DeMeglio v. Auto Club Ins. Ass'n

Cavanagh, J.

I respectfully dissent from the majority’s opinion because I believe that foreign no-fault benefits fall outside the intended scope of § 3109(1) benefits.

The Michigan no-fault act,1 in my view, dictates this result. It is axiomatic.that Michigan no-fault benefits are not § 3109(1) benefits.2 No compelling statutory basis exists to conclude that foreign no-fault benefits must be treated as § 3109(1) benefits. The Legislature drafted a specific provision to deal with liability issues that may arise when an out-of-state resident, who is insured under a private *50automobile insurance policy, suffers injury because of a motor vehicle accident that occurs in Michigan and that involves an insured Michigan motorist. That provision is § 3163, and it provides:

(1) An insurer authorized to transact automobile liability insurance and personal and property protection insurance in this state shall file and maintain a written certification that any accidental bodily injury or property damage occurring in this state arising from the ownership, operation, maintenance or use of a motor vehicle as a motor vehicle by an out-of-state resident who is insured under its automobile liability insurance policies, shall be subject to the personal and property protection insurance system set forth in this act.
(2) A nonadmitted insurer may voluntarily file the certification described in subsection (1).
(3) When a certification filed under subsections (1) or (2) applies to accidental bodily injury or property damage, the insurer and its insureds with respect to that injury or damage have the rights and immunities under this act for personal and property protection insureds, and claimants have the rights and benefits of personal and property protection insurance claimants, including the right to receive benefits from the electing insurer as if it were an insurer of personal and property protection insurance applicable to the accidental bodily injury or property damage. [MCL 500.3163; MSA 24.13163. Emphasis added.]

Section 3163 demonstrates that the Legislature contemplated the issue of coverage for an insured out-of-state resident who is involved in an accident in Michigan, and formulated § 3163 to address that issue. Section 3163 also shows that the only situation in which the Legislature deemed the liability of an automobile insurer of an out-of-state resident to be a relevant consideration under Michigan no-fault law is when the conditions un*51der § 3163 have been satisfied.3 Paraphrasing § 3163(1), those conditions are: .(1) certification of the insurer in Michigan; (2) existence of an automobile liability policy between the insurer and the out-of-state resident; and (3) a sufficient causal relationship between the out-of-state resident’s injuries and the ownership, operation, maintenance, or use of a motor vehicle as a motor vehicle.4 When all three of these conditions are met, the private automobile insurer of the out-of-state resident becomes subject to the requirements and exclusions under Michigan no-fault law, and, in most cases, its liability would be determined by applying the normal priority rules under §§ 3114 and 3115.

The language that is emphasized in § 3163(1) makes clear that the liability of an automobile insurer of an out-of-state resident under Michigan no-fault law is not coextensive with the liability of a no-fault insurer of a Michigan resident.5 A significant condition for the liability of an insurer of an out-of-state resident is § 3163(1)’s requirement that *52the out-of-state resident own, operate, maintain, or use one of the motor vehicles that gives rise to the resident’s accidental bodily injury. As this Court and several Court of Appeals panels have acknowledged, if the out-of-state resident is not owning, operating, maintaining, or using a motor vehicle that gives rise to the injury at the time of the accident, the certified insurer of the out-of-state resident is not liable, and primary responsibility rests with the insurers of the Michigan resident owners or operators of vehicles involved in the accident.6

Applying § 3163 to the case at bar, State Farm’s *53liability is not a controlling consideration under Michigan no-fault law, even though it had to pay no-fault benefits to its insured under Pennsylvania law.7 Because State Farm regularly transacts automobile liability insurance in Michigan, it is likely that it is authorized to do so, and that it has filed a certificate of compliance as required under § 3163(1). Even if State Farm is considered a certified insurer, and even if it is undisputed that the accident arose out of the use of a motor vehicle as a motor vehicle, State Farm’s liability does not come into play because the accident did not arise from an out-of-state resident’s use of a motor vehicle as a motor vehicle. Marisa is the out-of-state resident, and she was using a bicycle, not a motor vehicle, when the accident occurred. Consequently, the conditions for liability for an insurer of an out-of-state resident have not been met under § 3163, and State Farm’s connection to the accident is irrelevant for purposes of coverage determinations.8

