United States District Court, Western District of Michigan; Docket No. 1:89-CV-1042;
Opinion by Judge Richard A. Enslen; Unpublished
Official Federal Reporter Citation: Not Applicable; Link to Opinion
In this written Opinion, Judge Enslen held that §3109a of the Michigan No-Fault Act permitting coordination of benefits with other health and accident coverages is not preempted by the federal ERISA statute. The court relied upon Northern Group Services v Auto Owners (Item No. 1090) and held that there was no evidence showing how the federal interests in national uniformity might outweigh the state interests in coordinating no-fault benefits with other coverages. In addition, Judge Enslen held that the group health plan involved in this case contained a coordination clause as opposed to a no-fault exclusion because the language of the plan did not unequivocally preclude payment of benefits in auto accident cases. Although the plan contained general language excluding benefits "for any injury incurred as a result of any vehicular accident," the plan goes on to state that if the participant has no other coverage for personal injuries arising from a motor vehicle accident, then the benefits committee may consider paying benefits. Judge Enslen ruled that this did not create a true exclusion; and therefore, under the rule in Federal Kemper, the health plan was primary to a no-fault coordinated policy.