6
Client Hotline: 1-800-590-1555 www.GoodmanAcker.com Your Guide To Michigan No-Fault Law Client Hotline: 1-800-590-1555 www.GoodmanAcker.com Phone: 248-483-5000 Fax: 248-483-3131 17000 West 10 Mile Road, Second Floor Southfield, MI 48075 Why Goodman Acker For The Filing Of Your No-Fault Insurance Claim? Insurance companies and their defense attorneys oſten consider the skill and expertise of your lawyer in considering whether or not to pay. eir knowledge that a full and convincing presentation of your damages will ultimately be made to any jury by our office has a substantial impact on the evaluation of your claim.

How Does Michigan No-Fault Insurance Work?

Embed Size (px)

Citation preview

Page 1: How Does Michigan No-Fault Insurance Work?

Client Hotline: 1-800-590-1555 www.GoodmanAcker.com

Your Guide To Michigan No-Fault Law

Client Hotline: 1-800-590-1555 www.GoodmanAcker.com

Phone: 248-483-5000Fax: 248-483-3131

17000 West 10 Mile Road, Second Floor

Southfield, MI 48075

Why Goodman Acker For The Filing Of Your No-Fault Insurance Claim?

Insurance companies and their defense attorneys often consider the skill and

expertise of your lawyer in considering whether or not to pay. Their knowledge that a full and convincing presentation

of your damages will ultimately be made to any jury by our office has a substantial impact on the evaluation of your claim.

Page 2: How Does Michigan No-Fault Insurance Work?

Michigan No-Fault LawThis brochure contains an overview of Michigan no-fault law. It does not include all of the details contained in the No-Fault statute, but gives you some of the important highlights and will be a helpful resource for you.

Our team is always available to answer any questions you may have regarding your No-Fault benefits and ongoing claim.

Under a Michigan No-Fault policy there are benefits which injured individuals may be entitled, regardless of who was at fault for the automobile accident.

There is a particular order of priority dictated by the No-Fault statute as to which insurance company will be responsible for providing benefits. We will be assisting you in this determination to ensure that the proper entity is held responsible for your benefits.

2

MIC

HIG

AN

NO

-FAU

LT LA

W

www.GoodmanAcker.com

We Can HelpThe law firm of Goodman Acker can assist you

with the handling of your No-Fault claim to ensure you receive all benefits to which you are entitled. Without an attorney, an insurance company will do everything they can to make sure they pay out

as little money as possible. Remember, the less insurance companies pay, the more they make.

At Goodman Acker, we understand that injuries caused by automobile accidents bring anxiety to

your life. By hiring Goodman Acker to assist in the processing of your No-Fault claim, you can focus on more important matters—attending to your injuries

and recuperation.

Please take a few minutes to read this brochure. It explains the various benefits to which you are entitled under the No-Fault statute and provides

additional information that will help us ensure you receive the benefits you deserve.

Page 3: How Does Michigan No-Fault Insurance Work?

Coordinated Medical CoverageIf you have a coordinated medical coverage policy with your automobile carrier, you must use your health care insurance first-unless it is Medicare and/or Medicaid. The No-Fault carrier will pay for costs not paid for by your health insurance—such as your deductible or co-pay. If a particular service is not available under your health insurance policy, you would still need to have the health insurance carrier billed first so they can deny the expense. It can then be submitted to the automobile insurance carrier for payment.

Because Medicare and Medicaid do not cover automobile accident injuries, all automobile related medical bills should be submitted to your No-Fault insurer and not to Medicare and Medicaid.

If you have selected Coordinated Medical Coverage under your automobile insurance carrier and you do not have any health insurance available, or if your carrier has an exclusion for payment of medical expenses relating to an automobile accident (this would include Medicare and/or Medicaid), it is possible that your automobile insurance carrier will not only hold you responsible for any deductible written into your original policy, but also charge you a “penalty” because you purchased a coordinated policy without having applicable health insurance coverage.

3 4

ME

DIC

AL

BE

NE

FIT

SCO

OR

DIN

AT

ED

ME

DIC

AL CO

VE

RA

GE

Client Hotline: 1-800-590-1555 www.GoodmanAcker.com

Medical BenefitsThe No-Fault Act requires that the no-fault insurer is liable to pay benefits for accident bodily injury arising out of the ownership, operation, maintenance or use of a motor vehicle. Benefits are payable for allowable expenses consisting of all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation.

