Coordinating No-Fault Insurance with Health Care Insurance

The Michigan No-Fault law provides in pertinent part: An insurer providing personal protection insurance benefits shall offer, at appropriately reduced premium rates, deductibles and exclusions, reasonably related to other health and accident coverage on the insured.

Case law supports that there was no intent by the Legislature when it mandated that no-fault carriers make available coordinated coverage at a reduced cost to correspondingly prohibit health insurers from including coordination of benefits clauses in the coverage provided by the health insurance policy. As a matter of contract interpretation, a no-fault insured is not entitled to receive duplicate payment for medical expense where the insured had elected uncoordinated benefits under his no-fault policy, but his health insurance policy contained a coordination of benefits clause.

The option of choosing between uncoordinated or coordinated no-fault automobile insurance does not exist for an individual who does not have underlying health or accident insurance that applies to automobiles. That individual must pay the higher premium for uncoordinated no-fault insurance. Therefore, the individual who is unemployed or does not have employment that provides health insurance must purchase uncoordinated no-fault insurance.

Keep this in mind when electing whether you would like to carry coordinated vs. uncoordinated no-fault benefits as you will need to know if your health insurance company will be primary if you are involved in an auto accident or if it specifically excludes auto accidents. While most no-fault policies are coordinated policies, many more health care companies are no longer provding primary coverage for claimants involved in auto accidents. As a result, it is important to know what you are paying for when it comes to your health care and auto insurance before you sustain injuries.