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Farmers Insurance Exchange and Michigan Catastrophic Claims Association v South Lyon Community Schools; (COA-PUB, 8/17/1999; RB #2089)

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Michigan Court of Appeals; Docket No. 206054; Published   
Judges Doctoroff, Sawyer, and Fitzgerald; Unanimous; Per Curiam   
Official Michigan Reporter Citation:  237 Mich App 235; Link to Opinion alt   


STATUTORY INDEXING:   
Standards for Deductibility of State and Federal Governmental Benefits [§3109(1)]   
I.D.E.A. Benefits (Individuals with Disabilities Education Act) [§3109(1)]

TOPICAL INDEXING:    
Education of Individuals with Disabilities Act (I.D.E.A. – 20 USC Section 1400, et seq.)    


CASE SUMMARY:    
In this unanimous published per curiam Opinion, the Court of Appeals ruled that plaintiff Fanners Insurance Exchange and the Michigan Catastrophic Claims Association were entitled to a set off for nursing services required by a quadriplegic student during school hours and while traveling to and from school, to the extent that those nursing services were "related services" under the Individuals With Disabilities Education Act (IDEA). The court held that these benefits are governmental benefits under section 3109(1) of the Michigan no-fault law because they are "required to be provided" by federal law. Therefore, the defendant school district is obligated to provide those services and reimburse plaintiffs for no-fault benefits plaintiffs paid to provide those services to the quadriplegic student.   

The student in this case was injured in a bicycle-automobile accident in 1993 and was rendered a quadriplegic who required a tracheostomy and a ventilator to breathe. He required 24 hour per day nursing care which was provided by a nurse. This care included continuous monitoring of the student, as well as periodic catheterizations, tracheostomy suctioning and ventilator adjustment. The services were not, however, of such a nature that they could only be performed by a physician or a person with medical training. Plaintiff insurer requested that defendant school district pay for these nursing services during school hours and while the student was being transferred to and from school.    

Plaintiff asserted that defendant was required to provide these services under IDEA because they are considered to be "related services" under the federal act. The defendant school district refused to provide the services. In this declaratory judgment action, the Court of Appeals found that these nursing services were indeed "related services" under IDEA and thus were required to be provided under state and federal law. As such, plaintiff no-fault insurer was entitled to a set off to the extent such benefits were available. The court accordingly concluded:

"Because defendant does not dispute that Benjamin requires the nursing services to benefit from any special education plan and because the Supreme Court has conclusively determined that the nursing services required by Benjamin are 'related services' that the IDEA requires defendant to provide, the trial court correctly determined that the nursing services are benefits that are 'required to be provided' by defendant under the IDEA for the purpose of section 3109(1). Therefore, we affirm the trial court's declaratory judgment that plaintiffs are entitled to subtract from no-fault benefits otherwise payable as the result of Benjamin's accident, the cost of nursing care required by Benjamin during school hours and during his transportation to and from school. We further affirm the trial court's decision that plaintiff was entitled to monetary reimbursement from defendant of the amounts plaintiff has paid to provide Benjamin with the required nursing services during school hours and during his transportation to and from school. While we acknowledge that this court cannot direct defendant to include the nursing services in Benjamin's IEP, nothing in this opinion is meant to suggest that the defendant is not obligated to pay for the nursing services at issue, now that we have determined that plaintiff is not required to pay for such services pursuant to section 3109."


Michigan auto accident attorney Stephen Sinas is the lead editor of the appellate case summaries published on this site regarding the Michigan auto insurance law. To learn more about how Stephen Sinas and how the Sinas Dramis Law Firm can help you if you have been injured in a Michigan auto accident, visit SinasDramis.com.

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