In 2021, over 70,000 Michigan drivers suffered severe injuries in car accidents. Those injured in car or truck accidents are typically entitled to no-fault benefits in the state, also known as personal injury protection benefits. However, some people find the term “no-fault” confusing, believing that it absolves them from liability in a car crash. In this guide, we will break down the meaning of personal injury protection benefits and no-fault benefits.
Learn about PIP coverage benefits, time limit claims, and what happens with PIP benefits if you are a pedestrian, bicyclist, or passenger in a car accident in Michigan. If you have questions or need help fighting for compensation, call the car accident lawyers at Matz Injury Law.
PIP coverage in Michigan is a form of coverage on your auto insurance policy that pays for your medical bills, lost wages, mileage to and from the doctor, and help around the house if you get hurt in a car accident. PIP medical benefits are typically guaranteed by Michigan’s no-fault law and are intended to be paid regardless of whether you are at fault for the accident. These benefits are paid by your own car insurance company.
Michigan PIP benefits cover specific expenses after your accident, up to the policy limits. These include medical bills, medical mileage, wage loss, household services, attendant care, and survivor’s benefits.
This includes all of your medical care and medical expenses related to the crash, including doctor’s visits, procedures, medication, necessary medical equipment, the costs of specialized medical care, and other medical bills you incur. Medical costs also include necessary attendant care and are both considered allowable expenses.
Part of your medical expenses benefits include travel to and from appointments. If you need to take a rideshare, cab, bus, or specialized transportation to a doctor’s office, PIP will cover it.
Besides medical costs, PIP covers reimbursement for lost wages for up to three years from the date of the accident. They are subject to a monthly maximum and cap out at 85% of your wages since they are not subject to income tax.
The costs of replacement services, up to $20 per day is also covered. This is not considered an allowable expense like the payment of medical bills so if someone opts out of PIP medical they could still be entitled to replacement services. This is to cover ordinary and necessary services like housekeeping, lawn maintenance, snow removal, meal preparation, babysitting, driving family members around, taking out the garbage, and the like.
When a Michigan resident is killed in a car accident, that person’s dependents can recover survivor’s loss benefits under no-fault law. These benefits are payable for up to three years and are subject to the same limitations as wage loss benefits. Survivor’s loss benefits also cover reasonable burial and funeral expenses. These benefits consist of three years of the decedent’s earnings and replacement services up to $20/day.
The cost of no-fault insurance coverage in Michigan will depend on the level of coverage you choose. If you select unlimited PIP insurance, it will probably make your insurance premiums slightly higher but will result in you having the best coverage available. Unlimited PIP coverage is what the lawyers at Matz Injury Law recommend to all of their clients. You will need to speak to your insurance company about the coverage options available to you, including deductions, exclusions, and coverage limits. In the end, you may be able to get premium reductions by choosing lower caps, but you will regret that decision if you get into an accident.
The amount of personal injury protection coverage you need depends on several factors, including your personal financial situation, your health insurance coverage, and your risk tolerance. In Michigan, PIP coverage can range from basic to comprehensive, with options for unlimited medical coverage or capped amounts.
Following Michigan auto insurance reform, the new law requires that auto insurance providers offer policyholders the option of six PIP levels of coverage on their auto policy. Your benefits will cap out at the maximum allowable coverage under your policy. The best of these is unlimited coverage. Unlimited PIP will cover all of your expenses with no upper limit.
If you do not pick a PIP medical option, the default is unlimited coverage.
While you may be tempted to keep your insurance premiums as low as possible, it’s important to strike a balance between cost and coverage. Lower premiums keep your expenses down day-to-day, but there are long-term financial risks to minimizing your insurance coverage. If you are in a major accident, your medical expenses can escalate quickly. Having more comprehensive PIP coverage can help you minimize the impact on your long-term finances and save you from steep medical debt.
All motorists in Michigan must carry personal injury protection benefits on their auto policy. You have the option to opt out of certain PIP benefits in exchange for slightly lower premiums but the coverage is required by law.
Unfortunately, no-fault insurance does not cover pain and suffering in Michigan. To get compensated for your emotional trauma, PTSD, physical pain and suffering, loss of consortium, and other injuries, you will have to make a claim with the insurance company responsible for affording Bodily Injury coverage. Typically, that is the insurer for the driver that caused the crash. If that driver is uninsured sometimes your own auto policy contains a provision that will pay for your pain and suffering.
Personal injury protection coverage in Michigan is a great thing for those who need to begin getting reimbursement for medical bills, lost wages, and expenses quickly. It does not, however, cover everything to which you are entitled when another driver strikes you. You should not attempt to negotiate with any insurance company without first contacting a lawyer. The insurance company has an interest in trying to get you to accept less for your serious injuries, an attorney can help you fight for the compensation you deserve.
