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In Re: Hales Estate; (COA-PUB, 1/17/1990; RB #1488)

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Michigan Court of Appeals; Docket No. 111361; Published  
Judges Brennan, Murphy, and Cavanagh; Unanimous; Per Curiam 
Official Michigan Reporter Citation:  182 Mich App 55; Link to Opinion alt   


STATUTORY INDEXING:  
Injured Person and Dependents as Payees [§3112] 
Service Providers as Payees [§3112] 
General / Miscellaneous [§3112]

TOPICAL INDEXING: 
Not Applicable   


CASE SUMMARY:  
In this unanimous per curiam Opinion, the Court of Appeals held that by virtue of the provisions of §3112 of the no-fault statute, no-fault personal protection insurance benefits payable under the act belong to the injured person. The court cited Geiger v DAIIE (Item No. 510) for the proposition "that §3112 confers a cause of action upon the injured person to collect PIP benefits from the insurer for expenses incurred as a result of the injury." The court went on to hold that where duplicate benefits for injuries are payable under a non-coordinated no-fault policy and are also payable under a health insurance policy, the right to retain the duplicate payments belongs to the injured person not to the individual who provided the health insurance or who assumed legal responsibility for payment of the medical bills. However, a third person is entitled to be reimbursed from the proceeds of the no-fault policy to the extent that the third person (in this case the injured person's mother) "incurred expenses out of her own pocket which were reasonably necessary to her son's care, recovery and rehabilitation."  

The court rejected the mother's argument that under the doctrine of subrogation, she is entitled to the duplicate benefits simply because she provided the duplicative health insurance and assumed legal responsibility for the payment of medical bills. The court stated that subrogation is an equitable doctrine which is applicable to a non-volunteer who discharges a debt for which another person is primarily liable. Subrogation is available only in favor of those who actually pay the debts of another. Reimbursement is available only to the extent of the amounts paid and discharge of the obligation assumed by the subrogee. Therefore, in the case at bar, to the extent that the injured person's mother paid money from her own funds for expenses related to her son's medical care and rehabilitation which were not covered by Blue Cross, the mother would be subrogated to the rights of her son in the proceeds of the no-fault policy, which represent compensation for the expenses paid by the mother. The mother is not, however, subrogated to the rights of her son and the proceeds from the no-fault policy which duplicate the benefits paid under the Blue Cross/Blue Shield policy. 

The court concluded, "Neither the fact that [the son] benefited from [the mother's insurance] nor the fact that [the mother] agreed to guarantee payment of [the son's] medical expenses dictates that [the mother] is now entitled under the doctrine of subrogation to the duplicate benefits under the no-fault policy." 

[Author's Comment: This case was unintentionally omitted from previous supplements and is added for completeness.]


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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