Osterhart v. Detroit Automobile Inter-Insurance Exchange

302 N.W.2d 622, 103 Mich. App. 143, 1981 Mich. App. LEXIS 2686
CourtMichigan Court of Appeals
DecidedJanuary 22, 1981
DocketDocket No. 48361
StatusPublished

This text of 302 N.W.2d 622 (Osterhart v. Detroit Automobile Inter-Insurance Exchange) 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
Osterhart v. Detroit Automobile Inter-Insurance Exchange, 302 N.W.2d 622, 103 Mich. App. 143, 1981 Mich. App. LEXIS 2686 (Mich. Ct. App. 1981).

Opinion

J. T. Kallman, J.

On September 26, 1977, while in the course of employment, plaintiff and two coworkers were standing on the shoulder of a road between two parked motor vehicles. A third motor vehicle, negligently operated by Ken Boroff, Jr., went off the traveled portion of the pavement and struck one of the parked vehicles, pinning plaintiff between the two parked vehicles. As a result of this accident, plaintiff was severely and permanently injured. At that time, plaintiff was insured under a policy of no-fault insurance issued by defendant.

Since plaintiffs accidental bodily injury occurred while he was in the course of his employment, he became entitled to workers’ compensation benefits, which were paid by his employer’s insurer, Celina Mutual Insurance Company. Celina paid all of plaintiff’s medical expenses, more than $12,000, [145]*145plus wage benefits of $132 per week during the period of plaintiffs disability. Plaintiff also recovered certain social security disability benefits.

Defendant paid plaintiff some benefits for plaintiff’s accidental bodily injury, but set off sums for plaintiff’s social security benefits and for his workers’ compensation payments. Because all medical expenses had been paid by Celina, defendant paid no medical expenses. Similarly, only a small amount of plaintiff’s lost wages were not paid by Celina, so defendant’s wage-loss benefit payments were small.

Plaintiff sued Kenneth Boroff and Ken Boroff, Jr., the owner and driver respectively of the striking vehicle, for noneconomic damages resulting from serious bodily injury. The Boroffs were insured for the statutory minimum bodily injury liability insurance coverage of $40,000 for each occurrence, so under the insurance only that amount was available for the third-party tort claims of plaintiff and his two injured co-workers. Plaintiff negotiated a settlement with the Boroffs’ insurer, under which plaintiff received $14,810.

Plaintiff claims Celina had a workers’ compensation lien on this tort recovery and was entitled to reimbursement in an amount in excess of $14,810. Therefore, plaintiff negotiated a settlement with Celina whereby the latter accepted the sum of $4,936.66 out of the proceeds of the noneconomic damage recovery in full satisfaction of its alleged workers’ compensation lien. Plaintiff contends the pro-rata share of the attorneys’ fees and costs attributable to the settlement with Celina was $1,105.15.

Plaintiff sued to recover the amount paid to Celina, plus the pro-rata share of attorneys’ fees and costs attributable to the Celina settlement, a [146]*146total of $6,041.81. Plaintiff claims this amount represents no-fault benefits unpaid and overdue.

Plaintiff moved for summary judgment under GCR 1963, 117.2(3). In an opinion dated October 18, 1979, Muskegon County Circuit Court Judge Ronald H. Pannucci found defendant obligated to pay $4,936.66 on the ground that "any other conclusion leads to an unjustified windfall for defendant”. The court refused plaintiff’s request for costs and attorneys’ fees.

Defendant now appeals by right and no cross-appeal has been filed.

Defendant argues that plaintiff had no obligation to pay monies over to the workers’ compensation carrier, as the carrier was not entitled to be reimbursed from plaintiff’s tort recovery, and that where plaintiff unnecessarily volunteered to pay Celina he was not entitled to repayment from defendant.

We must determine whether a workers’ compensation carrier is entitled to be reimbursed from an injured employee’s third-party tort recovery under the no-fault act.1 The right of a workers’ compensation carrier to be reimbursed is statutorily created. MCL 418.827; MSA 17.237(827) provides, in subsection 5:

"In an action to enforce the liability of a third party, the plaintiff may recover any amount which the employee or his dependents or personal representative would be entitled to recover in an action in tort. Any recovery against the third party for damages resulting from personal injuries or death only, after deducting expenses of recovery, shall first reimburse the employer [147]*147or carrier for any amounts paid or payable under this act to date of recovery and the balance shall forthwith be paid to the employee or his dependents or personal representative and shall be treated as an advance payment by the employer on account of any future payments of compensation benefits.”

