Perez v. State Farm Mutual Automobile Insurance

T. M. Burns, P.J.

(dissenting). Respectfully, I dissent.

In Mays v Ins Co of North America, 407 Mich 165; 284 NW2d 256 (1979), the Supreme Court addressed an issue somewhat similar to that at bar. In that case, the defendant insurance company argued that it was entitled to offset against its liability to the plaintiff under a disability insurance policy those benefits to which the plaintiff theoretically was entitled but which had not been paid to him under the Workmen’s Compensation Act. The insurance policy provision in question stated:

"The Weekly Benefit Amount shall be reduced by the weekly pro-rata portion of any benefits payable under the Workmen’s Compensation Act and the primary disability monthly benefit payable under the Federal Social Security Act regardless of actual receipt of such benefit due to the Insured’s failure to apply therefor * * 407 Mich 170-171.

The Court held that no setoff for workers’ compensation benefits could occur under this policy provision unless the benefits were actually paid:

"A setoff of such benefits, even if no application was filed, cannot he countenanced under the instant provision, except when such benefits are actually received.” 407 Mich 172.

In spite of the difference between Mays and the case at bar, the similarity between them is suffi*208cient to make Mays controlling here. The insurance policy in Mays clearly provided for a setoff for that portion "of any benefits payable under the Workmen’s Compensation Act”. This phrase is substantially similar to that contained in MCL 500.3109(1); MSA 24.13109(1) which states that benefits "provided or required to be provided” under the law of any state or the Federal government shall be subtracted from benefits payable under the no-fault automobile insurance act. In this regard, see Mathis v Interstate Motor Freight System, 408 Mich 164, 187, 190; 289 NW2d 708 (1980). Further, at least one panel of this Court has held that § 3109(1) of the no-fault act requires a setoff for the amount of workers’ compensation benefits "received for an injury”. Wolford v Travelers Ins Co, 92 Mich App 600, 604; 285 NW2d 383 (1979).

Contrary to what the majority believes, I do not believe that the Legislature intended to leave accident victims such as the plaintiffs in the present case without some source of recompense for their injuries. The purpose behind §3109 of the act is to insure that duplicate benefits are not paid to an accident victim and to coordinate such benefits as the victim may receive. This purpose would not be furthered, rather it would be hindered, by the interpretation given this statute by the majority in this case. Although the majority’s opinion cannot said to be without some case law support, see Moore v Travelers Ins Co, 475 F Supp 891 (ED Mich, 1979), that opinion works an injustice to employees of employers who have not fulfilled their statutory duty with regard to providing workers’ compensation coverage, and it impedes the important policy of this state to provide full and adequate compensation for automobile accident victims. Therefore, I would affirm the lower court.