Second Appeals Court panel allows health plan to take "pain and suffering" recovery without PIP reimbursement
Sarah Muntean had health insurance through her employer. She also bought mandatory No Fault Personal Injury Protection (PIP) medical coverage through Citizens Insurance. She paid a slightly reduced premium for "coordinated benefits," meaning that her health insurance had to pay medical first. When she was badly hurt in a car accident, she also sued the insurer of the at-fault driver to collect for wage loss after three years and non-economic damages.
Her health insurer immediately demanded a lien on her "third-party" suit against the at-fault, claiming reimbursement for the expenses it incurred. Through her attorneys, Muntean then notified her No Fault PIP insurer that she was "incurring" the medical expenses and being forced to pay them out of her "third-party" non-economic recovery. This week a second panel of the Michigan Court of Appeals followed the Republican reversal of precedent and held that Muntean must turn her "pain and suffering" and future work loss recovery over to her health carrier, without contribution from Citizens to payment of her medical expenses.
Thus, Muntean paid two premiums for medical expense insurance, cannot sue the at-fault directly for medical coverage, and must relinquish her claim for pain and suffering and lost wages to pay her own medical expenses, because of the combination of fine print in her two insurance policies, as interpreted by Republican, insurance-oriented judges. She paid two premiums for health coverage and still must pay those expenses out of her own money. Guess who dominates the judiciary in Michigan.