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Darmer v Citizens Insurance Company; (COA-UNP, 7/7/2005, RB #2577)

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Michigan Court of Appeals; Docket #260479; Unpublished
Judges Cooper, Fort Hood and Gribbs; unanimous; memorandum
Official Michigan Reporter Citation: Not applicable, Link to Opinion courthouse graphic


STATUTORY INDEXING:
Coordination with Other Health and Accident Medical Insurance [3109a]

TOPICAL INDEXING:
Not applicable


CASE SUMMARY:
In this unanimous unpublished memorandum opinion, the Court of Appeals reversed the trial court determination that Citizens was not entitled to deduct an employer’s self-funded long-term disability benefit payments from plaintiff’s entitlement to no-fault work loss benefits under a coordinated policy. In reversing the trial court determination disallowing such deductions, the Court of Appeals relied on the Supreme Court decision of Jarrad v Integon National Insurance Company [RB #2515], issued after the trial court’s decision in this case. The Supreme Court in Jarrad held that an employer’s self-funded long-term disability plan may be coordinated with no-fault wage loss benefits as “other health and accident coverage” under MCL 500.3109a. The Supreme Court ruling held the phrase “other health and accident coverage” contained in §3109a “includes a self-funded long-term disability plan” such as existed in that case.

In the instant case, although compelled to follow Jarrad, supra, the Court of Appeals nevertheless noted that plaintiff also had argued that an issue remained as to whether coordination is permitted under §3109a in light of the fact the language of that statutory provision requires a determination as to whether an “appropriately reduced premium was provided in light of his employer’s self-funded long-term disability plan and whether the reduction was ‘reasonably’ related to his being entitled to such benefits.” Section 3109a specifically provides:

An insurer providing personal protection benefits shall offer, at appropriately reduced premium rates, deductibles and exclusions reasonably related to other health and accident coverage on the insured. . . .
(emphasis added)

The Court of Appeals remanded this case to the trial court for consideration of plaintiff’s claim regarding whether the statutory provisions of §3109a, as discussed above, had been met.


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