Your Automobile No-Fault Rights And What You Must Do To Protect Them

When you are involved in an automobile accident, generally you are entitled to certain benefits under the Michigan No-Fault Insurance law, regardless of fault. Your basic No-Fault benefits potentially available to you include coverage for your medical expenses, wage loss, replacement services and survivor's loss.

Your insurance company is required to pay those benefits that your are entitled to within 30 days from when it receives "reasonable proof of the fact of an amount of the loss," e.g., when it receives copies of your medical records from your treating physician(s) substantiating your claim. If your insurance company does not pay your benefits after the 30 days, it is required to pay you 12% interest per annum as to each claim.

Also recognize that if you were injured, you may have a separate claim against the other driver or owner of the vehicle involved in the accident for your pain, suffering and disfigurement; therefore, you should immediately seek legal counsel to preserve and prosecute this possible lawsuit.

You must file a lawsuit within 12 months from the date that you incurred the particular expense denied or terminated; otherwise, you will lose all rights to be reimbursed for that expense. While you have 12 months to file a lawsuit, it is advisable to seek legal counsel as soon as you are experiencing difficulty with your insurance company so that your potential lawsuit/claim can be properly documented and pursued.

Medical expenses: All necessary medical care for your rehabilitation and recovery from injuries caused by the auto accident are covered and paid for life. Examples include hospital care, doctor visits, physical therapy and assistance with daily living by a nurse or family member; incidental medical expenses may also include reimbursement for medical prescriptions, mileage to and from the medical care providers or necessary alterations to your vehicle and/or home.

Wage loss: You are entitled up to 85% of your lost wages for time off due to your injuries caused by the auto accident. This benefit is available to you for up to 3 years from the date of the accident but is subject to a maximum monthly benefit, adjusted every year by the Michigan Insurance Bureau.

Replacement services: You are entitled to reimbursement up to $20.00 dollars a day for up to 3 years from the date of the accident, for reasonably incurred expenses for ordinary services performed by family or friends, that you traditionally performed but now cannot because of your injuries. Examples of uch services include, but are not limited to, ordinary household tasks like mowing the lawn, cleaning, laundry, etc.

Survivor's loss: The dependents (spouse and children) of a deceased individual who is killed in an automobile accident are entitled to a survivor's loss benefit for up to 3 years from the date of the accident, subject to the maximum monthly benefit.

If you have health and/or disability insurance through your employer, you may have purchased coordinated auto insurance coverage. If so, then your auto insurance company will pay only those medical expenses or wage loss claims that your primary insurer (through your employer) will not pay.

Furthermore, medical, wage and survivor's benefits are subject to setoff by your insurance company for those benefits "provided or required to be provided by statute or Federal law." Examples include, but are not limited to, Medicare, social security disability, state worker's compensation and military benefits.

When involved in an automobile accident, you should:

1. If injured, immediately seek legal counsel regarding your potential claim for pain, suffering and disfigurement against the other driver involved in the accident.
2. Immediately file an Application for No-Fault Benefits with your insurance company. Failure to do so within 12 months of your automobile accident will prevent you from ever obtaining those benefits you may be entitled to receive.
3. Monthly, submit a claim letter for reimbursement of medical expenses, wage loss and replacement services. Always include your name, claim number and date of the accident. Always submit, if available, copies of your receipts, work releases or notes from your doctors or your employer, and summaries of household jobs done on your behalf (see below).

1. Inform all medical providers (hospitals, doctors, etc.) of your insurance company name and claim number.
2. Submit copies of all receipts for medical expenses incurred (e.g., prescriptions) to your insurance company, immediately.
3. Keep a log or diary of all miles driven to and from medical providers.
4. Request letters from physicians/therapists recommending needed expenditures for assistance with daily living by a nurse or family member, rehabilitation devices or equipment.
5. If requested to submit to an independent medical exam set up by your insurance company, take a family member or friend with you and time the duration of the entire exam.

1. Request letters or notes from your doctor(s) who have placed you on work restrictions with the applicable dates; diary or log each and every day missed from work.
2. If an hourly employee, calculate hours for potential overtime loss.

1. Orally or in writing agree to pay family members or friends up to $20.00 dollars a day for help around the home.
2. Diary or log all services performed on your behalf identifying the nature of the service performed and who performed it.
3. Request letters or notes from your doctor(s) who have placed you on general restrictions (e.g., no lifting).