October 23, 2026
The Court of Appeals, in Van Heusen v MAIPF, ___ Mich App ___ (10/15/26), addressed a question of first impression: whether a person who is injured in a motor vehicle accident while not an occupant of a motor vehicle may claim personal protection insurance (“PIP”) medical benefits under the Michigan Assigned Claims Plan (“MACP”) if that person has a PIP policy but opted out of medical coverage. In short, the Court concluded the Plaintiff could not claim PIP from the MACP because under the statutory language used in MCL 500.3107d, Plaintiff did not opt out of a “policy described in [MCL 500.3101(1)],” MCL 500.3114(1); he opted out of having medical coverage in a “policy described in [MCL 500.3101(1)],” Id. As described in MCL 500.3107d, his policy without medical coverage is still a “policy described in [MCL 500.3101(1)].”
In Van Heusen, Plaintiff owned a Honda SUV he insured through a no-fault policy issued by Auto-Owners Insurance Company. The policy included PIP coverage for replacement services and survivor’s benefits, but not medical or work-loss coverage. Plaintiff, the named insured, had opted out of PIP medical because he was covered under Medicare Parts A and B (and his spouse and other resident relatives were covered by qualified health coverage or other PIP medical coverage). Plaintiff paid a reduced premium as a result of this “opt out.”
Plaintiff was operating his Honda when it was struck by a Saturn SUV. While outside his Honda inspecting the damage, a third vehicle struck the Saturn which then struck Plaintiff causing injuries. Plaintiff filed a claim for PIP benefits under the MACP which was denied because Plaintiff had identifiable and applicable insurance from Auto-Owners and had elected to opt out of medical coverage. Plaintiff then filed suit seeking no-fault medical benefits from the MACP as a non-occupant of a motor vehicle, MCL 500.3115. The Circuit Court found Plaintiff was entitled to recover PIP medical benefits from the MACP because he was a non-occupant, was not covered for medical expenses under his PIP policy, and was not otherwise excluded from receiving benefits.
The Court of Appeals disagreed. Thoroughly analyzing the applicable, and non-applicable statutory provisions, the Court determined that the MACP statutes themselves – MCL 500.3171 to MCL 500.3175 – contain their own eligibility requirements and render Plaintiff ineligible to claim PIP medical benefits from the MACP. Steanhouse v MIAPF, 351 Mich App 209; 34 NW3d 627 (2024). Specifically, one of the four conditions set forth in MCL 500.3172(1) must be met in order for an injured person to be eligible to receive assigned-claim benefits and in the present case, only the first condition applied: whether Plaintiff’s policy is “applicable to the injury.”
The Court noted MCL 500.3114(1) provides that a PIP policy described in section 3101(1) applies to accidental bodily injury to the person named in the policy, and section 3101(1) requires motor vehicle owners or registrants to maintain security for payment of PIP benefits “[e]xcept as provided in [MCL 500.3107d].” The Court read this “except as” clause to acknowledge available limitations included within the requirement to maintain PIP insurance which generally encompasses medical benefits. The fact that the statute allows for PIP policies not to include medical coverage, however, does not change the policy’s fundamental character as a PIP policy. In other words, a PIP policy with an opt-out is still a PIP policy as described in section 3101(1). As a result, such a policy applies to accident bodily injury to the person named in the policy, MCL 500.3114(1), and is applicable to the injury, MCL 500.3172(1)(a).
The Court concluded that holding opt-outers such as Plaintiff to the coverage limits and exclusions that they choose is consistent with the 2019 reform legislation’s goal of controlling the cost of automobile insurance. Furthermore, the opt-out is only available to those with other qualified health insurance coverage and the MACP is the insurer of last resort so the overall aim of the no-fault statute to ensure that persons injured in auto accident have some form of medical coverage for their injuries is satisfied.