Michigan No-Fault

Macomb Law Group, Auto Insurance Attorneys in Metro Detroit

You have the right to auto insurance benefits after an auto accident. Michigan’s No-Fault Act lays out what you can expect, and what you have to do to get it. If your insurer denies your auto insurance claims or doesn’t follow the law or your policy, the Macomb Law Group can help you fight for the auto insurance benefits you are entitled to.

Auto Insurance Claims Benefits Under the Michigan No-Fault Act

Michigan’s No-Fault Law provides injured motorists extremely valuable benefits following motor vehicle accidents. On May 30, 2019, the Michigan Legislature passed sweeping legislation, also known as SB1, reforming the No-Fault Laws. The economic benefits (“PIP Benefits”) – things you have paid for or bills you owe that are reasonably necessary because of your injuries – are illustrated below and changes to these benefits are discussed:

Medical Expenses – Section 3107

Macomb Law Group | Auto Insurance attorneys | image of an insurance claimThe medical expenses provision requires your auto insurance provider to pay for all medical expenses you incur because of your injuries. Your insurance policy may be “coordinated” with your health insurance, or “uncoordinated.” If you have coordinated coverage, your auto insurance policy will pay all expenses not covered by your basic health insurance. With uncoordinated coverage, your auto insurance provider pays all medical expenses incurred, even those normally paid by a health insurance provider.

Part of the medical expenses provision covers reimbursement for transportation expenses including mileage to and from doctors, hospitals, or rehabilitation clinics. If you don’t drive, this can include bus fare or taxi fare. To collect these auto insurance claim benefits, you will need to keep a complete record of all your mileage expenses and submit them to the insurance company along with your other medical bills.

The medical expenses provision also includes attendant care services. If you require one-on-one supervision or assistance with your day-to-day needs due to an automobile accident, you are entitled to have attendant care services paid for. (This is different than replacement services benefits which are explained below). You can receive no-fault auto insurance claims benefits for attendant care provided by a family member or professional service. It may be as little as an hour or two a week, or as much as 24/7, 365 days a year, depending on how severe the injuries are.

Is my auto insurance company required to pay for all my medical expenses related to the accident?

If your accident was prior to June 30, 2020, your auto insurance company is required to pay for all reasonably incurred medical expenses related to your accident. In other words, if your doctor relates your treatment to the accident, then your auto insurance company is required to pay the reasonably incurred expenses. However, for policies issued or renewed after July 1, 2020, the personal protection insurance (PIP) benefit coverage level you choose will determine how much, if any, of your medical expenses your auto insurance company will be required to pay.

What will my PIP coverage level options be for policies issued or renewed after July 1, 2020?

  • Unlimited
    Under this option, your auto insurance company will be required to provide lifetime coverage for all reasonably incurred medical expenses related to your accident. Prior to July 1, 2020, this was the only option Michigan residents were offered.
  • $500,000
    Under this option, your auto insurance company will be required to pay up to $500,000.00 for all reasonably incurred medical expenses related to your accident.
  • $250,000
    Under this option, your auto insurance company will be required to pay up to $250,000.00 for all reasonably incurred medical expenses related to your accident.
  • $50,000
    This option is limited to any person who satisfies the following two conditions:
    The person is on Medicaid; and
    The person’s spouse and resident relatives all have PIP coverage, have health insurance or are enrolled on Medicaid.

Will I have the option to completely opt-out of PIP coverage?

You can completely opt-out of the PIP benefit, if you can satisfy the following two conditions:

  1. You are covered by Medicare Parts A and B; and
  2. Your spouse and any resident relatives have PIP coverage under a separate policy or have “qualified health coverage” under Medicare.

What if my medical expenses are more than the PIP coverage level I choose?

In the event you choose a PIP coverage level less than your medical expenses related to your accident, you will be responsible to pay them. This could be through your health insurance, if it provides coverage for auto accidents. In the event you did not cause the accident we can include your unpaid medical expenses in the lawsuit against the person or persons whom caused the accident.

Will coordination of benefits still be offered?

Yes. For the unlimited, $500,000 and $250,000 levels, you will have the choice to coordinate your policy. However, the attorneys at Macomb Law Group recommend checking with your health insurance company and requesting a “Summary Plan Description” to determine whether your health insurance policy will “coordinate” with your auto insurance policy or exclude auto accident related care and treatment.

How will attendant care be impacted by the new law?

  • Weekly Hour Limitations
    Beginning July 1, 2020, your auto insurance company will only be required to reimburse you for up to 56 hours per week of attendant care provided by relatives, household members, and any individuals the injured party had a business or social relationship before the accident.
  • Attendant Care Rider Option
    If you choose a PIP coverage level of $500,000; $250,000; or $50,000, you have the option to purchase an attendant care rider. The law states your auto insurance company has no obligation to offer a rider providing for more than 56 hours per week. If purchased, payments made by your auto insurance company to your attendant care providers would not be applied to your selected coverage level.

What if my accident was before July 1, 2020, will my family provided attendant care still be impacted?

Yes. You will be subject to the 56 hours per week cap imposed by MCL 500.3157(10), unless you have contracted with your auto insurance company for a different amount of hours per week.

Wage Loss

If you had to miss work because of your injuries after an auto accident, the wage loss provision requires your insurance provider to pay you auto insurance claim benefits. These benefits will reimburse you for 85% of any actual lost wages, up to a statutory monthly maximum (Currently $5,718 per single 30-day period from October 1, 2019 through September 30, 2020) which is adjusted every year. You are eligible for this benefit for up to three years after your accident.

Will the new law impact my wage loss?

The wage loss provision was not changed in the new law.

Replacement Services

Your auto insurance claim also entitles you to up to $20.00 a day, according to the replacement services provision of the No-Fault Act. This covers any chore services (i.e. laundry, cutting the grass, taking out trash, etc…) you did before the accident, but are medically unable to do now because of your injuries. These benefits allow you to hire someone else to do them for you. This provision should be used with caution, as abuse of it may affect your ability to receive medical treatment. You are eligible for this benefit for up to three years after your accident.

Receiving Auto Insurance Claim Benefits

Under the Michigan No-Fault Act, the Medical Expense Provision is a lifetime benefit, but wage loss and replacement services are only payable for 3 years from the date of the accident. To secure these benefits, there are some important things you must do.

First, you must immediately file a No-Fault Application with the applicable insurance carrier. This auto insurance claim must be filed within 12 months of the date of the accident, or you will forever lose any right to receive benefits.

Secondly, if your insurance provider denies any part of your auto insurance claim, you must file a lawsuit to recover that particular item within twelve (12) months of incurring the expense, or forever lose the claim.

When to Contact an Auto Insurance Claims Attorney

Remember you do not have to hire an attorney to get your benefits unless your insurance company has refused to pay for them. Don’t pay a percentage of your benefits to a lawyer when the insurance company is paying them voluntarily.

The auto insurance claims process can seem complicated. The No-Fault Act can be difficult to understand. It is important to remember you must file a No-Fault Application immediately. If, after a reasonable period of time, you have trouble with your insurance provider, the Macomb Law Group can help you get the benefits you deserve. Contact the Macomb Law Group for a free consultation, and let us get to work for you.

Disclaimer: The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.