What Are No-Fault PIP Benefits?

What are you actually paying for when you buy no-fault insurance? You may have heard about PIP benefits, but what does that mean? What can you expect to receive from your auto insurance provider after an auto accident?

Michigan No-Fault Auto Insurance

Drivers in the State of Michigan are legally required to maintain no-fault auto insurance on each vehicle they intend to use on a public road. The insurance is designed to cover you and your passengers after a crash. But no insurance policy pays for everything. So what are you getting for your money?

Michigan no-fault insurance policies consist of personal injury protection (PIP) benefits and liability benefits. The liability section of your policy provides a base level of coverage when something you do severely injures another person or causes substantial property damage. PIP benefits include medical expenses, lost wages, attendant care, and replacement services.

PIP Medical Expense Benefits

After an auto accident, your no-fault auto insurance is required to pay for "all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person's care, recovery, or rehabilitation." The No-Fault Act is written broadly to cover a wide range of rehabilitative services. You can be compensated for everything from hospital stays and surgeries to therapeutic massage and prosthetics.This includes 100% of your reasonable medical bills.

When an insurance provider denies claims for medical expenses, it often claims:

  • The injury wasn't caused by an accident
  • The treatment you received wasn't reasonably necessary for your care
  • You had already reached your full recovery, so the treatment did not benefit you
  • The amount charged for your medical treatment was more than reasonable

An experienced auto accident attorney can protect your claim against each of these defenses and make sure all your medical expenses are covered.

PIP Wage Loss Benefits

If your auto-related injuries cause you to miss work, your PIP benefits will cover up to 3 years of lost wages. The No-Fault act allows benefits for "Work loss consisting of loss of income from work an injured person would have performed during the first 3 years after the date of the accident if he or she had not been injured". However, this award will be reduced by 15% to account for your normal tax liability. The result is that most car crash victims will receive 85% of your normal salary or hourly wages. There is also a maximum recovery that changes every year. This means very high wage earners may receive less than 85% of their total salaries.

To collect wage loss benefits you must show that you actually would have earned that income had you not been injured. Merely being able to work is not enough. For most auto accident victims, lost wages are measured based on their pay stubs or tax returns from the period immediately before the accident. But if you are self-employed or between jobs, your auto accident attorney may need to do more to establish what you actually would have earned had the accident never happened.

Attendant Care Costs

Recovery from a serious auto accident doesn't end when you are released from the hospital. Sometimes you need help at home with things like bathing, dressing, eating, and preparing meals or medications. These attendant care costs are considered part of your reasonable medical expenses. Even if the person providing the care is a family member or neighbor, that person is still entitled to the reasonable market rate for attendant care services.

To collect these benefits, auto accident victims and their family members should keep a careful log. For each day of care, include:

  • The date
  • Who provided the service
  • What was done
  • How many hours it took

Replacement Services

After a serious auto accident, there will be some household tasks that you are medically unable to perform. Whether it is childcare, laundry, or landscaping, you may need to hire someone to do the work you would have done if the accident never happened.

PIP benefits will pay up to $20 per day for the first 3 years after your accident. However, the costs must be reasonably necessary given your condition. To make sure you qualify, ask your doctor to provide proof of your medical restriction. Often this will take the form of a "prescription" for snow removal or housekeeping. Your auto accident attorney can use that prescription form, along with receipts from the replacement service provider, to make sure you get reimbursed for the costs.

PIP benefits cover a wide variety of expenses and lost income that result from an auto accident. Getting the most out of your benefits often requires the work of a skilled auto accident attorney. At Sachs Waldman, we have extensive experience helping auto accident victims recover PIP benefits from no-fault insurance providers. We can help you get your expenses covered. Contact our Detroit personal injury law office at 1-800-638-6722.

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