Great-West Life & Annuity Insur. Co. v. Allstate Insur. Co., 202 F.3d 897 (6th Cir. 2000); 2000 FED App. 0045P (6th Cir.)-This court affirmed the district court's decision that Allstate had coverage priority for the auto accident expenses of Matthew Gerig. Allstate’s no-fault automobile insurance, issued to his parents by Allstate, and an ERISA-qualified employee benefit plan administered by Great-West by virtue of his father's employment with the Prince Corporation, covered Master Gerig.
The plans both contained
provisions dealing with priority. The
federal common law states that in such a conflict between coordination of
benefits provisions, the terms of the ERISA plan control.
The Great-West policy provided that "a plan that covers a person
other than as a Dependent will determine its benefits before a plan that covers
such person as a Dependent." Allstate
conceded that Gerig was a dependent under the Great-West policy, but claimed
that its policy covered Gerig as a dependent also.
This court disputed Allstate's assertion that coverage as a
"resident relative" was effectively the same as coverage as a
dependent, and further pointed out that Gerig, by virtue of being over 18 (he
was 20), did not meet Allstate's own definition of "dependent."
As a result of Allstate's own policy language, the district court was correct in subordinating Great-West's plan to Allstate's.