In a case that arose before the passage of the no-fault act, Pelkey v Elsea Realty & Investment Co, 394 Mich 485; 232 NW2d 154 (1975), the Supreme Court held that a workers’ compensation carrier could be reimbursed for its payments for lost income and medical expenses out of a plaintiff’s third-party tort recovery for pain and suffering. The Court noted that an injured employee could pursue both a workers’ compensation claim and his common-law tort remedy. Pelkey, 493. The right of reimbursement was therefore necessary to avoid a double recovery windfall for the injured employee.

The passage of the no-fault act has altered the circumstances under which an injured employee may pursue his common-law tort remedy.2 3Under [148]*148the no-fault act, tort liability arising from a motor vehicle accident is abolished, with certain exceptions. Tort liability for noneconomic loss remains only when the injured person suffers death, serious impairment of bodily function or permanent serious disfigurement. MCL 500.3135(1); MSA 24.13135(1). This provision has been recognized as expressing the Legislature’s intent to provide compensation for catastrophically injured victims and for victims with extraordinary economic losses in addition to that available under the no-fault act. Workman v Detroit Automobile Inter-Insurance Exchange, 404 Mich 477, 509; 274 NW2d 373 (1979).

A split of authority has arisen over the effect of the no-fault act’s elimination of most common-law tort remedies on a workers’ compensation carrier’s right of reimbursement. In the first Court of Appeals case to address this issue, Wrobel v Wayne County Road Comm, 79 Mich App 484; 261 NW2d 58 (1977), one panel recognized an "inequitable” result but considered Pelkey as binding and allowed a workers’ compensation carrier to be reimbursed through an injured employee’s tort recovery for noneconomic loss. In Reliance Ins Co v Messina Trucking, Inc, 83 Mich App 159; 268 NW2d 328 (1978), another panel distinguished Pelkey and denied reimbursement to a workers’ compensation carrier. The Court reasoned that under the law applicable when Pelkey was decided an injured employee could recover from two sources for economic losses. The Court noted that under the no-fault act, no double recovery was possible, since the injured employee is limited in tort to [149]*149noneconomic damages. The Court found that the legislative object of making the injured person whole would be frustrated if a workers’ compensation carrier could be reimbursed for payments for economic loss from an injured employee’s third-party tort recovery for noneconomic loss. The Court held that reimbursement would deprive seriously injured parties of the equal protection of the law. Reliance Ins, id., 165.

The Reliance opinion was followed in Great American Ins Co v Queen, 86 Mich App 362; 272 NW2d 659 (1978),

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Related

Mathis v. Interstate Motor Freight System
289 N.W.2d 708 (Michigan Supreme Court, 1980)
Foremost Life Insurance v. Waters
278 N.W.2d 688 (Michigan Court of Appeals, 1979)
Reliance Insurance v. Messina Trucking, Inc.
268 N.W.2d 328 (Michigan Court of Appeals, 1978)
Workman v. Detroit Automobile Inter-Insurance Exchange
274 N.W.2d 373 (Michigan Supreme Court, 1979)
Wrobel v. Wayne County Road Commission
261 N.W.2d 58 (Michigan Court of Appeals, 1977)
Pelkey v. Elsea Realty & Investment Co.
232 N.W.2d 154 (Michigan Supreme Court, 1975)
Great American Insurance v. Queen
300 N.W.2d 895 (Michigan Supreme Court, 1980)
Great American Insurance v. Queen
272 N.W.2d 659 (Michigan Court of Appeals, 1978)
Flower v. Gensterblum
272 N.W.2d 726 (Michigan Court of Appeals, 1978)

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Bluebook (online)
302 N.W.2d 622, 103 Mich. App. 143, 1981 Mich. App. LEXIS 2686, Counsel Stack Legal Research, https://law.counselstack.com/opinion/osterhart-v-detroit-automobile-inter-insurance-exchange-michctapp-1981.