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Michigan First Party Claims

After a car crash, your first recourse is against your own no-fault insurance provider. This PIP claim covers your medical expenses, lost wages for up to 3 years, and other payments essential to a full recovery.

Which Company Covers You?

The first step in claiming your First Party insurance coverage is to figure out which insurance company covers you. Once you narrow it down, complete the Application of Benefits form for that company and mail it to your provider right away.

To find out what company covers you, ask yourself the following questions:

Do You Own a Car?

If you have auto insurance on any vehicle, your own insurance company covers you, even if someone else caused the crash. Fault doesn’t matter. Even if the collision was because of your own carelessness, you can still receive benefits under your own no-fault insurance.

What If You Don’t Own a Car?

Just because you don’t have no-fault insurance doesn’t mean your out of luck when it comes to an automobile accident. Coverage could come from three sources:

  • Do you live with a family member who has auto insurance? If so, your “resident relative’s” insurance could cover your injuries.
  • No family coverage? No worries. You can still be covered by the insurance on the vehicle you were in at the time of the crash.
  • When all else fails, your claim will be turned over to the Assigned Claims Facility.

What Are Your No-Fault Benefits?

No-Fault insurance covers a variety of injuries and benefits. If you’ve been hurt in a car crash you can recover your:

Medical Expenses

Usually, your health insurance is the first line of defense in covering your medical expenses after an accident. But if your health insurance doesn’t cover it, or if you have to pay deductibles, the no-fault auto insurance company is required to pay all your accident-related medical bills for the rest of your life. That includes:

  • Medical bills: The no-fault insurance company must pay for reasonably necessary medical care related to injuries from your auto accident.
  • Mileage: The no-fault insurance company has to cover the actual cost of our transportation to and from accident-related medical treatment or reimburse you for your mileage.
  • Handicap Accessibility: If you need to modify your home because of your new medical circumstances, the no-fault insurance company can be required to pay for ramps, grab bars, or even structural modifications or additions.
  • Attendant Care: If you require home care – from high-intensity nursing to simple supervision and assistance, the no-fault insurance company must pay your aids for their work. That includes paying your friends or family for providing in-home care. Attendant care is an extremely valuable benefit that must be carefully and thoroughly documented. Many insurance companies will look for holes on your documentation as a basis to deny payment. Work with your doctor and your attorney to get the right documentation to get the most out of this extremely valuable benefit.

Wage Loss

If you can’t work because of your injuries, the no-fault insurance company is required to pay your lost wages. You can get up to 85% of your gross income for up to 3 years after your accident. Even if you were unemployed at the time of the accident, you may still qualify for wage loss benefits.

Household Services

After your accident you may not be able to do common household chores like cleaning or laundry. If you need someone to help you, the no-fault insurance company must pay up to $20 per day for these services for up to 3 years. That’s true even if your family members are the ones doing the work.

How Do You Get Your Benefits?

If you are ready to file your claim, here’s how to do it:

  1. File the Application for Benefits.
  2. Submit medical bills. Your doctors and medical providers must bill the correct insurance company within one year of providing you the necessary care and services.  If they miss the one-year mark, the insurance company does not have to pay the claims.
  3. The insurance company will verify your job and pay rate with your employer.
  4. Get a disability slip from your doctor and give it to your insurance provider. This should start the regular wage loss payments.
  5. Get a prescription from your doctor specifying the number of hours and nature of attendant care you need, and provide that prescription to your insurance provider.
  6. Document your replacement services and turn them in to the insurance provider with the date and nature of the service and the person who performed it.

Michigan’s no-fault laws are surprisingly complicated and changes frequently. If you need help, consult with an attorney that specializes in auto injuries full time.