MEEMIC (teachers' insurer) unsuccessfully attempts to cheat teacher out of wage loss
In one of the most brazen abuses of an insured that we have seen in recent years, MEEMIC, the "captive" MEA insurer that touts its special understanding of teachers, recently lost its bid to cheat an injured teacher out of her post-motor vehicle accident wage loss. When a person is hurt in a car wreck in Michigan and can't work, his or her own insurer must pay the injury victim 85% of gross pay for "work he or she would have performed" -- up to the statutory maximum ($4,714 per month in 2009). Needless to say, insureds pay for this coverage in annual premiums.
Doreen Copus is a special ed teacher who was badly hurt in a wreck and missed the entire 2008-2009 school year. Her salary was $63,895.00. Everyone agrees on those facts, so a pretty easy calculation, right? She should get $54,310.75 (or 85%) of what she lost that year right? Well, no, maybe not so easy.MEEMIC argued that her income should be attributed only to the months of the school year (even though Copus had elected to be paid in 26 bi-weekly segments through the year including summer). On this basis, MEEMIC calculated her loss on a per diem basis. Since that loss would be greater during the school year, by MEEMIC's calculation, she exceeded the statutory cap during the school year months, and her total recovery should only be $44,268.64 total for the year--about 70 percent of her pay, rather than the statutory 85%.
Fortunately, Judges Cavanagh, Stephens and Ronayne Krause of the Court of Appeals saw this clever chicanery for exactly what it was: "Defendant seeks to create a fiction, completely unwarranted by anything in the statute, that plaintiff's income was something other than what it actually was..." The judges noted that the Attorney General opinion relied upon by MEEMIC to support its fancy calculation "is not even substantively consistent" with MEEMIC's position and it upheld the lower court's calculation of Copus' wage loss, which was....85 percent of her gross pay--as defined by statute.