Michigan No Fault Benefit Overview


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Michigan car accident lawyer shares a complete overview of Michigan no fault benefits and what benefits an auto accident victims is entitled to. These benefits include attendant care, wage and income loss, and medical benefits.

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Michigan No Fault Benefit Overview

  1. 1. By Daniel Buckfire, Attorney Michigan Car Accident Lawyer
  2. 2. I. OVERVIEW OF MICHIGAN NO-FAULT SYSTEM A. NO-FAULT ACT ENACTED IN 1973   - Michigan is a “pure” no fault state   - provides best benefits of any state in the country for seriously injured accident victims   - expected prompt payment of economic claims   - trade-off: limited ability to sue negligent drivers Contact our experienced Michigan no-fault insurance lawyers now! (800) 606-1717
  3. 3. <ul><ul><li>B. ECONOMIC CLAIMS AGAINST OWN INSURANCE COMPANY </li></ul></ul><ul><ul><ul><li>ALL MEDICAL EXPENSES (“ALLOWABLE EXPENSES”) </li></ul></ul></ul><ul><ul><ul><ul><li>Unlimited Coverage </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Coordinated vs. Uncoordinated coverage </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Allowable expenses include many types of services, and not just medical expenses. </li></ul></ul></ul></ul>
  4. 4. <ul><ul><ul><ul><ul><li>These include: </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Transportation </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Vehicle modifications </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Home modifications </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>In Home Nursing care/home aide care </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Mileage reimbursement </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Prescriptions </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Physical Therapy </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Occupational Therapy </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Vocational Training </li></ul></ul></ul></ul></ul>
  5. 5. <ul><li>  </li></ul><ul><li>WAGE LOSS CLAIMS FOR FIRST THREE YEARS AFTER ACCIDENT </li></ul><ul><li>85% of gross wages up to certain maximum amount </li></ul><ul><li>Self-employed, seasonal workers, and individuals looking for employment or about to start a new job are entitled to receive wage loss benefits </li></ul><ul><li>Retirees in certain situations may be entitled to receive wage loss benefits </li></ul><ul><li>  </li></ul><ul><li>  </li></ul>
  6. 6. <ul><li>Entitled to receive $20.00 per day for household chores provided to injured person or injured person’s dependents. </li></ul><ul><li>Typical services: cleaning, laundry, cutting the grass, cooking, shopping, etc. </li></ul><ul><li>Providers are usually family members or friends </li></ul><ul><li>  </li></ul><ul><li>REPLACEMENT SERVICES CLAIMS FOR FIRST </li></ul><ul><li>THREE YEARS AFTER ACCIDENT </li></ul>
  7. 7. <ul><ul><li>C ENTITLED TO RECEIVE NO-FAULT BENEFITS REGARDLESS OF FAULT IN THE ACCIDENT </li></ul></ul><ul><ul><ul><li>Drunk and intoxicated drivers can receive benefits </li></ul></ul></ul><ul><ul><ul><li>Negligent drivers can receive benefits </li></ul></ul></ul><ul><ul><ul><li>Drivers in one vehicle accidents can receive benefits </li></ul></ul></ul><ul><li>  </li></ul>
  8. 8. <ul><ul><li>D INTERESTING SITUATIONS WHERE CAN RECEIVE NO-FAULT BENEFITS </li></ul></ul><ul><ul><ul><li>Injured while getting into or while exiting a vehicle </li></ul></ul></ul><ul><ul><ul><li>Injured while loading or unloading a vehicle, such as groceries </li></ul></ul></ul><ul><ul><ul><li>Injured while performing maintenance on a vehicle </li></ul></ul></ul><ul><li>  </li></ul>
  9. 9. <ul><li>E. No-Fault Insurance Priority </li></ul><ul><ul><li>How to determine which insurance company has priority for paying no-fault claims. </li></ul></ul><ul><ul><li>If more than one insurer has equal priority in paying claims, claims should be submitted to both insurers. </li></ul></ul><ul><ul><li>Pedestrians/Bicyclists injured in auto accidents in </li></ul></ul><ul><ul><li>Michigan always entitled to no-fault benefits </li></ul></ul>
  10. 10. <ul><li>  F. NON-ECONOMIC DAMAGE CLAIMS AND EXCESS ECONOMIC DAMAGE CLAIMS AGAINST NEGLIGENT DRIVER </li></ul><ul><li>Non-economic damages includes damages for pain and suffering, disfigurement, and wrongful death </li></ul><ul><li>In order to receive non-economic damages, must have a threshold injury </li></ul><ul><li>If do not have a threshold injury, can not recover non-economic damages </li></ul><ul><li>Threshold Requirement: Objective impairment of an important body function that affects a person’s ability to lead his or her normal life </li></ul><ul><li>Threshold requires that injured person have a serious injury in order to make a claim for non-economic damages against the negligent driver. </li></ul><ul><li>Can recover excess economic damages against negligent driver without meeting threshold </li></ul>
