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Copyright 2003 Michael J. Gallagher - All Rights Reserved |
Legal Tips: ALERT FOR ALL AUTOMOBILE INSURANCE POLICY HOLDERS Recently, in a split decision, the Appellate Court, Judges Hilda Gage and Richard Bandstra, decided to ignore Michigan’s Compiled Law 500.3116 and the clear language set out in Great Lakes Insurance v Citizens 191.Mich. App 589 (1999) in a case styled Bradley Dunn v. Detroit Auto Insurance Exchange, (December 3, 2002). The case involved an automobile negligence action in which Mr. Dunn made a recovery for non-economic damages (pain and suffering) from the party who caused the accident. Mr. Dunn‘s medical insurance plan with Rockwell International (ERISA plan) made a claim against Mr. Dunn’s insurance carrier (AAA) for reimbursement for sums they paid for Mr. Dunn’s medical treatment. The judges decided that Rockwell had the right to recoup its loss for Mr. Dunn’s medical bills because it was an ERISA self-insured fund and therefore not subject to the prohibitions under the no-fault statute for such recoupment. As a result of this recent Appellate Court Decision, if you are injured by a negligent party while operating your motor vehicle and his policy has a maximum liability insurance available of either $20,000.00, $50,000.00 or $100,000.00 for your injuries and you are insured by your employer’s ERISA medical plan, the ERISA health care plan can take from your settlement all that they paid. In other words, if there was a $100,000 policy and you made a $100,000.00 settlement for your injuries and the ERISA health care plan paid out $100,000.00 for medical costs for you, they get it all and you get nothing. The basis of this decision is that policy holders in Michigan received reduced premiums for their automobile policy by buying coordinated benefits; therefore, having a job with a health care coverage plan that is self-funded you are obligated to surrender that portion of your settlement which equals their payment on your behalf. You can fight back by instructing your insurance agent, if you are covered by a self-funded group health plan organized and governed by an employees’ retirement security act by your employer ERISA or receive Medicare benefits as a senior, to provide you with a non-coordinated medical benefits no-fault policy for a few more dollars and preclude the health plan from taking anything from your settlement. Don't take NO for an answer from your insurance agent. If you have any questions, please contact me: Michael J. Gallagher, Personal Injury Attorney mike@lawyerinjuryexpert.com 1-877-445-4446 |
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