Acia is the only other potentially liable party. As the majority explicitly observes, acia is liable under §§ 3101(1) and 3115(l)(a). Unlike the majority, I would apply § 3163 to find that acia is primarily liable for the full share of benefits owing under Michigan no-fault law. Foreign no-fault benefits are outside the purview of § 3109(1), and § 3109a for that matter, because § 3163 exists as the provision for determining the extent of coverage available to an out-of-state resident whose insurer has filed a certificate of compliance. Application of § 3163 would permit priorities between *54competing no-fault policies issued in and outside Michigan to be governed by §§ 3114 and 3115 in accordance with the treatment given to competing no-fault policies issued in Michigan only. I consider it beneficial to maintain' consistency under the no-fault act as far as possible. I also believe that application of § 3163 will lead to the fairest results in the majority of cases like the one before the Court now.

In arriving at my position in this case, I am not unmindful of the policy considerations that would favor a setoff — i.e., avoiding duplicative recovery and reducing premium costs. However, to find that § 3109(1) benefits include foreign no-fault benefits would, in my view, amount to judicial legislation. The Legislature drafted § 3163 to serve as the primary9 mechanism to resolve liability issues that may arise from motor vehicle accidents that occur in Michigan and that implicate automobile insurers of out-of-state residents and Michigan residents. Any liability of a certified insurer of the out-of-state resident for its insured’s injury becomes a pertinent consideration under Michigan no-fault law only when the conditions under § 3163 have been satisfied. When such conditions cannot be met, primary liability lies with the insurers of the Michigan residents.

While it is not for this Court to judge the wisdom of the Legislature’s policy determinations, it is reassuring to recognize that when § 3163 is applied to situations that entail a motor vehicle áccident in Michigan involving both an insured out-of-state resident and a Michigan resident, the possibility for double recovery by the out-of-state resident is a narrow one. For duplicate recovery to occur, the following combination of circumstances *55would have to exist: an out-of-state resident would have to be involved in an accident while traveling in Michigan; the out-of-state resident would have to possess automobile liability insurance; such insurance would have to provide that coverage under the policy is primary; and, finally, the conditions under § 3163 either could not be met, or they could be met but the insurer of the out-of-state, resident is not liable because an exception applies under the normal priority rules.10

For these reasons, I would affirm the decision of the Court of Appeals.

Mallett, J., concurred with Cavanagh, J. Weaver, J., took no part in the decision of this case.

MCL 500.3101 et seq.; MSA 24.13101 et seq.

The Legislature drafted the priority provisions under §§ 3114 and 3115 to deal with situations involving multiple no-fault policies. If Michigan no-fault benefits were considered to be § 3109(1) benefits, these priority provisions would be rendered meaningless.

It is also instructive to note that this Court has held that Michigan no-fault benefits are not § 3109a benefits. Dep’t of Social Services v American Commercial Liability Ins Co, 435 Mich 508; 460 NW2d 194 (1990). In so holding in DSS, we emphasized that the priority provisions controlled for liability determinations.

Because the facts in this case do not require me to do so, I decline to express any opinion about whether a judgment for or against an insurer of an out-of-state resident may, in certain cases, be a relevant consideration under the doctrine of res judicata. See, generally, Jones v State Farm Mut Automobile Ins Co, 202 Mich App 393, 397; 509 NW2d 829 (1993).

