MICHIGAN NO FAULT BENEFITS - OVERVIEW

No Fault Benefit Overview

Hi.  My name is Larry Gursten and I'm going to try to explain to you the no‑fault law in your action against the insurance company for your benefits, and I'm going to give you knowledge and understanding to help you in collecting these benefits.

This law was passed October 1, 1973, and you really have a contract with your insurance company, and what it allows you to do is collect five different benefits.  Four of them, your insurance company will tell you about.  The fifth one many times they don't, but I will give you that knowledge and understanding.

I'd also like to explain to you the initial procedure when you have an automobile accident. Obviously, you have contacted your auto insurance company, and if you have no auto insurance, then your relative in your household, and if there's no auto insurance in your household, then you can go to what is called the Assigned Claim Fund of the State of Michigan.  There's an application for benefits form.  It's a notice form, but it must be filled out as soon after the accident as you can and you have it in within one year of the date of the accident or you lose entirely your right to collect all no‑fault benefits.  So please, make sure you do that.

The first no‑fault benefit is medical bills, and I know that is a concern because everybody wants to get their doctor bills paid, their hospital bills paid.  The doctors are pressing you to be paid.  And fortunately in Michigan, that is an excellent coverage.  If you have medical insurance first in your household, you have to go to that medical insurance and if they pay if it's an automobile accident, because that you'll also have to check on, then the medical insurance will be first.  If you do not have medical insurance in the household or they say to you, We don't pay if it's an automobile accident, that is not a problem because then your auto insurance or the auto insurance of a relative in your household is going to pay all of your medical bills for life.  That is a great coverage.

You always want to check if it's your policy, do you have what's called coordinated or excess coverage and you have to check your relatives in your household if you're collecting from them if they have coordinated or excess that says you must go to your medical insurance first and then your auto insurance will pay.  The reason that it's so important is if you have a book of doctors or your relative has a book of doctors and you're covered under that auto insurance, you must go to the doctors in that book.  Be very careful.  If you go to other doctors outside of that book, your auto insurance company may deny your coverage for those doctors.  So the medicals for life, it is a great coverage.

The next benefit is lost wages and this is also a great benefit.  You are entitled to eighty‑five percent of your lost wages, your gross lost wages tax free every month you are disabled for up to three years.  That is a wonderful benefit.  So remember, it's tax free.  It's just a form from your employer that filled it out.  If you have overtime, please put in your overtime.  And you're entitled to collect overtime not even the date of the accident, but while you were disabled if you would get a raise, you are entitled to also have that raise included in your lost wages.

The third benefit is called replacement services.  Sadly when this law was passed in 1973, that benefit was $20 a day for people doing the work that you can no longer do: housework, shoveling the snow, cutting the lawn.  That has never gone up by the cost of living.  So there's another form for your doctor to fill out stating you're in need of replacement services and then there is also a form for the people doing the work to fill out.  They could be a husband, wife, family, friends, whoever is doing that, and they are entitled to be paid at $20 a day.

Your fourth benefit is called mileage and you are entitled mileage every time you go to a doctor or hospital.  So please, track your mileage.  There are mileage forms ‑‑ the insurance companies have them, we have them ‑‑ you fill them out and you're entitled to mileage.

The fifth benefit sadly is where you are seriously hurt, whether it is physical injury where somebody has to help you with what is called assist you with the functions of daily living: dressing, eating, going to the bathroom.  There are many functions.  And if you have that or you have a closed head injury that is serious enough that you need help, somebody near you to help supervise at night, somebody has to be there in case you cannot get out of the house in case there's an emergency, that is called attendant care and that is paid on an hourly basis.  That is an extremely important coverage, because sadly where people are seriously hurt, you are entitled to collect twenty‑four hours a day, seven days a week if that's what the doctor says, and that goes on indefinitely.  So lost wages are three years, replacement services are three years, but the attendant care can be for life or as long as you need it.  It is complex, it is sophisticated, but it is a great benefit for you.

You only have one year from the date you have gone and incurred a bill to have the auto insurance pay that bill or you lose the right to collect that bill.  So whether they say it's under investigation or they need more information, that does not do it.  You have to have a lawsuit started within one year of the date you have gone to a hospital, doctor, have incurred lost wages, incurred attendant care.  Anything you have done as a no‑fault benefit must be paid within one year or a lawsuit must be started.

Now those are the five benefits.  Please understand that every factor can change an answer and it is extremely important that you call an attorney and talk to him about these benefits as to any questions because this is a technical, complex law.  And I hope this has given you knowledge and advice in terms of explanation of no‑fault benefits.

And if there are any questions, please feel free to call us.  We're here to help you and make sure things go well for you.  Thank you.