Michigan Court of Appeals; Docket No. 94680; Published
Judges Cynar, Weaver, and Hausner; Unanimous; Per Curiam
Official Michigan Reporter Citation: 163 Mich App 115; Link to Opinion 
STATUTORY INDEXING:
Standards for Deductibility of State and Federal Governmental Benefits [§3109(1)]
Veterans / Military Benefits [§3109(1)]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
In this unanimous per curiam Opinion, the Court of Appeals affirmed the trial court decision denying no-fault medical expense reimbursement to plaintiff.
•
Plaintiffs sought recovery of medical expenses incurred for surgery performed on his back. Plaintiff was injured while being driven to National Guard training, and therefore, was entitled to medical care paid for by the Veteran's Administration. According to plaintiff, he sought approval for the surgery, but was told that the military would not pay for the surgery because it was considered an elective procedure. Plaintiff then had the surgery at a non-military hospital, and when he subsequently requested reimbursement from the military, his claim was denied because non-emergency surgery performed at a non-military hospital is not authorized without written prior approval.
When plaintiff then filed for recovery of these expenses from his no-fault insurance carrier, the defendant denied the benefits under §3109(1) which allows a setoff of governmental benefits provided or required to be provided under the laws of the federal government.
Citing the cases of Perez (Item No. 701) and Gregory (Item No. 847), the Court of Appeals interpreted those Supreme Court decisions as indicating that a no-fault insurer may offset primary insurance benefits except when an injured person fails to receive benefits through no-fault of his own. In this case, the plaintiff might have been entitled to medical benefits provided by the military if he had received treatment at a Veteran's Administration hospital. Since he chose to have non-emergency surgery performed at a non-military hospital, he was denied those governmental benefits.
The Court held that recovery from defendant in this case would defeat the purpose of the setoff provision by allowing plaintiff to choose which insurance would pay for his medical treatment.
