Defendant Omega Communications, doing business as Cable Vision, Inc., appeals as of right from the trial court’s judgment entered upon competing motions for summary disposition, supported by the parties’ stipulated facts, finding in favor of plaintiff Auto Club Insurance Association as against Omega and in favor of defendant State Farm Insurance Companies as against Omega. We affirm in part and reverse in part.
This appeal stems from a dispute regarding which insurer has the duty to provide coverage for injuries that Jennifer Schneider suffered in an automobile accident on July 21, 1991. At that time, Jennifer, a minor, was living with her mother, Wanda, who did not have no-fault insurance. Her parents were estranged. Because plaintiff was the no-fault insurance provider for the driver of the vehicle in which Jennifer was riding when the accident occurred, it paid $47,658.09 in no-fault benefits on her behalf. Plaintiff subsequently sought reimbursement from Omega, which provided health benefits to Ross
At the hearing on the parties’ motions for summary disposition, the trial court found that Omega was solely liable for providing medical coverage to Jennifer because the ERISA plan provided coverage for employees’ nonresident dependents if a court order or divorce decree specifies that the employee must provide coverage. The court found that the policy of this state, as set forth in Tousignant v Allstate Ins Co,
i
First, Omega asserts that the trial court erred in concluding that Jennifer Schneider was a covered dependent within the plan’s eligibility requirements; as a result, Omega was held solely responsible for Jennifer’s medical bills. Upon review de novo, we partially agree. See Vargo v Sauer,
Pursuant to the Omega plan’s choice-of-law provision, the plan must be construed according to the ERISA and Indiana law. In Indiana, it is the court’s main duty to ascertain the intent of the parties and give the language of an insurance policy its plain and ordinary meaning. First Federal Savings Bank of Indiana v Key Markets, Inc,
Order of Benefit Determination: If a person is a Participant under this Plan and another plan at the same time, the Plans will pay benefits in this order:
a. Any Plan that has no Coordination of Benefits provision will pay first.
b. When all Plans have a Coordination of Benefits provision, the Plan that covers the participant as an employee will pay first.
The term “plan” is defined within Omega’s policy to mean “any policy, contract, or other arrangement to pay the cost of Medical, Dental, or Vision Care,” including “any [policy under the] No Fault Automobile Act or similar law.”
Although the stipulation of facts that the court used as the basis of its summary disposition ruling contained no reference to the existence or nonexistence of a COB clause in plaintiff’s no-fault policy, this Court on its own motion remanded the case to the trial court with instructions to ascertain whether plaintiff’s policy contained a COB clause. At the conclusion of the hearing on remand, counsel for all parties acknowledged that plaintiff’s policy in effect on July 21, 1991, contained a “coordinated medical benefits” personal protection insurance endorsement. In light of plaintiff’s COB provision and the residency requirement in Omega’s policy, we believe that plaintiff and Omega share responsibility for Jennifer Schneider’s insurance coverage.
Finally, we reject Omega’s assertion that the subrogation provision within its plan prevents plaintiff from recovering any benefits because the benefits in question were paid pursuant to the no-fault act and not because plaintiff’s insured was negligent. MCL 500.3107; MSA 24.13107.
n
Second, Omega asserts that it has no obligation to reimburse State Farm where State Farm was not legally obligated to reimburse plaintiff. We agree. Implicit in this issue is the question whether plaintiff could pursue recovery from State Farm for benefits paid to Jennifer Schneider because State Farm was Ross Schneider’s no-fault insurer. We find that plaintiff was not entitled to recoupment from State Farm. We also find that State Farm may not recover from either plaintiff or Omega the amount it paid to plaintiff pursuant to the mediation-induced settlement.
If an insurance company claiming recoupment is found to be at a higher level of priority with respect to providing coverage than the company from which recoupment is sought, that higher priority insurer is not entitled to recoupment. Allstate Ins Co v Transamerica Ins Co,
Nevertheless, we also find that State Farm is not entitled to receive reimbursement from either plaintiff or Omega because it voluntarily paid plaintiff $24,000
Third, Omega argues that the trial court erred in awarding plaintiff attorney fees because neither court rule nor statute supports the award. We agree.
We will uphold the trial court’s award of attorney fees absent an abuse of discretion, i.e., where an unprejudiced person, considering the facts upon which the trial court acted, would say there was no justification or excuse for the ruling. Cleary v Turning Point,
Moreover, the recovery of attorney fees incurred as a result of an insurer’s bad-faith refusal to pay an
Finally, Omega argues that the trial court erred in awarding plaintiff twelve percent prejudgment interest because its health insurance plan was not a “written instrument” within the meaning of MCL 600.6013(5); MSA 27A.6013(5). We disagree.
