No-Fault lawyer explains that Michigan PIP benefits pay for a ‘replacement’ to perform tasks and chores that an auto accident victim would have performed
An injured Michigan resident who is hurt in an auto accident may not be able to perform normal household chores and tasks, such as shoveling snow. But Michigan No-Fault PIP “replacement services” benefits make it possible for an accident victim’s normal household duties to still get done. It is an important Michigan No-Fault benefit (also referred to as Michigan PIP), that many people know nothing about.
No-Fault “replacement services” benefits pay for someone — i.e., a replacement — to perform the “ordinary and necessary services” the victim would have done for himself and his family had he not suffered disabling injuries in the accident.
Under Michigan’s No-Fault Law, MCL 500.3107(1)(c), an auto accident victim is entitled to “replacement services” under the following conditions if his accident-related injuries have disabled him from performing his normal household chores and tasks:
“Expenses not exceeding $20 per day, reasonably incurred in obtaining ordinary and necessary services in lieu of those that, if he or she had not been injured, an injured person would have performed during the first 3 years after the date of the accident, not for income but for the benefit of himself or herself or of his or her dependent.”
It is understood that No-Fault “replacement services benefits” (which are also referred to as “household services”) are the “expenses” referenced in the No-Fault Law as having been “reasonably incurred in obtaining ordinary and necessary services.”
Chores that are covered under No-Fault replacement services
The replacement services required for any given auto accident victim will depend on both the specific victim and the unique facts of his case.
The following services are frequently covered by No-Fault replacement services benefits:
o Dish washing
o Making bed
o Changing linens
o Snow shoveling
o Grass cutting
o Leaf raking
o Grocery shopping
o Taking out garbage
o Running errands
o Child care
o Home repairs
o Car repairs
o Window washing
No-Fault replacement services and proving disability
The critical factor in establishing that a Michigan auto accident victim is entitled to No-Fault replacement services benefits is showing that the victim’s accident-related injuries have disabled him from performing his normal household chores and tasks (“ordinary and necessary services”).
A victim’s replacement services disability is most commonly verified through a “replacement services disability certificate” by one or more of the physicians who are treating the victim for his accident-related injuries.
A physician-issued replacement services disability certificate will specify the following:
o The auto accident victim is totally disabled from performing his normal household chores and tasks and/or “ordinary and necessary services;”
o The services and/or household chores and tasks that the auto accident victim is disabled from performing;
o The period of time during which the replacement services disability is expected to last;
o The injury and/or injuries that cause the victim to be disabled from performing his normal household chores and tasks and/or “ordinary and necessary services.”
Household services statement
Almost as important as showing the disability that gives rise to the need for replacement services is showing that the prescribed replacement services were actually performed.
Without proof of both disability and performance, a No-Fault auto insurance company is likely to refuse payment of replacement services benefits.
To prove that replacement services have been performed, the auto accident victim and/or his replacement services provider must complete and submit a “Household Services Statement” to the victim’s No-Fault insurer.
Among other things, the “Household Services Statement” should contain the following information:
o Name of the person who provided replacement services to the victim.
o The replacement services that were provided.
o The dates on which replacement services were provided.
Providers of replacement services
Neither Michigan’s No-Fault Law nor Michigan case law place any restrictions on who can provide replacement services to an auto accident victim.
No-Fault insurer pays for replacement services
The Michigan auto accident victim’s No-Fault insurance company pays for the victim’s replacement services or “ordinary and necessary services” — so long as the expense does not exceed $20 per day and the services are those the victim would have done for himself and his family had he not suffered disabling injuries in the accident.
Limits for replacement services
The maximum daily amount payable for No-Fault replacement services benefits is $20 per day.
A Michigan auto accident victim is entitled to receive No Fault replacement services benefits for the first three years after the date of the accident.
Excess replacement services
If the daily limit and/or the three-year limit is insufficient to cover a Michigan auto accident victim’s actual expenses for replacement services resulting from his accident-related injuries, then the victim can pursue a claim for “excess” replacement services benefits. (MCL 500.3135(3)(c); Johnson v. Recca, Michigan Court of Appeals, #294363, April 5, 2011)
To pursue a claim for excess replacement services benefits, the victim will have to sue the driver who allegedly caused the accident and prove in court that the driver was actually “at fault” in causing the accident.
– Steve Gursten is one of the nation’s top No-Fault lawyers handling car accident cases. He is head of Michigan Auto Law and president of the Motor Vehicle Trial Lawyers Association. Steve frequently writes about the Michigan No-Fault law and is available for comment.
Related information to protect yourselves:
Michigan No-Fault Law 101 – How to fill out an application for benefits
The pain and suffering lawsuit
Michigan No-Fault insurance resource center
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 to better serve you. Call (248) 353-7575 for help from a Michigan No-Fault lawyer.