Photo of an auto accident

Michigan No Fault Benefits (PIP Benefits)

What are no-fault insurance (PIP) benefits and how do I get them?

No-fault insurance benefits are paid to any Michigan resident who is injured in an accident involving a motor vehicle.  These are always paid regardless of who was at fault for the accident.

You obtain these benefits by filing a claim for no-fault benefits with the proper motor vehicle insurance company, typically your insurance company, but there are some exceptions to this rule.  These benefits are referred to as “PIP benefits;” “no-fault benefits;” “first party benefits;” and “economic loss benefits.  Hereafter, we will call them PIP benefits.

One rule that confuses many Michigan residents is that even if you are rear-ended or you are not the at fault driver, you still must make a claim against your own insurance company.  Anyone involved in a motor vehicle accident in Michigan is entitled to certain Michigan no fault benefits, unless they were driving a car that they owned with no insurance.

Pedestrians, bicyclists, and maybe even motorcyclists are entitled to Michigan PIP benefits. The law specifically excludes motorcycles from no-fault insurance coverage unless the motorcycle is involved in an accident with a vehicle, or other special situations.

To receive PIP Benefits you must complete a written Application for Benefits and submit it to the proper insurance company within one year of the date of the accident.  If you do not, you will not be entitled to PIP Benefits.  Also, all written claims for PIP Benefits must be sent to the proper insurance company within one year of the date the expense was incurred. Again, if this is not done, you will be unable to receive these benefits. This is a very confusing area of Michigan No Fault law.

These Michigan PIP benefits include payment of medical expenses, lost wages, household replacement services, attendant care and mileage reimbursement for travel related to medical care.  They are discussed briefly below:

Medical Expenses:

The Michigan No Fault Law allows a person to obtain all allowable expenses, which is defined as “all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery or rehabilitation.”

Michigan PIP Benefits for Lost Wages Or Earnings:

Work loss benefits are payable to an injured person for three years following an accident, which covers 85% of the gross lost wages with a State maximum every year (i.e. 10/1/2013 the maximum benefit was $5,282 per month for up to three (3) years.)

Michigan PIP Replacement Services Benefits:

A person may obtain up to $20.00 per day in household replacement services for up to three (3) years after the date of the accident.  These include:  housekeeping, yard work, home maintenance, child-care, etc.

Michigan PIP Benefits for Mileage Expenses:

Transportation expenses incurred for the purpose of obtaining medical treatment is also a benefit that can be recovered by submitting a mileage form.

Michigan PIP Death Benefits:

In the event of death, no-fault benefits can be paid to surviving dependents.  If a family member is killed in an accident, your policy will pay your family up to 85% of the gross lost wages with a State maximum every year (i.e. 10/1/2013 the maximum benefit was $5,282 per month for up to three (3) years.)  This depends on what they would have received from the deceased’s earnings and fringe benefits.

You must file the claim within a year of the accident date or lose the right to receive your PIP benefits.

Michigan Car Accidents (Third-Party Tort Liability)

You are entitled to compensation for pain and suffering if:

  • The other driver was more than 50% at fault for the accident;
  • You suffer from a “serious impairment of a body function, or a serious and permanent disfigurement or death”;
  • You did not intentionally cause the accident; andYou were not the driver or owner of an uninsured automobile involved in the accident

The seriousness of your injury must be validated by a physician and usually includes diagnostic tests.  Most importantly, the injury must significantly affect your life.

Courts look to see how long you were off work and what activities you can no longer do.  If you continue to work after your accident and your activities are not significantly altered, then you are probably not suffering from a serious impairment of a body function.  If you have scarring from the accident, an experienced attorney can evaluate whether or not you have a serious and permanent disfigurement.

A claim must be filed within three years of the date of the accident, or if the injury is to a minor, before the minor’s 19th birthday.

If you or a loved one was seriously injured in a Michigan auto accident, talk with an experienced Michigan car accident lawyer.  The staff of Andrus Law Firm, PLC is always available to answer your questions.  Please contact us should you need any further assistance by either calling for a free consultation, or by submitting a simple, free, and confidential legal consultation form now.