Michigan Court of Appeals; Docket No. 93942; Published
Judges Maher, Walsh, and Stell; Unanimous; Per Curiam
Official Michigan Reporter Citation: 156 Mich App 837; Link to Opinion 
STATUTORY INDEXING:
Coordination with Other Health and Accident Medical Insurance [§3109a]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
In this unanimous per curiam Opinion, the Court of Appeals reversed a circuit court order declaring the no-fault insurer to be primarily liable for payment of medical benefits in a case where the injured party was covered under a health insurance program through her employer.
The injured person was covered under a no-fault policy with a "coordination of benefits endorsement." The insured had purchased coordinated coverage at a reduced premium. The insured also had health insurance through a self-insured benefit program provided by her employer. Her employer's medical insurance plan contained an exclusion clause which sought to exclude coverage for charges which the employee was entitled to receive benefits under any no-fault automobile statute. Relying upon the exclusion clause, the trial court ruled that the no-fault insurer was primarily liable.
Based upon the decision of the Supreme Court in Federal Kemper v Health Insurance Administration (Item No. 897), the Court of Appeals held that the two policies contained conflicting "other insurance" provisions, and therefore, the employer provided health coverage was primarily liable for payment of medical expenses. The Court rejected defendants argument that its policy "excludes" coverage as distinguished from the "other insurance" provisions at issue in the Federal Kemper case. The Court noted that a similar argument was made, and rejected, in Kemper.
