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Aetna Casualty & Surety Company v American Community Mutual Insurance Company; (COA-UNP, 11/19/1992; RB #1582)


Michigan Court of Appeals; Docket No. 125198; Unpublished  
Judges Holbrook, Sullivan, and Taylor; Unanimous; Per Curiam  
Official Michigan Reporter Citation:  Not Applicable; Link to Opinion alt  

Standards for Deductibility of State and Federal Governmental Benefits [§3109(1)] 
Medicare Benefits [§3109(1)]

No-Fault Insurer Claims for Reimbursement 
Medicare Benefits   

In this unanimous unpublished per curiam Opinion, the Court of Appeals relied upon the Supreme Court's decision in John Hancock Property & Casualty Insurance Company v Blue Cross & Blue Shield of Michigan (Item No. 1492) and held that a no-fault insurance company was not entitled to obtain reimbursement of medical expenses from a Medicare supplemental insurance policy issued by defendant to the insured person. Approximately two years after her accident, Margaret Meyer turned 65 years old and became eligible for Medicare. At that time, she purchased a Medicare supplemental insurance policy from defendant who had previously issued her a comprehensive health care policy that terminated when she became eligible for Medicare. After the Medicare supplemental insurance policy went into effect, defendant refused to pay any of Meyer's medical expenses arising out of her automobile accident injuries. Those medical expenses were then paid by plaintiff, Meyer's no-fault insurer, and plaintiff sought reimbursement from defendant. The Court of Appeals found the John Hancock decision to be controlling even though plaintiff did not become eligible for Medicare and did not purchase the Medicare supplemental insurance policy until after the accident The parties agreed that the original comprehensive health care policy issued by defendant had been properly terminated and therefore any benefits owed by defendant to Meyer were owed under the Medicare supplemental insurance policy. In light of the John Hancock decision, benefits were not owed under that policy for automobile accident injuries, and therefore, the no-fault carrier was not entitled to be reimbursed for paying those auto related medical expenses.  

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