Medical Expenses are payable for life and are unlimited in amount. Medical expenses would include:

• Hospital, doctor bills

• Medical tests, physical therapy

• Prescriptions

• Durable medical equipment (crutches, wheelchairs, prosthetic devices)

• Home modifications

• Home /residential care (attendant care)

Page 4: How Does Michigan No-Fault Insurance Work?

Primary Medical CoverageIf you are covered by a health insurance policy but have selected Primary Medical Coverage/Uncoordinated Medical Coverage for your No-Fault coverage, under some circumstances medical expenses related to your accident could be paid twice. Once by your health insurance carrier to the medical care provider, and a second time by the No-Fault carrier to you directly. However, there is often policy language in these policies which would prevent this from happening. We will review your policies to determine how these provisions will apply to your individual situation and advise you accordingly.

Attendant CareAttendant care is defined as in-home nursing care and/or nurse’s aide care rendered to an injured person, and is a benefit to which you are entitled under your No-Fault policy. Examples include showering, dressing, personal hygiene, helping with bandages, medications and therapy, activities of daily living, and executive functions and supervision. However, many of us are not comfortable with strangers in our home and would prefer to have our friends or family help us. Fortunately, the law provides that this care can be performed by family members and/or friends. The No-Fault carriers will pay the injured person so the family and friends can be compensated for the help they provide. We can provide assistance in obtaining this benefit on your behalf if it is prescribed by your physician. This type of care can also be provided by an outside agency who will assign personnel to come into your home to provide assistance.

6

AT

TE

ND

AN

T CA

RE

5

PR

IMA

RY

ME

DIC

AL

COV

ER

AG

E

Client Hotline: 1-800-590-1555 www.GoodmanAcker.com

Page 5: How Does Michigan No-Fault Insurance Work?

Transportation CostsTransportation costs are a benefit to which you are entitled under your No-Fault claim. This would include round trip mileage from your home to the following:

• Doctor appointments

• Hospital visits

• Medical Testing

• Therapy

• Pharmacy

You will be given forms from our office to track your transportation costs.

Work LossWork loss consists of lost wages or income an injured person would have collected from work performed during the first three (3) years after the date of the accident if he/she had not been injured. Work loss is a benefit to which you are entitled under the No-Fault law if a physician disables you from working. Because the benefits received from personal protection insurance for loss of income are not taxable income, the benefits payable for such loss of income generally are reduced 15%. No-Fault work loss does not include most fringe benefits including health insurance, life insurance, etc. However, No-Fault work loss does include overtime pay, wage increases and bonus payments that have been lost due to the injuries sustained in the accident. Proof of work loss must be submitted to the No-Fault carrier before any work loss claim will be considered. We will work with you to ensure that all necessary and available documentation is submitted to the No-Fault carrier and work loss benefits are paid appropriately.

7 8

ME

DIC

AL

MIL

EA

GE

WO

RK

LOS

S

Client Hotline: 1-800-590-1555 www.GoodmanAcker.com

Page 6: How Does Michigan No-Fault Insurance Work?

Replacement ServicesReplacement services are the routine household activities that you would have performed around the home except for the accident injuries. The insurance company will pay the injured party up to $20.00 a day for reimbursement of expenses incurred for having family or friends perform the injured parties’ household activities. This reimbursement can be paid for up to three (3) years. Examples of these types of activities would include:

• Housecleaning

• Child care

• Yard care

• Home maintenance

• Child transportation

• Pet care

The law provides that assistance with these routine activities can be performed by family members and/or friends. The No-Fault carriers will pay you so your family and friends can be compensated for the help they provide. We can provide assistance in obtaining this benefit on your behalf.

Statute of LimitationsYou need to be aware that you have one (1) year from the date an expense is incurred (this would include not only medical expenses, but also mileage, prescriptions, attendant care, replacement services and work loss) to submit an expense to your No-Fault carrier for payment of the benefit. Any expense not submitted in a timely manner, within the one (1) year from the date incurred, could result in the denial of payment of the benefit by the carrier. It is important that all bills, and claims for benefits are promptly submitted to our office. If you receive any medical billings in the mail, you must immediately forward them to our office. In some instances, the non-payment by the No-Fault carrier will result in our office filing suit to protect your claim. We will discuss this with you as your case continues.

9 10

RE

PL

AC

EM

EN

T S

ER

VIC

ES S

TAT

UT

E O

F LIMITA

TIO

NS

Client Hotline: 1-800-590-1555 www.GoodmanAcker.com