If you were injured in a car crash in Michigan, you might be able to receive Michigan medical expense benefits through no-fault insurance. If successful, these expenses might cover costs for hospital visits, doctor appointments, physical therapy treatment, prescriptions, ambulance trips, and medical appliances, such as wheels, crutches, and others.

Furthermore, you might be entitled to payment for mile and transportation expenses for your medical appointments. However, navigating the claims process alone and understanding how to request compensation might be difficult. By working with a skilled attorney, you could have help to understand your options and decide how to proceed.

Medical Expenses Covered by No-Fault Insurance

Michigan’s no-fault coverage has some of the most generous medical expense provisions in the United States. Outlined in MCL 500.3107, the allowable expenses in the state consist of virtually any expense incurred by an injured claimant that is essential to their recovery process—including care and rehabilitation costs.

However, exceptions to this cover exist—such as needing to justify expenses—which is why an injured motorist may benefit from the counsel of a well-versed attorney when seeking compensation. Essentially, to receive these benefits, an applicant must:

  • Determine which insurance company is responsible for paying a no-fault claim
  • Request an Application for no-fault insurance benefits
  • Submit an Application for no-fault insurance benefits
  • Obtain attending physicians report
  • Submit medical expenses to the insurance company within one year of the date of service

Are There Limits on Payments of Medical Expense Benefits?

Until a change in the law on July 1, 2020, there were no limits on the amount of medical expenses the insurance company was obligated to pay over a person’s lifetime.   The only limitation was that the medical bills must be reasonable and necessary for a person’s care, recovery, and rehabilitation. However, a change in law made a drastic change to these benefits.

Under the new law, drivers have several six (6) options to buy medical benefits coverage.  The insurance company is only obligated to pay the limits of the coverage purchased.

Option 1:   Unlimited PIP Coverage:  This is the same that existed before the change in the law and pays for unlimited medical expenses over an injured person’s lifetime.

Option 2:  $500,000 PIP Coverage:  This pays for medical treatment and expenses up to $500,000. While this may seem significant, it will rarely cover a catastrophic injury.

Option 3:  $250,000 PIP Coverage:  This pays medical bills for accident-related injuries to a maximum of $250,000.00.

Option 4: Limited PIP Medical Coverage o $250,000 Exclusions:  This allows persons who person the $250,000 maximum to opt of of coverage for themselves and relatives.

Option5:  $50,000 PIP Coverage:  This is available to persons enrolled in Medicaid.  Persons must also have their own health insurance that covers auto-accident related injuries.

Option 6: No Medical Coverage:  This coverage is only available to applicants or named insureds who are covered under Medicare Parts A and B. Persons must also have their own health                                     insurance that covers auto-accident related injuries.

Which is the best Medical Expense Option to Buy?

The best option is the Unlimited PIP Coverage.  This provides people with unlimited, lifetime medical payments and benefits.  If affordability is an issue, we suggest that you purchase the highest amount of PIP coverage you can afford.  Although you may never need the coverage, it is comforting to know that medical expenses will not destroy your credit and that you can receive treatment for as long as it is needed.  With the cost of medical treatment rising every year, the unlimited coverage is the best way to protect you and your family.

Medical Mileage Payments

Along with other medical expense benefits, no-fault insurance might require an insurance company to pay a reasonable rate, per mile, for every mile of travel that an injured person travels to and from medical appointments. Furthermore, if a person does not have a form of transportation available, the insurer might have to pay a transportation company to take them to and from doctor appointments, therapy treatments, and other required medical trips.

These claims must be submitted to the insurance adjuster working on the claim. To do so, a person must make a list of the days they attended appointments, the name and address of the doctor or clinic, and the distance to and from their home. These claims should be submitted every thirty days.

If an insurance company refuses to pay these benefits, a claimant’s only legal recourse is to file a lawsuit. If so, a person must pursue a lawsuit within one year from the date when their last unpaid benefit was incurred. Usually, these lawsuits seek payment for unpaid expenses, such as medical bills or attendant care services.

Call a Lawyer to Pursue Medical Expenses Through Michigan’s No-Fault Insurance

If you were injured in a car collision, consider reaching out to a dedicated lawyer to discuss your legal options and avenues for pursuing recovery. Even if no other driver can be deemed at fault for a civil lawsuit, you might still be able to pursue medical expenses through Michigan medical expense benefits under no-fault insurance.

However, navigating the claims process alone might prove confusing, especially as you recover from your injuries. To learn more, call a legal professional at Buckfire & Buckfire, P.C. today.

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