The laws that govern Michigan car accidents are long and complex. Often, the terms spoken by automobile insurance agents and lawyers can be confusing. Two important terms you need to know are:
First-Party Benefits
Third-Party Benefits
Michigan is a “No-Fault Insurance” state. This means that your own auto insurance company pays most of your economic damages resulting from a Michigan car accident, whether or not you were at fault. These economic benefits are called First-Party Benefits.
At the same time, Third-Party Benefits usually cover non-economic losses, including damages for pain and suffering for injuries you suffered from a Michigan car accident. Both of these types of benefits are described in detail below.
Michigan First-Party Basics
The Michigan law defining First-Party Benefits states:
First-Party Benefits are payable to anyone who suffers an injury arising out of the ownership, operation, maintenance or use of a motor vehicle as a motor vehicle.
The following analysis looks at:
Who has to pay your Michigan No-Fault Benefits?
What are the specific benefits you may be entitled to receive?
Michigan First-Party Order of Priority
Although your own auto insurance is first in line to pay in a Michigan car accident, there are times when an uninsured individual is an innocent passenger in a motor vehicle. In these circumstances, determining who is responsible to pay Michigan No-Fault Benefits can be complicated. If you have questions about how these complex rules apply to you, contact an experienced Michigan car accident lawyer. Please submit a simple, free and confidential legal consultation form about your car accident claim to get help now.
Driver or Passenger Order of Priority for Payment of First-Party Benefits
1st priority is your own insurance policy, if none then...
2nd priority is the insurance company of a resident relative (i.e. spouse, parent, or sibling), if none then...
3rd priority is the insurer of the owner of the vehicle occupied, if none then...
4th priority is the insurer of the driver of the vehicle occupied, if none then...
5th priority is the State of Michigan Assigned Claims Facility.
Pedestrian Order of Priority for Payment of First-Party Benefits
1st priority is your own insurance, if none then...
2nd priority is the insurance company of a resident relative (i.e. spouse, parent, or sibling), if none then...
3rd priority is the insurer of the owner of the motor vehicle involved in the accident, if none then...
4th priority is the insurer of the driver of the vehicle involved in the accident, if none then...
5th priority is the State of Michigan Assigned Claims Facility.
Motorcycle Order of Priority for Payment of First-Party Benefits
There is a different order for benefit payments, if you were on a motorcycle when the car accident happened, because a motorcycle is not considered a “motor vehicle” under Michigan law. In a Michigan motorcycle/automobile collision, the priority would be:
1st priority is the insurer of the owner of the car involved in the accident, if none then...
2nd priority is the insurer of the driver of the car involved in the accident, if none then...
3rd priority is the motor vehicle insurer of the driver of the motorcycle involved in the accident, if none then...
4th priority is the motor vehicle insurer of the owner of the motorcycle involved in the accident, if none then...
5th priority is the State of Michigan Assigned Claims Facility.
The Michigan Assigned Claims Facility
The Michigan Assigned Claims Facility is a State Agency with the power to assign an insurance company to provide First-Party Benefits, if an injured victim cannot obtain benefits from other sources. However, uninsured drivers who were operating motor vehicles that they owned at the time of an accident do not qualify for Michigan Assigned Claim Facility assistance.
To apply for Assigned Claims Benefits, call the Michigan Assigned Claim Facility directly at 517-322-1875.
Specific Michigan First-Party Benefits
The First-Party No-Fault Benefits that you claim from your own auto insurance company after a Michigan car accident include:
Medical Bills for Life
Michigan law requires that medical coverage continue for life, or for as long as you need treatment for injuries suffered in the Michigan car accident. There may be many complicated factors in actually getting your medical bills paid after a Michigan car accident. If you have questions about the way these complex issues apply to you, contact an experienced Michigan car accident lawyer. Please submit a simple, free and confidential legal consultation form about your car accident claim to get help now.
To qualify for medical expense reimbursement, a medical bill must be reasonable (in cost and necessity) and the bill must be actually incurred. Michigan law does not provide for guaranteed pre-payment of bills for treatment of injuries resulting from a Michigan car accident. Sometimes, an insurance company will try to escape its responsibility, by questioning the need for a medical test or procedure ordered by your physician, or by disputing the amount of the medical bill.
Michigan No-Fault insurance companies offer two types of medical coverage:
Uncoordinated benefits.
