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Czerniawski v Farmers Ins Exchange; (JDC-UNP, 11/21/1986; RB #1053)

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52nd Judicial District Court; Docket No. 86-C00888-GC; Unpublished  
Judge Michael Batchik; Written Order  
Official Michigan Reporter Citation:  Not Applicable; Link to Opinion alt    


STATUTORY INDEXING:  
Coordination with Other Health and Accident Disability Insurance [§3109a]

TOPICAL INDEXING:
Not Applicable    


CASE SUMMARY:  
In this written Order, District Judge Michael Batchik ruled that a no-fault insurer was not legally entitled, under either a coordinated benefits or full coverage policy, to reduce its liability for no-fault wage loss benefits by setting off certain wage continuation benefits paid to plaintiff, even though those benefits were paid in the form of sickness and accident benefits through an agent insurance company chosen by GM to administer the benefit program. The sickness and accident disability insurance benefits involved in this case were provided under a collective bargaining agreement between the UAW and GM. That portion of the agreement referred to as the "Supplemental Agreement" covering "group life and disability insurance programs," provided that General Motors would provide for payments to hourly employees in lieu of wages when the employees were unable to work because of sickness or accident. The collective bargaining agreement language provided for GM to pay either direct cash payments or to obtain group disability insurance program coverage, at the employer's option. The defendant insurance company argued that when GM paid these benefits through an insurance company, they became "other health and accident coverages" and thus could be set off against wage loss benefits pursuant to defendant's coordinated benefits policy. The Court agreed with plaintiff and held that it made no difference whether the employer made the direct cash payments or chose to delegate the administration and shift the risk of the expense of the wage continuation plan to an insurance company through the mechanism of a group insurance policy paid for by the employer. This did not change the basic nature of the wage continuation benefit. As such, the group insurance benefits were held to be "collateral source payments," and therefore could not be considered in the computation of wage loss benefits.

The case represents a logical extension of the decision of the Court of Appeals in Brashear v DAIIE (Item No. 860) and the Ingham County Circuit Court's decision in Birch v EVA (Item No. 647).


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