Court Opinion

ID: 9576232
Source: CourtListenerOpinion
Date Created: 2023-08-21 21:22:06.3955+00
Date Added: 2024-06-11T13:02:53.623549
License: Public Domain

Brickley, J.
(dissenting). The central issue in this case is whether the term "benefits provided or required to be provided under the laws of any state or the federal government shall be subtracted from the [no-fault insurance benefits]” under § 3109(1)1 of the no-fault act only applies to dollar amount benefits, or whether it also applies to services provided in kind by the government in its own hospitals.2_
*651The lead opinion provides a somewhat contingent response to this question by stating that the purpose of § 3109(1) is to "eliminate duplicative benefits” and that
[b]ecause of differences in quality and service, medical service provided in kind by a governmental source may not be duplicative of medical service obtainable in the private sector with the no-fault medical expense benefit. [Emphasis supplied. Ante, p 643.]
The majority adds to this the rationale that
[t]he benefits required to be subtracted are generally dollar amounts. When § 3109(1) has heretofore been invoked, the benefits sought to be deducted generally were dollar benefits. Section 3109(1) requires the subtraction of governmental dollar benefits from the dollar amount of no-fault benefits— governmental benefit dollars from no-fault insurer dollars. [Ante, pp 646-647.]
In response, I find no support, in law or in logic, that a given surgical procedure in a military hospital is not "duplicative” of a similar procedure in any other medical facility in terms of the overall purpose of the no-fault act.
It is certainly true that in a military hospital, as in any medical facility, a given service may be of inferior quality, and that by not having a choice under a given government benefit program an insured may at least lose the opportunity to exer*652cise discretion in an attempt to affect the quality of the chosen services. Also, although it is not the goal of the act that "the no-fault act preserves to the injured person a choice of medical service providers,” the act certainly does in its effect, in most cases, leave to the insured the choice of where to take advantage of medical services. Unlike the United States military, no-fault insurers are not in the business of owning and operating large-scale medical facilities. Of course, all of this sidesteps the central issue here whether or not § 3109(1) has a different effect.
Nowhere in the no-fault act is it provided that it is the goal, purpose, or preference of the act to preserve in all instances a choice of where medical services should be provided. The majority, in a conclusory manner, merely states that "[sjection 3109(1) does not deprive an injured person, who may be eligible to obtain service in kind in a military hospital, of such choice of medical service providers.” Ante, p 643. This statement begs the very question we must answer in this case.
I would hold that the benefits in kind in this case are governmental benefits under § 3109(1) "provided or required to be provided” and, accordingly, can be subtracted from the defendant insurer’s liability under the policy.3
The conclusion of the majority suggests that the Legislature, in using the words "benefits . . . under the laws of . . . the federal government” was unaware of the major sources of governmental benefits, and military hospitals in particular, a *653suggestion I think is implausible. To the contrary, there can be no doubt that the Legislature intended to avoid any evasion of the opportunity to have governmental benefits fully taken advantage of to effectuate a setoff for the no-fault insurer wherever such alternate benefits existed. The best evidence of that is the language of §3109(1) that mandates that not only "benefits provided” but that "benefits . . . required to be provided” also can be taken advantage of by the no-fault insurer. We have often in other settings discussed the legislative intent of the words "required to be provided,” but we have probably never had a better example of its purpose. See Perez v State Farm Mutual Automobile Ins Co, 418 Mich 634; 344 NW2d 773 (1984).
It is exactly in this setting where the "benefits provided” have been declined by the insured that the additional words "required to be provided” make the difference between the insured being able to frustrate the purpose of § 3109(1) by bypassing the "benefits provided” in kind and requiring the no-fault insurer to pay for the costs the insured incurred which could have been provided under federal law. By including the term "required to be provided,” the Legislature has stated that whether the benefits are taken or not, the fact that they are required to be provided is sufficient to allow the no-fault insurer to receive credit for the benefits which were available to the insured.
Furthermore, the fact that not only benefits that are provided can be "subtracted” from the no-fault benefits, but that benefits that are not provided or received but "required to be provided” can be subtracted from the no-fault insurer’s benefits, forces the conclusion that "subtracted” is not intended to be confined to the interpretation offered *654by the majority. See ante, pp 646-647. It is obvious that "subtracted” means that the no-fault insurer should not have to pay for what the insured did receive or could have received. The majority interpretation that "subtraction” in § 3109(1) is in this situation confined to dollar amounts would render the words "or required to be provided” a nullity because the value of benefits not received, but that could have been received, could not be set off.4
When the "benefits provided . . . under the laws of any state or the federal government” are provided in kind, rather than as reimbursement for expenses incurred, then under §3109(1) no "subtraction” is required because no costs have been incurred. Similarly, no costs having been incurred, the no-fault carrier is also free of obligation to reimburse. However, to allow the insured to decline benefits in kind and to incur the costs of treatment outside the "benefits provided or required to be provided by law,” and then not to allow the subtraction of those benefits would, in my judgment, be a clear frustration of the specific intent of § 3109(1) and the overall goal of the no-fault automobile insurance scheme. It is the intent of § 3109(1) that benefits provided by law be taken advantage of to lessen the cost of no-fault insurance. This effort to lower the costs of no-fault insurance is one of the stated goals of the no-fault insurance act generally. Shavers v Attorney General, 402 Mich 554; 267 NW2d 72 (1978); LeBlanc v State Farm Mutual Automobile Ins Co, 410 Mich 173; 301 NW2d 775 (1981).
*655Simply stated, it would defeat the obvious intention of the Legislature to suggest that the no-fault insurer can take advantage of money received by the insured from government benefits but not service provided in kind by the government in place of money.
Riley, C.J., concurred with Brickley, J.
Boyle, J., concurred only in the result reached by Brickley, J.

 MCL 500.3109(1); MSA 24.13109(1).

 I assume, as does the majority, that the plaintiff could have availed himself of the services of a military hospital, but that he declined to do so. Because I disagree with the majority that he could decline such services in a military hospital and collect the costs of those same services in a nonmilitary hospital from his insurer, I do *651not find it necessary to determine whether the insured plaintiff could have collected for his services in a nonmilitary hospital from the federal government. I do point out, however, that it was not until the beginning of the lawsuit when the plaintiff was asked in a deposition whether he had made an effort to seek reimbursement from the federal government and he answered that he had not, that he subsequently made the effort and secured the response referred to by the majority.

 There is nothing in the record or the arguments of this case suggesting that the benefits in kind at the military hospital were below standard or objectionable. I would not discount the possibility in an appropriate case of the validity of an argument that benefits in kind were sufficiently below standard that they in effect were not benefits at all, thus making § 3109(1) inapplicable. This is not such a case.

 It is my understanding that most policies do not specify dollar benefits, but rather specify medical procedures, hospital stay, home-care nursing, and similar descriptions of medical benefits. Because the costs of those benefits tend to be standardized, at least when they are being reimbursed by major carriers, "subtracting” benefits received or required to be received, rather than dollars, from those provided by the no-fault carrier insurance policy would not be a difficult task.