Learn about PIP benefits, time limit claims, and what happens for PIP benefits if you are a passenger in a car accident in Michigan.
“Can my auto insurance company make me use up all my sick days at work before I can draw no-fault wage loss?”
This is an issue that comes up very often in our practice. The answer is “No.” You do not have to “use up” all of your accumulated paid days off at work before your auto wage loss benefits begin. If you get hurt in an auto accident in Michigan, and you are taken off work by your doctor, you can start drawing your wage loss from your car insurance from the first day off. You don’t have to exhaust your “sick days” through your job first. This time off is not “other health and accident coverage” that the auto carrier can try to subtract from your benefits (that subtraction is called “coordination of benefits”).
If you are hurt in a car accident, no matter whose fault it was, your auto insurance has to pay you for your approved time off work from day one. The insurance company does not get credit for sick days you might have had coming anyway.
“I heard that I only get no-fault benefits for one year after the accident. Is that true?”
No. This is something our callers are often confused about. The “one year back rule” means you have to turn in your medical, wage loss, replacement services and other no-fault expenses to your car insurance no more than one year after you incur the expense. Let’s use an example to show you how the deadlines work. Suppose you were in a car accident and were injured on December 25, 2014. It doesn’t matter who was at fault for the benefits being discussed here. That’s what “no fault” means.
Accident date: 12/25/14
Please remember that wage loss has a three-year maximum that starts on the day of the accident. You can’t get more than three years of wage loss or replacement services from your own car insurance, even if you are totally disabled (you can go after the other driver for amounts beyond three years).
Please also remember that there is no time limit as to how long you may qualify for medical benefits or attendant care (nursing-type assistance for the seriously injured), as long as your doctor notes convince your insurance company that these claims are reasonable, necessary, and are related to the accident.
Bottom line: Your benefits don’t expire one year after the accident. You just need to 1) notify your carrier within a year that you were hurt in the accident and 2) turn in your expenses within one year from the date you incur the expenses.
“If I am a passenger in an uninsured vehicle, and do not have car insurance of my own, can I still get no-fault benefits?”
Yes, as long as you weren’t an “owner” of the uninsured vehicle you were riding in. (The word “owner” is in quotes because it has special meaning in Michigan no-fault cases, and you should talk to a lawyer about the definition of the term). There are some things you should know. Remember—we are talking about passengers here.
Even if you don’t have car insurance yourself, you will still qualify for no-fault benefits if you live with any relative who has an insured vehicle. Their insurance covers all relatives in the household for wage loss, medical benefits and several other types of payments—even if their car wasn’t involved in the crash.
If you are a passenger, don’t own the vehicle you are in, don’t have car insurance yourself, and don’t live with a relative who does, and the driver of the vehicle (this person may not be the owner) does not have car insurance, you can still apply to the Michigan Assigned Claims Plan for wage loss and the other benefits that are available through no-fault in Michigan. You can find out about the Plan online, or you can contact a lawyer who knows about no-fault law for more information about it.
Assigned Claims will ask you to fill out a form to determine if you qualify. If so, the Plan will assign a no-fault carrier to your case, and you will be eligible for all the no-fault benefits that any insured person would have.
Something to remember is that an insurance company, whether through the Plan or otherwise, has the right to go against the uninsured person to get the money back that the insurance company had to pay because the uninsured driver caused the insurance company to have to make payments for you or to you. It is important to realize that if you are a passenger in an uninsured vehicle owned or being driven by a friend or family member, that friend or family member could be sued later by the insurance company that has to “clean up” the situation on your behalf. They will probably also lose their drivers license.
And even if you choose not to file a claim for no-fault benefits because you want to protect your uninsured driver from being sued by an insurance company, you should know that the doctors and hospitals you visit to treat your injuries can file a claim on their own behalf to be reimbursed through no-fault. The insurance company can then go after your uninsured friend or relative whether you agree or not.
So the bottom line on this point is that it is a very bad idea to get in a vehicle owned or driven by an uninsured person at any time, especially if you don’t have no-fault insurance of your own!