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Wolverine Mutual Insurance Company v Rospatch Corporation Employee Benefit Plan; (USD-UNP, 3/19/1990; RB #1380)


United States District Court, Western District of Michigan, Southern Division; Docket No. l:90-CV-30;   
Opinion by Judge Robert Holmes Bell; Unpublished  
Official Federal Reporter Citation:  Not Applicable; Link to Opinion alt  

Coordination with Other Health and Accident Medical Insurance [§3109a]  
Coordination with ERISA Plans [§3109a]

Employee Retirement Income Security Act (ERISA – 29 USC Section 1001, et seq.)  
Federal Jurisdiction and Removal of PIP Claims 
No-Fault Insurer Claims for Reimbursement   

In this Opinion by Judge Bell, the United States District Court held that an action by a no-fault automobile insurer for reimbursement from defendant employee benefit plan, which plaintiff claimed was primarily liable under Michigan's coordination of benefits law, was a state action not properly removed to federal court.  

In this case, Wolverine, as assignee of its insured, brought action for reimbursement of medical expenses it paid on behalf of its insured. Wolverine claimed that its insured is a beneficiary of an employee benefit plan, who sustained injuries covered under the plan. Plaintiff’s claim is for reimbursement of benefits paid on her behalf, for which defendant was alleged to be primarily liable under Michigan's coordination of benefits law, and under the decision in Federal Kemper v Health Insurance Administration Inc, 424 Mich 537 (1986).  

The court held that Michigan's coordination of benefits rule is a state law which regulates insurance, and which is expressly saved from preemption under ERISA. Thus, plaintiff’s claim, unaided by any federal defenses, simply seeks enforcement of a rule of state law which is exempt from ERISA preemption. Since the federal question is first raised as a defense, and since the claim is not one by a plan participant or beneficiary, Judge Bell held this case presented no basis for removal jurisdiction. Consequently, the matter was remanded to the state court for further proceedings.

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