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What's the difference between attendant care and replacement services?

Learn about two important No-Fault insurance benefits for injured auto accident victims in Michigan

It’s easy to get these two important No-Fault benefits confused.  Often, when I appear in Court at case evaluation on a very significant lawsuit involving attendant care benefits, I have to even start off educating the lawyers serving on the panel about the difference between attendant care and replacement services (one of the many problems with case evaluation of No- Fault lawsuits in Michigan today, by the way).

If lawyers don’t even get this, it is easy to see how many people injured in auto accidents often have no clue that they’re entitled to No-Fault insurance benefits that can help them stay afloat while they’re recovering and unable to work.  Of course, there are far too many insurance company claims adjusters who will often deliberately mislead their own injured customers on some of these No-Fault benefits as well.

Attendant care (in-home nursing services) and replacement services (help around the house) seem similar but are very different. Auto accident victims are always asking our attorneys how these two benefits can help them, and what’s the difference.

We hope the information below provides some clarity on attendant care. Next week, I will blog about replacement services.

Attendant care

Under the Michigan No-Fault law, auto accident victims with serious injuries are entitled to reimbursement for in-home nursing services called attendant care. You must be prescribed attendant care from your doctor.

Attendant care benefits are defined as “activities of daily living,” and they can include:

  • Monitoring and supervision for safety reasons,
  • Administering medication,
  • Bathing,
  • Dressing,
  • Walking,
  • Styling of hair,
  • Other grooming,
  • Help using the bathroom,
  • Driving,
  • Fetching, carrying and lifting things for the patient,
  • Wound care.

Attendant care can be performed by nurses and  home health aides, but attendant care can also be performed by  family members, neighbors, close friends and  legal guardians. Your auto insurance company will be required to pay for the injury victim’s attendant care.  Most cases are litigated on the number of hours that attendant care is provided, and what is the fair and reasonable rate.

Warning: Most insurance companies deliberately offer significantly less than the commercial rate, and often these rates can be negotiated with the claims adjuster.

Keep in mind, Michigan courts have found that family-provided attendant care services can offer better overall care than services from a commercial company.  You also avoid the issues of absenteeism, criminal backgrounds, theft, and some people who generally should never have been hired by a commercial agency to begin with.  There are some excellent commercial agencies out there, but there are also some very bad ones.  It is a good idea to interview and get references when hiring a commercial agency to provide attendant care.

To be reimbursed by your No-Fault insurance company, you must remember to keep well-documented records of all services and hours that attendant care was provided. These records can be submitted monthly to the insurance company for reimbursement.

As of now, attendant care is a lifetime benefit, as long as it’s reasonably necessary. It’s not uncommon for a doctor to prescribe 24/7 — “around-the-clock” — attendant care, as many accident victims who need attendant care are catastrophically injured and this care also covers monitoring, supervision and safety issues during the night and when the accident victim is sleeping.  Often insurance company claims adjusters will at first refuse to pay for night-time attendant care.

However, there’s pending legislation (HB 4936) that would cap No-Fault insurance benefits – including attendant care – in Michigan if it becomes law.  Therefore, it’s important to check with an experienced insurance attorney to make sure the law has not changed, if you’re reading this blog post some time in the future.

– Steve Gursten is head of Michigan Auto Law. He is president of the Motor Vehicle Trial Lawyers Association and past co-chair of the Michigan Association for Justice Automobile Accident No‐Fault Committee. He frequently writes and speaks about Michigan No-Fault law, and is available for comment.

Michigan Auto Law is the largest law firm exclusively handling car accident, truck accident and motorcycle accident cases throughout the entire state. We have offices in Farmington Hills, Detroit, Ann Arbor, Grand Rapids and Sterling Heights. Call (800) 777-0028 to speak with one of our lawyers.

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