Have you been injured? you may have a case. GET A FREE CONSULTATION

Auto Lawyer’s Tip: How to stop a No-Fault fraud accusation against your client

August 23, 2017 by Steven M. Gursten

Lawyers who process clients’ attendant care claims MUST fact-check before submitting No-Fault forms to insurers, who are only too eager to allege fraud over the most innocent of mistakes

No-Fault fraud

Yesterday, I talked about a new case bringing further clarity to Michigan’s evolving No-Fault fraud rules. This case applies to an uninsured car crash victim who’s seeking No-Fault benefits through the Michigan Assigned Claims Plan.

Today, I want to talk about how that case — Mills v. Titan Insurance — highlighted for me a very important issue that most, if not all, car accident attorneys in Michigan need to be thinking about:

If you’re collecting, processing and submitting paperwork to the auto insurance company in support of your client’s attendant care or replacement services claims, are you taking the steps that are now necessary to protect your clients — and yourself — from a fraud accusation from the insurance company?

Wake-up call for Michigan auto accident lawyers to protect injured clients against a No-Fault fraud accusation by an insurance company

I think the Mills case can be a wake-up call for all auto accident attorneys in Michigan, but, especially, for those Michigan No-Fault car crash lawyers who assist their clients with submitting their attendant care or replacement services forms and paperwork to their auto insurers, often for a reduced fee in pre-litigation.

I don’t love this practice, and I always encourage my clients to do handle their own No-Fault PIP claim themselves with my advice and guidance, but I recognize today that many, perhaps even most, auto accident lawyers in Michigan don’t give their clients a choice in the matter. These auto lawyers are charging an attorney fee from day one after a case is signed, whether the No-Fault claim is being contested or not. I think this is regrettable.

In Mills, Titan Insurance Company was doing what most car insurance companies do these days after a policyholder is involved in a car crash and needs help. Titan was trying to get out of paying the claim for No-Fault benefits by claiming, as insurance companies are doing at the drop of a hat nowadays, that the car crash victim committed No-Fault fraud based on conflicting and contradictory information submitted on his attendant care forms.

Seemingly in an effort to distance his client from the contents of the attendant care forms, the lawyer for the auto accident victim in Mills told the trial court that he — the lawyer — had personally submitted the attendant care forms from both of the victim’s attendant care providers to Titan Insurance.

Then (inexplicably) the attorney also said he had received at least one set of forms directly from his client, i.e. the auto accident victim.

OK, so maybe that doesn’t seem like such a big deal given how many auto lawyers nowadays process the No-Fault PIP paperwork for their clients, such as the various forms and submittals for their clients’ attendant care and replacement services claims.

But it could become a very big deal.

Especially if the information contained in the forms you’re submitting as an auto accident lawyer to the insurer on your client’s behalf is anywhere near as messed up as these forms were in Mills.

For instance, in Mills:

  • The two attendant care providers contradicted each other and the car crash victim about where he was living (!) when the attendant care was being provided.
  • The attendant care providers also contradicted each other about the dates on which attendant care was provided to the auto accident victim.
  • One of the attendant care providers claims to have provided attendant on the nonexistent day of “June 31.” Note: Unlike the first two, and the point below, I classify this in the innocent mistake category and one more example of how even the most innocent and silly mistakes can cause an insurance company claims adjuster or insurance defense lawyer to carelessly allege fraud and cut off all No-Fault benefits.
  • One attendant care provider’s account of how many hours per day she helped the car accident victim conflicted with the victim’s own account.

You break it, you own it: To protect against a No-Fault fraud accusation, auto accident lawyers must carefully fact-check their clients’ attendant care forms

I bring attention to this aspect of Mills not because the content of the attendant care forms in the case is so problematic.

But because those attendant care forms — and their conflicting and contradictory contents — passed right through the hands of the victim’s auto attorney attorney before being submitted to the auto insurance company, it makes the lawyer look, at best, sloppy.

At worst, the lawyer could be complicit.

In either event, the attorney appears open to a claim of legal malpractice by his or her client for any money that is now barred by the cut-off and refusal to pay No-Fault benefits based upon the attendant care forms themselves.

Case in point is the Mills case, itself.

Because the lawyer blindly submitted the attendant care forms to Titan without first reviewing them (no one can seriously argue that the lawyer reviewed the forms before submitting them with this many mistakes), the car crash victim’s attendant care claim was thrown out.

Bad, right? But, oh, how much worse it could still get for his attorney.

What if, for example, this had been a case to which the draconian Bahri No-Fault fraud rule had instead been applied?

Dismissal of the attendant care claim — and the entire PIP claim for all past, present, and future No-Fault insurance benefits — should serve as wake-up call for all Michigan auto lawyers who process and charge an attorney fee on their client’s attendant care, replacement services and other No-Fault forms and paperwork.

Mistakes can happen, we all agree. A lawyer’s mistake in not catching one date at the end of the month does not constitute legal malpractice (or shouldn’t, if common sense is applied).

But mistakes like the ones that we see in Mills are different in scope and quantity.

Lawyers who are charging attorney fees to process their client’s No-Fault claims have a special responsibility to make sure they are actually looking at these forms first before passing them on mindlessly to the auto insurer.

Remember, you break it, you own it.

[Community Guidelines]

Leave a Reply

Your email address will not be published. Required fields are marked *

Related Posts
Breaking News: DIFS Bulletin orders insurers to apply Andary Ruling Now
Andary v. USAA Michigan Court of Appeals ruling: No-Fault changes do not apply retroactively (Updated with New DIFS Bulletin issued on 10/5/2022)
August 25, 2022
Car Insurance For Teenagers: Michigan Laws For Minors Explained
Car Insurance For Teenagers: Michigan Laws For Minors Explained
June 15, 2022
Car Insurance Advice For Young Drivers In Michigan: Here's What To Know
Car Insurance Advice For Young Drivers: Here’s What To Know
June 13, 2022