-3-
This Court reviews “the circuit court’s affirmance of the district court’s denial of
defendant’s motion for summary disposition . . . de novo.” First of America Bank v Thompson,
217 Mich App 581, 583; 552 NW2d 516 (1996). When deciding a motion for summary disposition
under MCR 2.116(C)(10), we consider the evidence submitted in a light most favorable to the
nonmoving party. Payne v Payne, 338 Mich App 265, 274; 979 NW2d 706 (2021). “Summary
disposition is appropriate if there is no genuine issue regarding any material fact and the moving
party is entitled to judgment as a matter of law.” Sherman v City of St Joseph, 332 Mich App 626,
632; 957 NW2d 838 (2020) (citations omitted).
Our Legislature has provided that a person can elect to coordinate health-insurance
coverage with no-fault coverage. See MCL 500.3109a(1). The parties acknowledge that the
vehicle collision in question happened prior to the effective date of the recent amendments to the
no-fault act, so we apply the prior version. With that said, neither party has argued that the
amendments have any impact on the operative question here.
Auto-Owners argues on appeal that, when a person elects to coordinate primary health-
insurance coverage with secondary no-fault PIP coverage, our Supreme Court’s decision in
Tousignant requires that the person mitigate any out-of-pocket expenses by seeking treatment that
would be maximally covered by the primary insurer. It is undisputed that Yglesias elected to
coordinate his benefits between CIGNA and Auto-Owners. “When no-fault coverage and health
insurance are coordinated, the health insurer is primarily liable for the insured’s medical
expenses.” Farm Bureau Gen Ins Co v Blue Cross Blue Shield of Mich, 314 Mich App 12, 21;
884 NW2d 853 (2016).
Contrary to defendant’s argument, however, Tousignant does not require an insured person
to mitigate damages through in-network treatment when out-of-network treatment is covered by
the primary insurer. Key to the Tousignant decision is that the insured had health insurance
through an HMO. Generally speaking, an HMO provides relatively inexpensive premiums,
deductibles, and charges for medical services, but in exchange, the choices with respect to
providers of medical services are strictly limited. In contrast, a PPO generally provides more
choices with respect to providers of medical services, but the out-of-pocket costs to the insured are
higher.
In Tousignant, the insured person had coordinated health insurance and no-fault policies,
and she was subsequently injured in a vehicle accident. Tousignant, 444 Mich at 305-306. Her
health-insurance policy was with Health Alliance Plan (HAP), an HMO. Id. at 304. When she
received treatment for her injuries from a provider that was outside of HAP’s network, HAP
refused to pay her expenses. Id. at 305-306. Her no-fault insurer also refused to pay the expenses.
The insured sued her no-fault insurer, arguing that “coordination does not require that a no-fault
insured seek all medical care from the health insurer.” Id. at 306.
Our Supreme Court concluded, however, “that the legislative policy that led to the
enactment of § 3109a requires an insured who chooses to coordinate no-fault and health coverage
to obtain payment and services from the health insurer to the extent of the health coverage
available from the health insurer.” Id. at 307 (emphasis added). HAP was an HMO, and this
meant that the insured had to seek treatment from HAP’s specifically designated providers;
otherwise, she had no health coverage through HAP. Id. at 309 n 11. Moreover, there was no