Farmers Insurance Exchange v. Titan Insurance

651 N.W.2d 428, 251 Mich. App. 454
CourtMichigan Court of Appeals
DecidedSeptember 10, 2002
DocketDocket 225349
StatusPublished
Cited by13 cases

This text of 651 N.W.2d 428 (Farmers Insurance Exchange v. Titan Insurance) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Farmers Insurance Exchange v. Titan Insurance, 651 N.W.2d 428, 251 Mich. App. 454 (Mich. Ct. App. 2002).

Opinion

Per Curiam.

Originating as a no-fault insurance action arising from an automobile accident in August 1995, this case now concerns only third-party proceedings involving two insurance companies. Third-party defendant Titan Insurance Company appeals as of right from the trial court’s order awarding third-party plaintiff Farmers Insurance Exchange “$491,302.42 by way of reimbursement from a no-fault insurer found to be equal in priority” plus twelve percent prejudgment interest pursuant to MCL 600.6013(5). 1 Titan does not contest on appeal the trial court’s rulings that Titan and Farmers are in equal priority and that Titan must pay half of future no-fault benefits due to the insured. On cross appeal, Farmers asserts that if this Court reverses the award *456 of interest, it should “revisit” the trial court’s failure to award administrative expenses to Farmers. We affirm in part, vacate in part, and remand to the trial court.

On appeal, Titan challenges the trial court’s rulings that it must pay Farmers for no-fault benefits, for which the Michigan Catastrophic Claims Association (mcca) already reimbursed Farmers, and pay prejudgment interest. According to Titan, these rulings result in Farmers receiving a double recoveiy of the payments previously reimbursed and a windfall of the interest amount. Titan claims instead that the MCCA is the appropriate recipient of $250,000 from Titan because Farmers cannot aggregate its loss with Titan to reach the $250,000 threshold for catastrophic claims. 2 We disagree. Resolution of Titan’s claims on appeal requires statutory interpretation, which is a question of law that we review de novo. Liberty Mut Ins Co v Michigan Catastrophic Claims Ass’n, 248 Mich App 35, 40; 638 NW2d 155 (2001).

To begin, we note that the no-fault act, MCL 500.3101 el seq., requires insurers to pay or reimburse their insured’s lifetime medical expenses — “[t]here is no dollar limit on the insurer’s liability for medical, hospital, and rehabilitation benefits under the statute.” League Gen Ins Co v Michigan Catastrophic Claims Ass’n, 435 Mich 338, 340; 458 NW2d 632 (1990). To alleviate some of the effect that large claims arising from severe injuries may have on insur- *457 anee companies, our Legislature created the MCCA. Id.; Liberty Ins, supra. In relevant part, MCL 500.3104 provides:

(1) An unincorporated, nonprofit association to be known as the catastrophic claims association [the MCCA], hereinafter referred to as the association, is created. Each insurer engaged in writing insurance coverages which provide the security required by section 3101(1) [MCL 500.3101(1)] within this state, as a condition of its authority to transact insurance in this state, shall be a member of the association and shall be bound by the plan of operation of the association. . . .
(2) The association shall provide and each member shall accept indemnification for 100% of the amount of ultimate loss sustained under personal protection insurance coverages in excess of $250,000.00 in each loss occurrence. As used in this section, “ultimate loss” means the actual loss amounts which a member is obligated to pay and which are paid or payable by the member, and shall not include claim expenses. [Emphasis supplied.]

In addition, the statute provides that the board of the association in conjunction with the commissioner shall establish a plan of operation in order to set out the rules and procedures for running the association. MCL 500.3104(17). Further, “each insurer authorized to write insurance providing the security required by section 3101(1) in this state . . . shall be bound by and shall formally subscribe to and participate in the plan approved as a condition of maintaining its authority to transact insurance in this state.” MCL 500.3104(20).

Another statutory provision, MCL 500.3115, addresses the distribution of loss among personal protection insurers. With regard to recoupment, MCL 500.3115(2) provides:

*458 When 2 or more insurers are in the same order of priority to provide personal protection insurance benefits an insurer paying benefits due is entitled to partial recoupment from the other insurers in the same order of priority, together with a reasonable amount of partial recoupment of the expense of processing the claim, in order to accomplish equitable distribution of the loss among such insurers.

The law allows one insurer that has paid out benefits to recoup half of the benefits paid, where it is determined that another insurer is in equal priority. See Citizens Ins Co of America v Clouse, 176 Mich App 138, 143-144; 439 NW2d 304 (1989).

Here, Titan’s position requires us to examine MCL 500.3115(2) in combination with MCL 500.3104. The undisputed facts of this case indicate that Farmers already paid out almost $1 million to or for the benefit of the insured, and that subsequently the MCCA reimbursed Fanners for the amount exceeding $250,000. Thus, Titan claims that if it is required to pay Farmers, then Farmers will receive more than the half of the benefits paid to which it is entitled under MCL 500.3115(2). Although Farmers claims that the money, less the interest amount, would be turned over to the MCCA, Titan points out that there is no indication from the MCCA or from the wording of the judgment that that would be the case.

However, the Legislature directed that a plan be developed that covers specific topics and provides for “[a]ny other matter required by or necessary to effectively implement this section [MCL 500.3104].” MCL 500.3104(10)(h). Because both Titan and Farmers are “bound by” and must “subscribe to and participate in the plan,” MCL 500.3104(20), we believe that reliance *459 on the language of the plan is appropriate in this situation.

Whenever a member recovers from a third-party an amount for which it has already been reimbursed by the Association, the member shall promptly turn such recovered monies over to the Association to the extent of any reimbursement theretofore received, provided that the Board may permit a member to retain therefrom such amount as the Board deems reasonable and necessary attorney fees and litigation costs incurred in connection with obtaining the recovery from the third party. [Michigan Catastrophic Claims Association Plan of Operation, Article X, § 10.06.]

The plan demonstrates that despite the lack of explicit direction from the Legislature with regard to the circumstances in the present case, the MCCA board anticipated such circumstances occurring and provided an answer. Under these circumstances, we believe that the MCCA plan of operation should be read in combination with the Legislature’s intent of a pro-rata distribution of expenses for insurers in equal priority. MCL 500.3115(2). Accordingly, when an insurer pays out benefits, it can recoup part of the money paid from another insurer in equal priority, even if the mcca already has reimbursed the initial insurer. 3

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Cite This Page — Counsel Stack

Bluebook (online)
651 N.W.2d 428, 251 Mich. App. 454, Counsel Stack Legal Research, https://law.counselstack.com/opinion/farmers-insurance-exchange-v-titan-insurance-michctapp-2002.