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No-Fault Insurance Benefits

Michigan PIP Benefits: What You Need To Know

Our insurance lawyers explain the Michigan PIP benefits you’re entitled to under the No-Fault law if you’re seriously injured in a car accident

Michigan PIP benefits help car accident victims recover and rebuild their lives after tragedy has struck.

By covering a victim’s accident-related medical bills, they help ensure that victims get the medical care and treatment they need to recover.

And by reimbursing victims for the wages that are lost when disabling injuries and limitations prevent a return to work, they provide the financial support that victims and their families need to begin rebuilding their lives.

Often referred to as “personal protection insurance” benefits or “personal injury protection” benefits, PIP benefits are guaranteed to car accident victims under the No-Fault law. They are payable regardless of whether (or to what extent) a victim was at-fault and they are paid by a victim’s own auto insurance company. Anyone who drives regularly in Michigan must have PIP benefits insurance on their vehicles.

What are Michigan PIP benefits?

Michigan PIP benefits will pay for your medical bills and lost wages after you’ve been injured in a car accident. Guaranteed by the No-Fault law, PIP benefits are paid regardless of whether you were at-fault. They are paid by your own auto insurance company, which means you don’t have to sue the at-fault driver.

Michigan PIP benefits available

If you have been injured in a car accident, then you are legally entitled to collect Michigan PIP benefits under the auto No-Fault law. These benefits, which will help you recover from your accident-related injuries and begin to rebuild your life, include the following:

  • Medical Expenses – Your accident-related medical bills and expenses will be covered up to the dollar amount of the No-Fault PIP medical benefits coverage level selected in the auto insurance policy through which you are claiming PIP benefits. Prior to July 1, 2020, all policies provided “unlimited” medical coverage. However, for policies issued or renewed after July 1, 2020, unlimited is one of the several coverage level options that drivers may select from.
  • Medical Mileage – PIP benefits cover your transportation costs for traveling to and from medical appointments at doctors’ offices, hospitals and rehabilitation and therapy clinics. These covered costs include mileage and/or bus, taxi or Uber/Lyft fares in the event that you do not drive.
  • Wage Loss – If your accident-related injuries have disabled you from returning to work after your car accident, then your PIP benefits will reimburse you for the wages you have lost. Wage loss benefits are available for three years from the date of the accident and subject to a monthly maximum. Because these benefits are not treated as taxable income, payments reflect 85% of your wages.
  • Replacement Services – PIP benefits will pay up to $20 per day during the first years after your car accident to reimburse people who help you by performing “ordinary and necessary services” that you can no longer do because of your accident-related injuries and limitations. Replacement services benefits typically cover every day, household tasks such as housekeeping, laundry, cleaning, lawn and garden maintenance, car maintenance, shoveling snow, meal preparation, baby-sitting/child care, driving family members to school and appointments and taking out the garbage.
  • Attendant Care – If your car accident-related injuries require you to have attendant care – whether it is on a 24/7 or more limited basis – then PIP benefits will pay the cost of that attendant care. The services can be provided in your home by a family member or a nurse hired from a commercial agency. Additionally, attendant care provided in a residential facility is also covered. Attendant care involves helping car accident victims with “activities of daily living” that they can no longer accomplish independently due to their accident-related injuries and limitations. Examples of covered activities include monitoring and supervision for safety reasons, administering medication, bathing, dressing, ambulation, styling/combing of hair, other grooming, help using the toilet, driving the patient, fetching things for the patient, carrying and lifting things for the patient, and wound care. Importantly, after July 1, 2021, No-Fault auto insurance companies will not be obligated to pay for more than 56 hours per week of in-home, family-provided attendant care. But attendant care providers and auto insurance companies can contract to provide paid coverage in excess of the weekly limit. (MCL 500.3157(10) and (11))

PIP benefits and medical coverage

The extent to which PIP benefits will cover your accident-related medical bills will depend on the No-Fault PIP medical benefits coverage level that was selected in the auto insurance policy through which you have filed your claim for PIP benefits. (MCL 500.3107(c)(5))

For auto insurance policies issued or renewed after July 1, 2020, the medical coverage level will be one of the following:

  • $50,000 limit on accident-related medical expenses for drivers who are enrolled in Medicaid (MCL 500.3107c(1)(a))
  • $250,000 limit on accident-related medical expenses (MCL 500.3107c(1)(b)
  • $500,000 limit on accident-related medical expenses (MCL 500.3107c(1)(c))
  • Unlimited or no dollar-amount limit on accident-related medical expenses (MCL 500.3107c(1)(d))
  • Opt out of No-Fault PIP medical benefits altogether for drivers on Medicare (MCL 500.3107d(1))

Prior to July 1, 2020, the No-Fault law required all drivers to carry “unlimited” No-Fault PIP medical benefits.

