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Profit v Citizens Insurance Company of America; (COA-PUB, 1/22/1991; RB #1443)

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Michigan Court of Appeals; Docket No. 120094; Published  
Judges Griffin, Sawyer, and Brennan; Unanimous; Opinion by Judge Griffin  
Official Michigan Reporter Citation:  187 Mich App 55; Link to Opinion alt  


STATUTORY INDEXING:  
Standards for Deductibility of State and Federal Governmental Benefits [§3109(1)]  
Social Security Disability Benefits [§3109(1)]

TOPICAL INDEXING: 
Legislative Purpose and Intent  


CASE SUMMARY:  
In this unanimous Opinion by Judge Griffin, the Court of Appeals affirmed the trial court holding that the defendant no-fault insurer could not, under plaintiff’s non-coordinated no-fault policy, setoff Social Security disability benefits from plaintiff’s work loss personal insurance protection benefits, even though plaintiff was receiving Social Security disability benefits for the same disability that formed the basis of plaintiff’s entitlement to no-fault wage loss benefits.  

The issue presented in this case was whether the insurer, pursuant to the governmental benefits setoff language of §3109(1), could subtract from plaintiff’s work loss personal protection insurance benefits social security benefits which plaintiff was receiving for the same disability when the policy between the parties was labeled "non-coordinated" as to wage loss but specifically authorized a setoff of governmental benefits.  

The court held that it could see no difference between the Social Security disability benefits at issue in this case and the federal military medical benefits addressed in Tatum v GEICO, 431 Mich 663 (1988). On the basis of Tatum, supra, the Court of Appeals stated that it reluctantly was compelled to follow Tatum and hold that such a setoff is not permissible for the reason that the defendant insurer failed to offer to the plaintiff a policy of no-fault insurance, which would not coordinate this governmental benefit. 

[Author's Comments: This case would seem to preclude setoff of any governmental benefit under a non-coordinated policy where the benefit, by its nature, is both a governmental benefit and "other health and accident coverage" as defined in §3109a.]


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