The law on car accidents in Michigan is a very strict one. With the new changes to the Michigan no-fault system, there is now the so-called “coordination of benefits”. With the birth of this new concept, you need the right guidance to help you through the way.
Here at Haque Legal, our Southfield personal injury lawyers want to make sure that you will get all of the new information as they come. Let us look at the Michigan No-Fault Coordination of benefits and what it means for you.
Two Types of Policies: Coordinated Benefits versus Uncoordinated Benefits
Uncoordinated Benefits Policy refers to a policy. This is where the no-fault benefits will be paid by the insurance company. This could happen even though similar payments will be made to the injured person under the health insurance policy.
Coordinated Benefits Policy refers to the policy as well. This is where the no-fault insurer is only obligated to pay the expenses and the benefits that are not paid by the other policies or coverage of the plan owner. This makes the no-fault insurance in Michigan secondary only to the other health insurance plans that individual claimants may have.
Which is more popular in Michigan?
In the state of Michigan, the coordinated benefits policy costs less than the uncoordinated policy so consumers are more leaning towards getting the coordinated benefits policy.
What does coordination of benefits mean?
Coordination of benefits means that when you have different insurance policies, they would both want to be secondary from the other – meaning, they do not want to be the first one to pay. When that happens, you cannot be dealing with both of them just so one of them would have, right?
The State of Michigan prevents this from happening through the no-fault coordination of benefits. This means that in whatever degree your injury comes in or the fault comes in, the no-fault insurance coverage will always be second only to your primary health insurance provider.
This was also the ruling of the Michigan court in Federal Kemper Ins Co v Health Ins Admin, 424 Mich 537 (1986). In this case, the court ruled the following:
“We conclude, therefore, that the defendant’s health insurer is primarily liable. Giving effect to the plaintiff’s coordinated benefits provision furthers the purposes of § 3109a to contain both auto insurance costs and health care costs while eliminating duplicative recovery. Further, this result is consistent with the legislative scheme vesting in insureds, rather than insurers, the option of coordinating benefits.”
What does un-coordination of benefits mean?
When you get an uncoordinated policy, your insurance policies cannot coordinate with each other which means you can claim the benefits from both policies. When neither of the policies can coordinate with each other, the claimant can claim damages from both.
Is this not illegal?
According to Michigan courts, it is not illegal to claim uncoordinated benefits. The court held this in the case of Haefele v Meijer, Inc, 165 Mich App 485 (1987). In this case, the court ruled the following:
“We are also aware that the coordination provision does refer to coordination of any “no-fault basic medical payments.” However, that term does not specifically mention privately purchased automobile insurance. Moreover, its meaning is modified by the fact that it follows the phrase “or one provided by or through the action of any government including…
”One” clearly refers to “another group health plan.” Thus, the ordinary meaning of the term “no-fault basic medical payments” would appear to be payments obtained under a group plan. We are obliged to construe policy terms following their ordinary meaning, Dairyland Ins Co v Auto-Owners Ins Co, 123 Mich. App. 675, 686; 333 N.W.2d 322 (1983), not forced or technical constructions, Powers, supra. Here it is uncontroverted that the plaintiff’s no-fault automobile insurance was purchased individually.
Applying the aforementioned principles, we conclude that the coordination provision is unambiguously directed toward other group health insurance policies, not privately purchased automobile insurance. Indeed, we would find it anomalous to conclude that plaintiff, who presumably paid a premium for uncoordinated automobile no-fault coverage, ultimately purchased nothing more than a reduction in the liability of her group health carrier.”
Hence, the Michigan Supreme Court ruled that uncoordinated benefits may pay the claimant for damages despite there being a double payment with another insurance company.
What if I have three insurance companies that can pay me?
If you have many insurance companies, you must pay your premiums regularly. As long as you have all of the proper documentation, you can always file for a claim. It does not matter whether you have a lot of insurance policies or just two, as long as you get the uncoordinated policies, you can file for damages.
What would you suggest I get?
Insurance is something that you want to get as protection. While the protection that you need would vary depending on a lot of specific things and while we want to provide you with different information we still need to talk to you to discuss your circumstances properly. Hence, we will only provide you with our suggestions during our consultation.
Contact Your Lawyer Today
If you have an insurance claim that you need assistance with, you should contact us today. A lawyer can help you get started with your claim. A lawyer at Haque Legal will see to it that your needs are met from beginning to the end of the proceedings. You are always in good hands with Haque Legal and what it has to offer.
Disclaimer:
The article that you have read is based on general applications of the law. This is not legal advice. This is not to be construed as any legal consultation with the firm. No client-attorney relationship is created when you read the articles we have provided.
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If you are having trouble with filing an insurance claim, call us immediately. If you have any problem with the law or are seeking justice and truth, our numbers are standing by to take your call.
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