Sibley v. Detroit Automobile Inter-Insurance Exchange

427 N.W.2d 528, 431 Mich. 164, 1988 Mich. LEXIS 1406
CourtMichigan Supreme Court
DecidedAugust 23, 1988
Docket80207, (Calendar No. 3)
StatusPublished
Cited by28 cases

This text of 427 N.W.2d 528 (Sibley v. Detroit Automobile Inter-Insurance Exchange) is published on Counsel Stack Legal Research, covering Michigan Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sibley v. Detroit Automobile Inter-Insurance Exchange, 427 N.W.2d 528, 431 Mich. 164, 1988 Mich. LEXIS 1406 (Mich. 1988).

Opinion

Cavanagh, J.

Several times this Court has determined whether § 3109(1) of the no-fault insurance act 1 requires various state and federal government benefits to be subtracted from no-fault benefits. In this case we must determine whether § 3109(1) applies to the benefits plaintiff received but was later required to refund under the Federal Employees’ Compensation Act (feca), 5 USC 8101 et seq. We hold that because plaintiff was required by law to refund the benefits he had received, those benefits were not "provided or required to be provided” and therefore should not be subtracted from the personal protection insurance benefits otherwise available to plaintiff under the no-fault insurance act.

i

The facts in this case were submitted to the trial court by the parties in a stipulated "Statement of Facts,” which is summarized in the Court of Appeals opinion:

On August 15, 1978, plaintiff was injured in an automobile accident during the course of his employment with the United States Postal Service. On the date of the accident, plaintiff was the owner of an automobile insured by defendant. That automobile was not involved in the accident.
Plaintiff filed a workers’ compensation claim against the federal government under the Federal Employees’ Compensation Act (feca). 5 USC 8101 et seq. The claim was honored and plaintiff was ultimately paid $17,221.87 by the federal government, representing all of his medical expenses and three-fourths of his lost wages.
*167 Plaintiff had also filed a claim with defendant for no-fault benefits. Defendant honored the claim, but, pursuant to § 3109 of the no-fault act, deducted from the no-fault benefits otherwise payable the benefits plaintiff received pursuant to feca. Defendant ultimately paid $14,498.68, which represented lost wages not reimbursed under feca.
Plaintiff also pursued a tort claim for noneconomic damages against the owner and driver of the other vehicle involved in the accident. See MCL 500.3135; MSA 24.13135. Plaintiff settled the claim for $32,500. Thereafter, the U. S. Department of Labor, Office of Workers’ Compensation, demanded reimbursement of benefits paid under feca from the amount received by plaintiff from the tort claim settlement. The department sought reimbursement under 5 USC 8132, which provides in pertinent part as follows:
"If an injury or death for which compensation is payable under this subchapter is caused under circumstances creating a legal liability in a person other than the United States to pay damages, and a beneficiary entitled to compensation from the United States for that injury or death receives money or other property in satisfaction of that liability as the result of suit or settlement by him or in his behalf, the beneficiary, after deducting therefrom the costs of suit and a reasonable attorney’s fee, shall refund to the United States the amount of compensation paid by the United States and credit any surplus on future payments of compensation payable to him for the same injury.”
On August 31, 1983, plaintiff repaid the Department of Labor the principal sum of $12,186.69 plus interest of $2,195.60. Thereafter, plaintiff sought reimbursement of this payment from defendant. Defendant denied the claim and this litigation ensued. The parties filed cross-motions for summary disposition and, on August 23, 1985, summary disposition was granted in favor *168 of defendant. [156 Mich App 519, 521-522; 402 NW2d 51 (1986).]

The Court of Appeals affirmed, finding no reason to treat feca benefits differently from state workers’ compensation benefits and holding that plaintiff’s feca benefits had been properly set off against his no-fault benefits.

We granted plaintiff’s application for leave to appeal. 428 Mich 910 (1987).

ii

Section 3109(1) of the no-fault insurance act provides that certain benefits must be subtracted from personal protection insurance benefits available under the act:

Benefits provided or required to be provided under the laws of any state or the federal government shall be subtracted from the personal protection insurance benefits otherwise payable for the injury. [MCL 500.3109(1); MSA 24.13109(1).]

The purpose of § 3109(1) is to reduce the basic cost of insurance by requiring a setoff of those government benefits that duplicate no-fault benefits 2 and coordinating those benefits a victim may receive. The focus of the analysis is whether the benefits are duplicative. 3 Thus, "not all '[benefits provided or required to be provided under the laws of any state or the federal government’ must be subtracted from no-fault personal protection insurance benefits otherwise due.” 4 _

*169 This Court formulated a test to determine whether particular benefits must be set off from no-fault benefits in Jarosz v DAIIE, 418 Mich 565, 577; 345 NW2d 563 (1984):

We conclude that the correct test is: state or federal benefits "provided or required to be provided” must be deducted from no-fault benefits under § 3109(1) if they:
1) Serve the same purpose as the no-fault benefits, and
2) Are provided or are required to be provided as a result of the same accident.

Unfortunately, the Jarosz test did not really anticipate the question presented by these facts. We are confronted here with legislation conferring on the payor of workers’ compensation benefits a right of complete recovery out of the worker’s tort recovery — a situation not specifically dealt with or contemplated by our Legislature when it crafted our no-fault scheme.

The primary underlying theme of the automobile no-fault act is that the automobile insurer pays without any right of reimbursement out of any tort recovery. It is an important, but secondary, concept that where benefits are provided from other sources pursuant to state or federal law, the amount paid by the other source reduces the automobile insurer’s responsibility. But to the extent that the reduction in the automobile insurer’s responsibility is from a source that retrieves reimbursement from the injured person’s tort recovery, the amount so retrieved should not be deemed "benefits provided” within the meaning of the automobile no-fault act relieving the primarily liable automobile insurer of its primary responsibility to pay full benefits without reduction by reason of any tort recovery. Were it to be other *170 wise, the worker’s tort recovery, contrary to the spirit of the automobile no-fault act, would be used, in effect, to reimburse the alternative source (the federal government) of the other "benefits provided” that substituted for automobile no-fault benefits.

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Bluebook (online)
427 N.W.2d 528, 431 Mich. 164, 1988 Mich. LEXIS 1406, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sibley-v-detroit-automobile-inter-insurance-exchange-mich-1988.