109a]
Duplicate Recovery [§3109a]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
In this 2-1 decision by Judge McDonald with Judge Murphy dissenting, the Court of Appeals enforced a coordination of benefits clause contained in a group health insurance policy so as to prohibit a "double recovery" by a plaintiff who was drawing benefits under an uncoordinated no-fault policy. The court acknowledged that permitting coordination between health and uncoordinated no-fault "does limit a no-fault insured's choice under §3109a," the court justified its result on the basis that there was a policy to eliminate duplicative recovery and to contain or reduce insurance costs. However, the court's decision appears to be premised upon the factual assumption that the coordination clause in the health insurance policy actually reduced the cost of the health insurance policy. In this regard, the court stated, "Presumably, plaintiffs employer pays smaller premiums, thus keeping the cost of insurance contained, and duplicative recovery is eliminated."
Judge Murphy filed a vigorous dissent. He stated, "In my view, the majority's holding totally vitiates the legislatively mandated option provided to insureds in §3109a of the No-Fault Act I find it inconsistent with the legislative scheme that the insured in this case, who was covered by a coordinated benefits health policy, by paying a higher premium to her no-fault automobile insurer, gets absolutely nothing in return. . . . I do not believe that this result is a matter of a consumer making a bad choice when deciding not to coordinate her medical benefits coverage under the no-fault policy. Rather, the insured's option, granted by the Legislature in §3109a, has been rendered a nullity. What possible good is vesting with the insured a choice under §3109a when that choice is made meaningless in situations where the insured is also covered by a coordinated health insurance plan?"
Judge Murphy also noted that there was no evidence in the record presented to support the conclusion that plaintiffs employer paid a lower premium because of the coordination of benefits clause in the group health policy. Judge Murphy concluded by saying, "As long as an insured is paying a higher premium, there should be some corresponding return to the insured for paying that premium. Under the facts of this case, why shouldn't the appropriate return to the insured for the payment of that higher premium be allowing plaintiff to recover benefits from both insurers? After all, it is undisputed that premiums were paid to both the no-fault and health insurers. Absent some return to plaintiff for the additional premium which was paid to the no-fault insurer, plaintiff has done nothing other than subsidize her health insurer."
