What Are No-Fault PIP Benefits?
Under the Michigan No-Fault Act, there are four specific categories of no-fault personal protection insurance (PIP) benefits payable in motor-vehicle accidents resulting in bodily injury or death. Your entitlement to these benefits will depend on the facts of your case and the type and extent of the losses you’ve suffered. The four types of no-fault PIP benefits are summarized below.
The Michigan No-Fault Act requires insurance companies to pay “allowable expenses,” which are defined as “all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery or rehabilitation.”
Unless otherwise limited under Michigan’s No-Fault Insurance Reforms of 2019, these benefits are payable for life and do not have a monetary cap on the amount that may be collected. The benefits are very broad and include medical expenses; in-home attendant care; barrier-free residential accommodations; vocational rehabilitation; special transportation and medical mileage; guardian/conservatorship expenses; and the services of an independent case manager.
It should be further noted that under the Michigan No-Fault Reform, there will be new rules and regulatory procedures that govern how no-fault benefits are pursued and paid for an injured person’s medical care following a motor vehicle crash. These rules and regulations are known as “Utilization Review” and will go into effect on July 1, 2020.
The No-Fault Act also provides that when an injured person cannot work as a result of an auto accident, work loss benefits are payable for up to three years for “loss of income from work an injured person would have performed … if he or she had not been injured.” These work loss benefits are payable at the rate of 85% of gross pay, including overtime.
However, the work loss benefit cannot exceed the monthly maximum, which is adjusted every October to keep pace with the cost of living. The statute also provides for the payment of wage loss benefits to those individuals who are considered to be “temporarily unemployed” from full-time employment at the time of the injury.
Michigan no-fault law also provides that an injured person may receive reimbursement in an amount not to exceed $20 per day for expenses incurred in having others perform reasonably necessary services that the injured person would have performed for the benefit of themselves or their dependents. This benefit primarily consists of domestic type services, such as housekeeping, lawn work or snow removal.
When a Michigan car accident results in death, dependents of the decedent are entitled to recover survivor’s loss benefits under the no-fault law, as well as funeral and burial expenses.
Survivor’s loss benefits are payable for three years and are subject to the same maximum monthly benefit ceiling applicable to work loss benefits. Survivor’s loss benefits essentially consist of the after-tax income earned by the decedent, the value of fringe benefits that are lost as a result of the death of the decedent, and replacement service expenses incurred because of the decedent’s death.