United States Sixth Circuit Court of Appeals;_____;
Judges Merritt, Jones, and Nelson;________
Official Federal Reporter Citation:_____; Link to Opinion 
STATUTORY INDEXING:
Coordination with Other Health and Accident Medical Insurance [§3109a]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
This written Opinion from the Sixth Circuit Court of Appeals reversed Item No. 794, and remands the matter to the district court for trial consistent with the opinion.
This case deals with the enforceability of an out-of-state insurance contract's coordination of benefits/reimbursement provisions in a situation where the policy beneficiary is also entitled to collect no-fault PIP benefits. The district court ruled that the health insurance reimbursement provision was not enforceable because the insurance company had not had the policy language approved by the Michigan Commissioner of Insurance. The district court held that such approval was required because the policy was issued or delivered in the State of Michigan. The Court of Appeals reversed this finding and ruled that this insurance policy was not issued or delivered in Michigan for the reason that only a certificate of insurance was delivered to beneficiaries which is not the same as the insurance policy. Therefore, it was not necessary to obtain the prior approval of the Michigan Commissioner of insurance.
The district court also ruled in the case below that the reimbursement provision was not enforceable because it failed to conform to the coordination of benefits provisions mandated by the Michigan Insurance Code. The Court of Appeals likewise reversed this finding for the same reason as the first issue, to-wit: that the coordination of benefits provisions of the Michigan statute (i.e., MCLA 500.3438 and §3440) are limited only to policies "delivered or issued for delivery to any person in Michigan." Because this policy was not issued or delivered in Michigan, these statutory provisions have no application to this case.
The Court of Appeals then ruled that the policy's provision that the laws of Minnesota would govern this insurance contract was an enforceable "conflict of law agreement." Accordingly, the circuit court remanded the case to the district court to be resolved under Minnesota law with instructions to apply Minnesota law jn interpreting the reimbursement provision and enforcing it if appropriate. Included as part of the issues to be resolved on remand is the propriety of the district court's ruling that the reimbursement provisions of the contract only applied to amounts recoverable from a tortfeasor rather than from a no-fault insurer. Although the Court of Appeals stated that this issue should also be resolved under Minnesota law, the court indicated that the district court appears to have reached the proper result in that the reimbursement provision applies only to funds paid by a third party who is "liable" for the injury. In this case, plaintiff’s no-fault carrier paid the benefits because Michigan's no-fault scheme requires payment, not because the no-fault insurer was "liable."
