Insurer priority under the No-Fault Act; MCL 500.3114(3); “Shall”; Whether policy exclusion affirmative defenses were waived; Effect of an insured’s assignment to a healthcare provider; An insured’s obligation to read the policy; Applicability of the mend-the-hold doctrine; Equitable estoppel & enforcement of policy exclusions

The court held that defendant-insurer was entitled to summary disposition under MCL 500.3114(3) because plaintiff-Matigian was driving a semi-tractor trailer owned by his employer and insured with another insurance company when the accident occurred. In addition, even if the policy exclusions at issue were affirmative defenses that defendant failed to properly assert, the court concluded that it did not waive its ability to assert their application. Further, neither the mend-the-hold doctrine nor equitable estoppel applied. Thus, the court affirmed summary disposition for defendant, which insured Matigian’s personal vehicle. The trial court based its ruling on the policy exclusions in defendant’s policy. But the court noted that because “MCL 500.3114(3) contains mandatory language stating that an employee who suffers injury ‘while an occupant of a motor vehicle owned’ by the employee’s employer ‘shall receive [PIP] benefits to which the employee is entitled from the insurer of the furnished vehicle,’ Matigian must obtain any PIP benefits he is entitled to from the insurer of” the semi-tractor trailer. In addition, as to the policy exclusions, the court noted that at “no point in either version of plaintiffs’ complaints did plaintiffs allege or disclose that Matigian was driving his employer’s vehicle at the time of the accident. Thus, plaintiffs failed to plead factual allegations sufficient to reasonably inform defendant that Matigian was involved in an accident while he was operating an employer-owned vehicle in the course of his employment and that its policy exclusions in this regard may be applicable. As a result, defendant was excused from raising the employer-owned-vehicle exclusion as an affirmative defense.” As to the other two relevant exclusions, plaintiffs admitted “that at the time of the accident, Matigian was driving a vehicle owned and insured by his employer and was driving the vehicle in the course and scope of his employment.” Thus, he was precluded by the exclusions “from seeking benefits from defendant as was” plaintiff-healthcare provider as his assignee.