No-fault personal protection insurance (PIP) medical benefits; Michigan Assigned Claims Plan (MACP); Nonoccupant of a motor vehicle; MCL 500.3115; MCL 500.3172(1); Medicare opt-out; MCL 500.3107d; Applicable PIP policy; MCL 500.3114(1); Steanhouse v Michigan Auto Ins Placement Facility (On Remand)

In an issue of first impression, the court held that a person injured in a motor-vehicle accident while not occupying a vehicle may not obtain PIP medical benefits through the MACP when the person has an applicable PIP policy but elected to opt out of medical coverage. Plaintiff was struck by a vehicle after exiting his own vehicle following an initial collision. His Auto-Owners policy provided some PIP benefits, but he had elected the Medicare opt-out under MCL 500.3107d and did not maintain PIP medical coverage. He sought medical benefits through the MACP under MCL 500.3115. The trial court denied defendant-MAIPF’s summary disposition motion. On appeal, the court assumed without deciding that MCL 500.3115’s exception referring to MCL 500.3114(1) did not itself bar plaintiff’s claim. But it concluded that he independently failed the eligibility requirements in MCL 500.3172(1). Applying Steanhouse, the court explained that statutes directing an injured person to claim benefits through the MACP do not establish eligibility because MCL 500.3171 through MCL 500.3175 “contain their own eligibility requirements.” Plaintiff’s Auto-Owners policy was both identifiable and “applicable to the injury.” The court reasoned that opting out of medical benefits does not transform an otherwise valid PIP policy into something other than “a personal protection insurance policy described in” MCL 500.3101(1). Plaintiff simply opted out of medical coverage within that policy. The court rejected his argument that the omission from MCL 500.3115 of the express opt-out exclusion appearing in MCL 500.3114(4) demonstrated legislative intent to provide MACP benefits to nonoccupant opt-outs. MCL 500.3172(1) independently limits eligibility. The court added that permitting a person who paid a reduced premium by declining medical coverage to obtain those same benefits through the MACP would undermine the 2019 reforms’ emphasis on individual insurance choices. Reversed and remanded.