Excess PIP benefits coverage

You may be able to sue the at-fault driver who caused your car accident for “excess” medical and wage loss benefits.

This is possible if: (1) your accident-related medical bills exceed the No-Fault PIP medical benefits coverage level in the policy through which you are PIP benefits; and/or (2) the wages you’ve lost because your injuries have disabled you from working exceed the No-Fault law’s 3-year or monthly limitations on wage loss benefits. (MCL 500.3135(3)(c))

How much does PIP cost in Michigan?

The cost of PIP in Michigan, which is approximately 35% of your total auto insurance bill, depends on: (1) the level of medical coverage you choose; (2) if you coordinate coverage; (3) if you choose a deductible; (4) your driving history; (5) other drivers on the policy; (6) your age; and (7) your income.

Importantly, after July 1, 2020, auto insurance companies are prohibited from using the following rate-setting factors in calculating driver’s auto insurance premiums for PIP benefits coverage: sex, marital status, home ownership, education level attained, occupation, the postal zone in which the insured resides and credit score. The prohibition against these non-driving factors begins July 1, 2020. (MCL 500.2111(4); 500.2105(6))

Is PIP required in Michigan?

PIP is required in Michigan. Also referred to as “personal protection insurance” or “personal injury protection” insurance, PIP is one of the mandatory auto insurance coverages under the No-Fault law. Anyone who drives regularly in Michigan must have it. There are severe penalties for driving without PIP.

Driving without the required PIP coverage means that you were driving “uninsured” and if you were injured in a car accident, then you will lose very important PIP benefits:

  • You will be barred from collecting PIP benefits to pay for your medical bills.
  • You will be barred from collecting PIP benefits to pay for your lost wages.
  • You will be barred from suing the at-fault driver for excess medical benefits and lost wages, pain and suffering compensation and vehicle damage (through a mini tort claim).
  • You could be held financially liable for PIP benefits paid by other insurance companies to other people injured in the accident, including the at-fault driver – even if you were 100% NOT AT-FAULT in causing the accident.

How do I claim my PIP benefits?

To collect PIP benefits after you were injured in a car accident, you must file an application for Michigan PIP benefits with the applicable auto insurance within ONE YEAR from the date of your car accident. (MCL 500.3145(1))

If you fail to file your application for PIP benefits (which is also called a “notice of injury”) on time – within one year from the date of your car accident – then you will forever lose any benefits to which you might be entitled.

Who pays my PIP benefits?

If you have your own auto insurance policy in which you are the “named insured,” then your own auto insurer will pay your PIP benefits.

Otherwise the No-Fault law’s “priority” rules will determine what insurer is responsible. Generally – albeit subject to certain exceptions – if you don’t have a policy, then the applicable insurance company to pay your PIP benefits will be your spouse’s insurer or the insurer for a family member who lives with you.

If you don’t have coverage through any of these sources, then you will file your application for PIP benefits with the Michigan Assigned Claims Plan and they will assign an auto insurance company to pay for your benefits.

When are PIP benefits paid?

Your auto insurance company is supposed to pay your PIP benefits within 30 days of receiving “reasonable proof” of what is owed. However, if it’s an outstanding medical bill that you would like paid and you don’t give the bill to your insurer within 90 days of your care or treatment, then the auto insurance company has an extra 60 days to pay. (MCL 500.3142(2) and (3)) If the insurance company doesn’t pay on time, then your unpaid PIP benefits are considered “overdue.”

PIP benefits lawsuit

When your PIP benefits are unpaid and overdue, you can sue your auto insurance company. But your lawsuit must be filed within one year from the date that the medical bill or wage loss or replacement service was incurred, otherwise you will lose your legal rights to sue to get recover the unpaid, overdue PIP benefits. (MCL 500.3145(2))

Significantly, the one-year period of limitations “is tolled from the date of a specific claim for payment of the benefits until the date the insurer formally denies the claim.” (MCL 500.3145(3))

Injured and need a lawyer? Call Michigan Auto Law

If you have been injured in a car accident and you have questions about your legal rights to Michigan PIP benefits, you can call toll free anytime 24/7 at (800) 777-0028 for a free consultation with one of our experienced auto accident attorneys. You can also get help from an experienced attorney by emailing [email protected] or you can use the chat feature on our website.

PIP Benefits
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