Michigan Court of Appeals; Docket No. 90925; Unpublished
Judges Kelly, Sullivan, and Carnovale; Unanimous
Michigan Official Reporter Citation: Not Applicable; Link to Opinion 
STATUTORY INDEXING:
Coordination with Other Health and Accident Medical Insurance [§3109a]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
This unanimous Opinion by Judge Kelly deals with the obligation of a no-fault "coordinated benefits" insurer to reimburse plaintiff for medical expenses that plaintiff must pay back to a health insurer out of a subsequent product liability tort recovery. At the time of plaintiff's injury, he was employed as a Teamster and was entitled to recover health insurance benefits under the Teamsters Welfare Plan. The Plan provides that if plaintiff recovers medical expenses in a subsequent action, the Teamsters Plan must be repaid out of that recovery. Following his accident, plaintiff filed a product liability tort action which he subsequently settled. The settlement included medical expenses that were paid by the Teamsters Plan. After reimbursing the Teamsters Plan out of the tort recovery, plaintiff filed a lawsuit against his no-fault insurance company alleging that the no-fault carrier was obligated to reimburse plaintiff inasmuch as he paid the medical expenses out of his own pocket (i.e., his tort money).
The Court of Appeals ruled against plaintiff on the basis that the sums paid by the Teamsters Plan were amounts recovered under "other health and accident coverage" as provided in §3109a of the No-Fault Act Plaintiff would not have been obligated to reimburse the plan had he not recovered the same benefits in his tort action. Therefore, plaintiff has been made whole. When he purchased coordinated benefits, "plaintiff elected to forego double recovery for medical expenses by limiting defendant's liability to secondary or excess coverage." Therefore, plaintiff cannot undo that election by passing off the reimbursement obligations to the coordinated no-fault insurer.
