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Although he paid for two insurance coverages, injury victim cannot collect both.

Both AAA and Blue Cross charged Charles Morris for uncoordinated health care coverage applicable to motor vehicle injuries. When  Morris was hurt, AAA paid his medical expenses, and he then sued Blue Cross to pay an equivalent amount  under the Blue Cross policy.  Blue Cross objected, arguing that the "parties' intent" was that Blue Cross not pay any expenses covered by another insurer. 

The court held that although Blue Cross's coordination provision applied, by its express language, only to "other health insurers" the parties' intent not to require double-payment was demonstrated by the fact that Blue Cross only owed for medical expenses owed by the insured.  The court held that since AAA had now paid the medical expenses, Blue Cross was "off the hook" because Morris no longer owed them.  Apparently, if he had rushed to sue, the outcome would have been different? 

The odd part is that Michigan Courts have refused to look beyond the specific language of the contract to determine "intent' or "reasonableness" when victims argue that enforcement of the "fine print" would be unreasonable:  the Engler Majority held that Michigan courts lack the power to interpret the "reasonableness" of contract terms.  On its surface, this appears to be the same issue--but with the outcome once again interpreted to benefit a large corporate insurer, rather than the "little guy." 

Should Blue Cross at least be obligated to return Morris's excess premiums paid for coverage he cannot collect?

Thompson O’Neil, P.C.
309 East Front Street
Traverse City, Michigan 49684
Toll Free: 1-800-678-1307
Fax: 231-929-7262