Transport Ins Co v Home Ins Co, 134 Mich App 645; 352 NW2d 701 (1984). Note that § 3163 would not apply if the out-of-state resident operates a motor vehicle in Michigan for more than thirty days in any calendar year because in that situation the out-of-state resident would be required to maintain Michigan no-fault insurance. MCL 500.3102(1); MSA 24.13102(1).

In addition, an out-of-state resident would not be entitled to collect no-fault benefits under Michigan law if at the time of the accident the out-of-state resident "was an occupant of a motor vehicle or motorcycle not registered in this state, and was not insured by an insurer which has filed a certification in compliance with section 3163.” MCL 500.3113(c); MSA 24.13113(c).

Mills v Auto-Owners Ins Co, 413 Mich 567; 321 NW2d 651 (1982); Cheatum v Hartford Accident & Indemnity Co, 121 Mich App 761; 329 NW2d 481 (1982).

Parks v DAIIE, 426 Mich 191, 209; 393 NW2d 833 (1986); Mills v Auto-Owners Ins, n 5 supra (an out-of-state resident was operating a motorcycle); Bach v State Farm Mut Automobile Ins Co, 137 Mich App 128; 357 NW2d 325 (1984) (an out-of-state resident was a pedestrian); Endquist v Cadillac Ins Co, 119 Mich App 801; 327 NW2d 368 (1982) (an out-of-state resident was a pedestrian); Guibord v Farmers Ins Exchange, 110 Mich App 218; 312 NW2d 219 (1981) (an out-of-state resident was operating a motorcycle).

In Jones v State Farm Ins Co, n 3 supra at 407, the Court of Appeals stated that § 3163 "was not intended to create an entirely new source of recovery, independent of the policy from which the claim arose.” In light of the language in § 3163(3) in particular, that general construction of § 3163 is not accurate. Section 3163(3) indicates that a new source of recovery would be available to the extent recovery is permitted under Michigan no-fault law. However, the extent of recovery under Michigan no-fault law could not result in the insurer of the out-of-state resident having to pay duplicate benefits to its insured for the same losses. Clute v General Accident Assurance Co of Canada, 179 Mich App 527; 446 NW2d 839 (1989). Because liability under Michigan no-fault law, in certain situations, may be broader than that provided under an out-of-state resident’s insurance policy, the Court of Appeals has recognized that an insurer’s decision to file a certificate of compliance pursuant to § 3163 may make a policy more attractive to potential insureds who might be regular travelers in Michigan. Safeco Ins Co v Economy Fire & Casualty Co, 182 Mich App 552, 557; 452 NW2d 874 (1990); Kriko v Allstate Ins Co of Canada, 137 Mich App 528; 532; 357 NW2d 882 (1984). While the extent of coverage provided under Michigan no-fault law may be the same for insured residents and qualified insured out-of-state residents, it must be kept in mind that the specific language "by an out-of-state resident” in § 3163(1) precludes the liability of an insurer of an out-of-state resident from being perfectly coextensive with the liability of an insurer of a Michigan resident. See Mills v Auto-Owners Ins, Bach, Endquist, and Guibord, supra.

State Farm had no choice when it paid the benefits that it did to Marisa DeMeglio because Pennsylvania no-fault automobile law provides that such no-fault coverage is "primary” to any other health and accident coverage of the insured, with the exception of worker’s compensation. 75 Pa Cons Stat Ann 1719(a).

Mills v Auto-Owners Ins, Bach, Endquist, and Guibord, n 6 supra.

See also §§ 3102(1) and 3113(c) discussed in n 4.

Significantly, the double recovery evidenced in this case is similar to the double recovery that would occur when a Michigan bicyclist or pedestrian, who is covered under an accident and health insurance policy — but not a no-fault automobile policy, suffers injuries from an accident that arose from the use of a motor vehicle owned and operated by a Michigan no-fault insured. In accordance with Michigan no-fault law, the bicyclist or pedestrian would be entitled to receive both benefits from her private insurer, and benefits from the no-fault insurer of the owner of the motor vehicle.