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Lose v Yanks, Inc.; (ICC-UNP, 9/29/1978; RB #117)

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Ingham County Circuit Court; File No. 77-227-NI; Unpublished   
Judge Jack W. Warren; Written Opinion   
Official Michigan Reporter Citation: Not Applicable; Link to Opinion alt   


STATUTORY INDEXING:
Standards for Deductibility of State and Federal Governmental Benefits [§3109(1)]
Coordination with Other Health and Accident Medical Insurance [§3109a]
Exception for Commercial Vehicles [§3114(2)]
Bona Fide Factual Uncertainty / Statutory Construction Defense [§3148]

TOPICAL INDEXING:
Legislative Purpose and Intent   


CASE SUMMARY:   
In a significant written opinion regarding the relationship between Blue Cross - Blue Shield benefits and PIP benefits, Judge Jack Warren ruled:

1.    That Blue Cross-Blue Shield benefits are not classified as "personal protection insurance benefits under any other policy" as that language is used in §3114(2)(e). Therefore, where plaintiff was injured while a passenger in a taxicab and plaintiff was not entitled to receive personal protection insurance benefits under any other PIP policy, but where plaintiff did have Blue Cross health insurance, the taxicabs' PIP insurer must pay plaintiff’s medical and hospital expenses even though the same expenses are payable under plaintiff’s Blue Cross - Blue Shield policy.

2.   That Blue Cross-Blue Shield benefits are private medical benefits and thus not covered by the language of §3109(1) as benefits provided or required to be provided under the laws of any state or federal government" Accordingly, the no-fault insurer could not claim any setoff for plaintiff’s receipt of said Blue Cross benefits.

3.    That because the above questions presented issues of statutory interpretation, the no-fault carrier's refusal to pay was not unreasonable under §3148 and thus plaintiff was not entitled to recover attorney fees.


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