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PIP Benefits

When the Auto Insurance Company Denies No-Fault PIP Benefits

And How Michigan Attorney Fees Are Handled When PIP Benefits are Denied

The law providing for Michigan attorney fees in first-party No-Fault auto accident injury cases is found in the No-Fault “Attorney Fees” statute, MCL 500.3148.

The law provides that a Michigan attorney can be paid a reasonable attorney fee helping a car accident victim recover “overdue” No-Fault benefits – and the fee can be charged against the victim’s auto insurer “if the court finds that the insurer unreasonably refused to pay the claim or unreasonably delayed in making proper payment.” (MCL 500.3148(1))

In Moore v. Secura, 482 Mich. 507 (2008), the Michigan Supreme Court set out the following analysis for when No-Fault attorney fees are owed under 500.3148:

MCL 500.3148(1) establishes two prerequisites for the award of attorney fees. First, the benefits must be overdue, meaning “not paid within 30 days after [the] insurer receives reasonable proof of the fact and of the amount of loss sustained.” MCL 500.3142(2). Second, in postjudgment proceedings, the trial court must find that the insurer “unreasonably refused to pay the claim or unreasonably delayed in making proper payment.” MCL 500.3148(1).   Therefore, assigning the words in MCL 500.3142 and MCL 500.3148 their common and ordinary meaning, “attorney fees are payable only on overdue benefits for which the insurer has unreasonably refused to pay or unreasonably delayed in paying.”

Michigan attorney fees can be awarded even though a portion of the No-Fault benefits was legitimately in dispute. Cole v DAIIE, 137 MA 603 (1984)

There can be no finding of attorney fees for No-Fault expenses submitted for first time at trial. Manley v DAIIE, 425 M 140 (1986) A late submittal, or a submittal for the first time during trial, does not preclude an attorney from submitting an overdue no fault expense. It just precludes that Michigan attorney from receiving attorney fees from the trial judge at the conclusion of the trial if the amount owing by the insurance company is considered overdue.

In Michigan, an insurance company’s refusal or delay to pay creates a rebuttable presumption of unreasonableness that places the burden on the insurer to justify its refusal or delay. Attard v Citizens Ins, 237 MA 311 (1999)

A hospital or a medical provider is considered a “claimant” for purposes of collecting reasonable Michigan attorney fees. Regents v State Farm, 250 MA 719 (2002)

Assessment of attorney fees should be based on quantum merit; however, court should also consider awarding the lawyer a contingency attorney fee. Hartman v Assoc Truck, 178 MA 426 (1989)

After a Michigan personal injury attorney has filed a lawsuit against the insurance company for overdue no fault benefits, if that lawyer later accepts the case evaluation award he or she will waive §3148 attorney fee sanctions (assuming both parties accepted the case evaluation). Larson v Auto Owners, 194 MA 329 (1992)