Even your own insurance company may undervalue your injuries and how serious they are. If the offer you get does not cover your actual losses, a Michigan personal injury lawyer can help you challenge the offer and fight for higher compensation. Remember never to sign off on an offer just to start getting payments. Call Matz Injury Law first at 866-226-6833 or use our contact form to understand your options.
If you have sustained serious injuries, you may be able to recover non-economic damages like pain and suffering. People often hire attorneys because they either were not at fault for the accident or their own insurance refuses payment, delays compensation, or offers a meager settlement. In such cases, a lawsuit may be required, and a personal injury attorney can help you hold the at-fault driver responsible and fight for the full compensation you need.
“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 a question that we frequently hear at our firm. The answer is “no.” You do not have to deplete 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 are taken off work by your doctor, you can start drawing your wage loss from your car insurance company from your 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.
“I heard that I only get no-fault benefits for one year after the accident. Is that true?”
No. This is something our newest clients often find confusing. 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. Additionally, you must notify your auto insurance carrier of your claims for PIP benefits within one year of the date of the crash.
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, 2022. It doesn’t matter who was at fault for the benefits being discussed here. That’s what “no-fault” means.
Accident date: 12/25/22
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 wage loss 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 satisfy your insurance company that these claims are reasonable, necessary, and are related to the accident.
Bottom line: Your benefits do not expire one year after the accident. However, you 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 a vehicle, whether insured or uninsured, and I do not have car insurance of my own, can I still get no-fault benefits?”
Yes, as long as you were not an “owner” of the uninsured vehicle in which you were riding (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 regarding your unique case.).
Even if you do not 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 was not involved in the crash.
If you are a passenger, don’t have car insurance yourself, and don’t live with a family member who has 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 learn about the Plan online, or you can contact a lawyer to provide further information.
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 up to a cap of $250,000..
Something to remember is that an insurance company, assigned by the Michigan Assigned Claims plan, has the right to seek recoupment from 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. 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 the no-fault insurance company.
Ultimately, it is a very bad idea to get into a vehicle owned or driven by an uninsured person at any time, especially if you don’t have no-fault insurance of your own!
“If I get hurt while I am loading or unloading my vehicle, can I get PIP benefits?”
Yes, if you are injured by making contact with equipment permanently mounted to the vehicle or if you are lifting objects into or from the vehicle when you get hurt. Keep in mind that injuries that occur while you are in the course of your employment will be covered by your workers’ compensation insurance if you are employed by a company that has that sort of insurance.
You should be aware that the courts are very strict about applying these tests. If, for example, you are walking around to the back of your truck and you trip over a temporary trailer hitch wiring harness, the courts will probably say that you don’t qualify for no-fault medical coverage because the harness wasn’t permanently mounted to the truck. Or say that you had taken some boxes out of your back seat, and you slip on an icy spot on your porch and twist your ankle. Again, the courts will probably rule that you weren’t injured due to the unloading process but because you slipped and fell.
As you can see, understanding Michigan’s PIP benefits quickly becomes a complex effort. However, hiring an attorney in the face of your auto accident can relieve you of this burden. Matz Injury Law has helped Michigan accident victims get the highest compensation possible for generations. To speak directly with our team of experienced personal injury attorneys, call 866-226-6833. Alternatively, you can use our contact form, and we’ll call you.
Steven J. Matz is a founding shareholder of Matz Injury Law. The firm’s concentration is on personal injury litigation, with an emphasis on traumatic brain injury.
The maximum contingency fee permitted by law is actually 331/3%. Michigan court rules require that the attorney fee be computed on the net sum recovered after deducting all disbursements properly chargeable to the enforcement of the claim.
We can charge 22% while virtually all other injury attorneys charge 331/3% because we are very, very, good at obtaining results for our clients.
We do not spend millions of dollars on television ads; instead, we offer a lower fee to all our clients. We do not have dozens of lower paid associates handling our work. All our clients are represented by Steven and Jared Matz. Steven Matz started the firm in 1977 and since then has dedicated his life to representing injury victims. Jared joined the firm in 2016 but grew up listening to stories, discussing theories, and generally learning at the dinner table about how to effectively and compassionately represent injury victims. Jared Matz was literally born to represent individuals involved in motor vehicle crashes.
All of our cases are handled on a contingency fee and all our cases are handled at 22%. Whether the case settles or goes through trial, the fee does not change. While our competitors make excuses as to why they charge so much, we are obtaining results for our clients at a lower fee.
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