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ARTICLE · 18 OCTOBER 2001

No Windfall Under PIP

Secrest Wardle Lynch Hampton Truex & Morley
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United StatesInsurance
Mark E Morley
Mark E Morley

In Bobalski v. Perri - Mich App - (2001), several of Plaintiff’s bones were broken when Mr. Perri’s car hit Plaintiff’s motorcycle. Plaintiff had coverage with Blue Cross & Blue Shield, and had an uncoordinated No Fault policy with Auto Owners Insurance Company.

All of Plaintiff’s medical bills were paid by Blue Cross, but Plaintiff’s medical providers accepted less than the full amount originally billed in satisfaction for Plaintiff’s treatment. Plaintiff and Auto Owners agreed that Auto Owners owed Plaintiff some PIP benefits pursuant to the uncoordinated policy, but they could not agree on the amount.

Plaintiff argued that the No Fault Act mandated coverage for "reasonable charges incurred" for treatment; therefore, amounts negotiated and paid for by Blue Cross were irrelevant and did not affect the amounts "incurred" by Plaintiff. Auto Owners argued that Plaintiff’s benefits were limited to the amounts that Plaintiff’s health care providers had accepted from Blue Cross as

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