Coordinated benefits.
An uncoordinated policy pays benefits, regardless of the presence of other health insurance. A coordinated policy requires your other health insurance to pay first, and your automobile insurance to pay amounts that your primary insurer does not cover. Your car insurance policy states which type of benefits you should receive.
It is common for a primary health insurance policy and auto insurance policy to contain contradictory language about which one has the first obligation to pay medical bills. Meanwhile, a motor vehicle insurance company may escape its obligation to pay a bill that it does not receive within one year of the date that you got the medical treatment. If you have questions about this, or find that neither insurance company is paying your medical bills in a timely manner, it is important to talk with an experienced Michigan car accident attorney immediately. Please submit a simple, free and confidential legal consultation form about your car accident claim to get help now.
Wage Loss
The Michigan No-Fault Law allows an injured individual to receive 85% of his or her lost wages, if a doctor found the victim disabled from work due to injuries suffered in a car accident. This benefit lasts up to 3 years. The wage loss benefit rate is set at 85%, rather than 100%, of lost earnings, because the benefit is tax-free. The law also sets a monthly cap on the amount of lost wages that the auto insurance company must reimburse.
In some cases, these and other rules create complicated issues. If you have questions about whether you are getting the correct wage loss benefits, consult an experienced car accident attorney immediately. Please submit a simple, free and confidential legal consultation form about your car accident claim to get help now.
Attendant Care
Michigan law requires a No-Fault auto insurance company to pay for attendant care (also known as nursing services) for an injured victim who needs supervision or assistance while recovering at home. A severely injured person may even need around-the-clock supervision.
A caregiver who is a member of the car accident victim’s family is entitled to reimbursement for attendant care services. Although the law does not set a specific hourly rate for the caregiver, the reimbursement should reflect the type and complexity of the services that the injured person receives.
Frequently, insurance companies refuse to pay for adequate attendant care. If this happens, you should contact an experience Michigan car accident lawyer. Please submit a simple, free and confidential legal consultation form about your car accident claim to get help now.
Replacement Services
This term refers to reimbursement for services that you would have performed on your own, if you were not injured in a Michigan car accident. If you paid or promised to pay for household services, chores, errands, etc., which you usually accomplished on your own, then you may be entitled to reimbursement for these expenses.
Your physician will need to provide a written statement identifying the tasks you are unable to do on your own. In addition, your auto insurance company may require documentation of who performed which services.
Michigan law states that an auto insurance company is obligated to reimburse up to $20 per day for replacement services and that these benefits last for up to three years.
Mileage Reimbursement
Often, proper medical treatment, tests, and physical therapy require an injured person to travel long distances. Michigan No-Fault auto insurance law provides for the reimbursement for mileage traveled to and from this medical care.
Third-Party Basics
While First-Party Benefits cover most economic losses, Third-Party Benefits provide damages for pain and suffering, scarring, disfigurement, or death, as well as wage loss in excess of 3 years.
A Third-Party legal claim is filed against the driver whose negligence caused the car accident. With the exception of excess wage loss, the damages claimed in a Third-Party lawsuit compensate the car accident victim for non-economic loss.
In Michigan, to prevail in a claim against a careless driver for non-economic damages, the injured victim must show that he or she suffered a "threshold injury." State law defines this as:
A serious impairment of an important body function, serious disfigurement or scarring, or death.
It is very common for the auto insurance company adjusters and attorneys who represent the negligent driver to assert that an injury is not a “serious impairment of a body function.”
However, if you have an objectively documented injury to an important part of your body, and this affects your life, you need an experienced Michigan car accident lawyer fighting to protect your rights. Please submit a simple, free and confidential legal consultation form about your car accident claim to get help now.
The Statute of Limitations (or time limit) for filing a Third-Party lawsuit is 3 years. Minors have until one year past their 18th birthday to take formal legal action. There are other exceptions for military personnel, mentally incapacitated individuals, and survivors of individuals killed in a Michigan car accident.
However, it is not wise to delay getting legal assistance after a car accident. To make the strongest possible case, you need to start as soon as possible on collection of valuable evidence and identification of potential witnesses.
If you or a loved one was seriously injured in a Michigan car accident, contact an experienced car accident lawyer immediately. Please submit a simple, free and confidential legal consultation form about your car accident claim now.
Protect your rights. Get the Bernstein Advantage today.