  11. 11. <ul><li>HOOVER VS. MICHIGAN MUTUAL INSURANCE COMPANY, 281 Mich. App. 617 (2008) </li></ul><ul><li>Lawsuit brought by parents on behalf of quad, vent-dependent 25 year old for real estate tax bills, gas and electric bills, homeowner’s insurance, home maintenance, telephone bills, security sytesms costs, gasoline backup generator, dumpster, medical alert pendant, television monitoring system, and inspections of the elevator. </li></ul><ul><li>Holding : “[T]he holding in Griffith requires a court to determine whether the expenses would not have been incurred but for the accident and resulting injuries.” </li></ul><ul><li>“ [T]he question is whether the expenses would have been incurred in the course of an ordinary life unmarred by an accident.” </li></ul>
  12. 12. <ul><li>Hoover requires that an “incremental” or “differential” approach be used for computing no-fault benefits. </li></ul><ul><li>For example, with regards to utility bills, “a court must allocate not the portion of a utility bill attributable to the injured person’s usage, but that portion of the bill attributable to the injured person’s usage that is only occurring because of the injuries, e.g. power to operate Michael’s ventilator.” </li></ul>
  13. 13. <ul><li>NO-FAULT INSURANCE REQUIRED TO PAY </li></ul><ul><li>FOR THE WHOLE COST OF THE VAN </li></ul><ul><li>See the following cases: </li></ul><ul><li>Begin v. Michigan Bell Telephone Company , 284 Mich. App. 581 (2009) </li></ul><ul><li>Bonnie Yackish v. State Farm , unpublished decision, No. 289671 (2011) </li></ul><ul><li>Kenneth Admire v. Auto-Owners , unpublished decision, No. 289080 (2011) </li></ul><ul><li>Yackish and Admire cases are currently being appealed to the Michigan Supreme Court. </li></ul>
  14. 14. <ul><li>THREATS TO THE NO-FAULT SYSTEM </li></ul><ul><li>A. FEE SCHEDULES </li></ul><ul><li>B. ELIMINATION OF UNLIMITED MEDICAL COVERAGE </li></ul><ul><li>C. LIMITATIONS ON ATTENDANT CARE </li></ul>
  15. 15. <ul><li>PIP CHOICE </li></ul><ul><li>  </li></ul><ul><ul><li>Insureds can elect to receive less than unlimited medical coverage, in the following increments - $50,000, $100,000, $200,000, $400,000. </li></ul></ul><ul><ul><li>Any person who is entitled to receive no-fault benefits but who is not a named insured, a spouse, or a resident relative will only receive $50,000.00 in medical coverage benefits </li></ul></ul><ul><ul><li>All claims through the Assigned Claims Facility will be capped at $50,000 in benefits </li></ul></ul>
  16. 16. <ul><li>LIMITATIONS ON ATTENDANT CARE </li></ul><ul><li>  </li></ul><ul><li>Payment to non-certified, non-registered, or non-licensed individual : </li></ul><ul><ul><li>Limited to 56 hrs. per week </li></ul></ul><ul><ul><li>shall not be in excess of $11/hr for basic care and $17/hr for skilled care </li></ul></ul><ul><li>Payment to certified, registered, or licensed individual for attendant care or nursing services : </li></ul><ul><ul><li>Limited to $17.00 per hour </li></ul></ul>
  17. 17. <ul><li>1. MUST HAVE UNINSURED MOTORIST COVERAGE AND UNDERINSURANCE MOTORIST COVERAGE. </li></ul><ul><li>Very inexpensive </li></ul><ul><li>A. UNINSURED MOTORIST COVERAGE </li></ul><ul><li>Provides protection if other driver did not have </li></ul><ul><li>auto insurance. </li></ul><ul><li>Instead of suing uncollectible and uninsured driver </li></ul><ul><li>for non-economic damages and excess economic </li></ul><ul><li>damages, you make claim for these damages </li></ul><ul><li>against your own insurance company. </li></ul>RECOMMENDATIONS REGARDING PURCHASING AUTO INSURANCE
  18. 18. <ul><li>Provides protection if other driver does not have enough insurance coverage </li></ul><ul><li>(2) Example: </li></ul><ul><li>Person suffers catastrophic injuries in car accident. </li></ul><ul><li>At-fault driver has minimum liability policy of $20,000. </li></ul><ul><li>Injured person has $500,000 in underinsurance coverage. </li></ul><ul><li>Injured person collects first $20,000 from at­fault driver for non-economic damage and then can make claim against own insurance company for an additional $480,000. </li></ul>B. UNDERINSURANCE MOTORIST COVERAGE
  19. 19. 2. RECOMMEND UNCOORDINATED MEDICAL COVERAGE A. Best coverage available B. Possibility of &quot;double dip&quot;
  20. 20. <ul><li>“ We are never too busy for your referrals.” </li></ul><ul><li>LAW FIRM MISSION STATEMENT: </li></ul><ul><li>We are a Michigan law firm that counsels injury victims and their families. By handling a small number of select cases, we offer high-quality personalized service to our clients, using experienced attorneys, not paralegals. We provide free legal books and information to the public and we maintain a superior Web site with frequently refreshed content that includes downloadable, no-cost legal forms and educational videos. We value our reputation for integrity and skill and enjoy an outstanding track record of success. </li></ul>
  21. 21. <ul><li>Free review of your insurance policy </li></ul><ul><li>Fax copy of your insurance declaration page to Daniel Buckfire at (248)569-6737 or mail copy to Daniel Buckfire at 25800 Northwestern Hwy., Ste. 890, Southfield, MI 48075 </li></ul><ul><li>Please include your phone number where he can reach you during work hours of 9:00 a.m. to 5:00 p.m. </li></ul><ul><li>NO-FAULT NETWORK (SOCIAL NETWORK) </li></ul><ul><li>NO FAULT NEWSLETTER </li></ul><ul><li>- PLEASE PROVIDE ME YOUR INFORMATION </li></ul>QUESTIONS Call Daniel Buckfire at 1-800-606-1717 or e-mail at [email_address] anytime