Understanding Michigan No-Fault/PIP Benefits

In Michigan, PIP (Personal Injury Protection) claims are a crucial aspect of the state's auto insurance system. Michigan has a unique no-fault insurance system, which means that regardless of who is at fault for an accident, each driver's own insurance company is responsible for covering their medical expenses and certain other losses resulting from the accident.

Here's how PIP claims work in Michigan:

1. Coverage: Michigan law requires you to have no-fault automobile insurance on your car. PIP benefits typically cover medical expenses related to injuries sustained in a car accident, including hospital bills, surgery costs, rehabilitation expenses, and in-home care.
2. Coordination of Benefits (COB): In Michigan, insured individuals have the option to elect coordination of benefits. If they choose this option, their health insurance becomes primary for covering medical expenses related to injuries sustained in a car accident, and their PIP benefits become secondary. This means that if coordination of benefits is elected, the injured person's health insurance company will be responsible for covering eligible medical costs up to the limits of the policy.
3. Claim Process: When a person is injured in a car accident, they must promptly notify their own insurance company and file a PIP claim. The insurance company will then investigate the claim and may require the injured person to undergo medical examinations to assess the extent of their injuries and the need for ongoing treatment.
4. Statute of Limitations: In Michigan, there is a limited time frame within which a person must file a lawsuit for PIP benefits or other damages resulting from a car accident. The statute of limitations for PIP claims is generally one year from the date of the accident.
5. Exclusions: Here's an explanation of each situation in which a person may be excluded from receiving No-Fault benefits under the Michigan No-Fault Insurance Act:

1. 1. Operating an Unlawfully Taken Vehicle: If a person willingly operates or uses a motor vehicle or motorcycle that they knew or should have known was unlawfully taken, they may be excluded from receiving PIP benefits.
   2. Owner of an Uninsured Vehicle: If the owner of a motor vehicle or motorcycle involved in the accident does not have insurance coverage for the vehicle, they may be excluded from PIP benefits.
   3. Nonresident without Michigan Insurance: Nonresidents are generally excluded from PIP benefits unless they owned a motor vehicle registered and insured in Michigan.
   4. Named Excluded Operator: If a person is named as an excluded operator under their insurance policy and they operate the motor vehicle or motorcycle, they may be excluded from receiving PIP benefits.
   5. Vehicle with Excluded Coverage: If a person owns or operates a motor vehicle for which coverage was excluded under a policy exclusion permitted by Michigan law, they may be excluded from PIP benefits.
   6. Employee with Worker's Compensation: Employees who are eligible for worker's compensation benefits and sustain an injury with a parked vehicle during the course of employment may be excluded from PIP benefits in certain circumstances, such as when loading, unloading, or doing mechanical work on a vehicle unless the injury arose from the use or operation of another vehicle.
   7. Intentional or Self-Inflicted Injuries: Persons whose injuries are intentional, self-inflicted, or caused intentionally by the claimant are excluded from PIP benefits, as such acts are not considered accidental under Michigan law.