The determination whether a statutory provision applies to a given action is purely a legal question to be resolved by statutory interpretation and reviewed by this Court de novo. Yaldo v North Pointe Ins Co,
Affirmed in part, reversed in part, and remanded to the trial court for further proceedings consistent with this opinion. We do not retain jurisdiction. Also, because plaintiff has not prevailed on all counts, we do not award plaintiff its costs and fees associated with this appeal MCR 7.219.
Notes
Employee Retirement Income Security Act of 1974, 29 USC 1001 et seq.
We note that this Court arguably could have interpreted the September 7, 1990, interim support order to require that Ross Schneider continue to pay for his nonresident children’s health-care coverage for three reasons. First, MCL 722.3(6); MSA 25.244(3)(6) provides that
[a] judgment entered under this section providing for support of a minor shall require that 1 or both parents shall obtain or maintain any health care coverage that is available to them at a reasonable cost, as a benefit of employment, for the benefit of the minor and, subject to section 3a, for the benefit of the parties’ children who are not minor children. [Emphasis added.]
Thus, the child support orders should have mandated that someone provide the children’s health insurance but, contrary to this statutory mandate, did not. Second, the stipulated facts established that Ross Schneider paid for his children’s continued health coverage on and before July 21, 1991. Third, the September 7, 1990, interim support order required him to pay ninety percent of all “uninsured health care expenses,” which would
On the other hand, the facts in this case do demonstrate that Ross Schneider would likely have a strong argument that Omega should be equitably estopped from denying or limiting coverage to Jennifer Schneider for any times after August 4, 1992, and when she was a covered dependent for a “pre-existing condition.” Under the heading “Maximum Comprehensive Medical Benefit,” section V of Omega’s group medical plan provides that the maximum benefit to be paid for a condition “for which a Participant has received medical treatment or taken medications within a twelve month period prior to the effective date of Participation shall be $1,000 until the earliest of these events: . . . (iii) for a Dependent, twelve
In explaining its rationale for awarding plaintiff its attorney fees, the court made the following observations:
[I] am going to award all attorney fees of plaintiff to be paid by . . . Omega, et cetera. The reason for that is: Under this so-called no-fault arena, the [Legislature was sold a bill of goods like the public, in that carriers were going to pay, and here is a situation — and I have been very critical of this plaintiff over the years, but they did what they were supposed to do — boom—paid the freight — big numbers — and now, as a matter of law, right or wrong, this Court found that they weren’t the ones that had to pay the freight — that another person, or entity, had to pay the freight — the health care provider.
The conduct on the part of the plaintiff should be commended. They did that which they were supposed to do. By filing suit and incurring additional attorney fees and expenses, to go after their money, ... if they prevail, they should be rewarded; and as far as this Court is concerned, the refusal of the health-care provider all along not to pay is unreasonable — totally unreasonable. . . .
Alternatively, in the event the Court is in error, the Court finds that based upon these facts and this case, when we are dealing with company against company, that public policy must be such, or should be such, that attorney fees must be paid and awarded to plaintiff against defendant to encourage companies to go out on the limb — even in questionable cases — and pay and go after somebody else, because we’ve got people who — or hospitals, or somebody — who is out a bundle of dollars, and then companies fighting over who was to pay or who was not. While people are fighting, little old John Doe Citizen gets dunning letters, et cetera.
While we understand the court’s sentiments and good intentions, we are constrained by the law to reverse the award.
See also MCL 500.2006(1); MSA 24.12006(1) of the Uniform Trade Practices Act, which awards twelve percent penalty interest if an insurer fails to pay claims to its insured or a third-party tort claimant on a timely basis. The penalty interest begins to run from sixty days after the offending insurer received the proof of loss. Yaldo, supra at 622. Notably, the penalty interest contained in MCL 500.2006(4); MSA 24.12006(4) applies for a longer period than the standard prejudgment interest on a written instrument under MCL 600.6013(5); MSA 27A.6013(5). Yaldo, supra. We agree with the dicta contained in Yaldo, supra at 622, n 1:
Even if MCL 600.6013(5); MSA 27A.6013(5) did not apply, it appears that MCL 500.2006(4); MSA 24.12006(4) would apply because defendant failed to timely pay under the terms of the insurance contract. Therefore, the trial court’s determination that the interest rate on the judgment should be twelve percent would have been proper although not based on the proper statute. This Court will not reverse the decision of a trial court where the right result is reached for the wrong reason. Welch v District Court,215 Mich App 253 , 256;545 NW2d 15 (1996).