Key Points of This Article:
- When a person is negligent for causing a motor vehicle accident, their car insurance company is responsible for compensating the victim for his or her injuries.
- If opening a medical claim with State Farm, injured persons should be aware that the company’s goal is to pay out the least amount of benefits it can without breaking the law.
- Because State Farm writes so many auto policies in Michigan, it also has several different teams of experienced adjusters who handle specific cases and may cause extra stress for individuals who are already injured.
- State Farm adjusters, like all insurance adjusters, tend to assign a lower value to a case if a lawyer does not represent a claimant.
How State Farm Handles Car Insurance Claims in Michigan
It’s reasonably easy to locate a State Farm Insurance sales representative in Michigan. Offices can be found in nearly every county from Van Buren to Wayne, making State Farm one of the largest insurance providers not only in the state but also in the country. In 2018, the company supported by a vast corporate structure of adjusters and support staff, wrote approximately $42 billion in car insurance policy premiums, representing more than 17% of the total US market. It is common for Michigan residents who have been injured in a car, truck, or even motorcycle accident to work with the group.
Under Michigan law, if an injured person is insured with State Farm, there is the potential to file three separate claims, including a no-fault medical claim, a claim for pain and suffering, and a property claim for vehicle damage. In each of these cases, State Farm will have a goal to pay the least amount of benefits it can without running afoul of the law.
- Medical Claim, including Wage Loss and Replacement Services
State Farm Insurance has an entire department responsible for handling and paying Michigan no-fault benefits, and they rarely miss a beat when evaluating claims. And similar to most other Michigan car insurance companies, State Farm does not require claimants to complete an Application for Benefits. Instead, the adjuster handling the claim will request a list of treaters and a signed medical authorization so they can begin to review medical records. They may also want the name of a current or former family doctor, so that they can review a person’s medical history prior to the crash.
Each medical adjuster has a team of support staff to help approve or challenge a claim. The company is very aggressive and routinely places injury claims under investigation. The team is also known to send injured individuals in for an “independent medical examination” or IME and spends a generous amount of money paying medical professionals from different specialties (orthopedic, chiropractor, pain management) to prepare reports used to justify denial or not paying the full value of the no-fault claim. These doctors are not hired to provide treatment, or help to patients but rather to:
- review medical records and documents the adjuster provides
- examine the auto accident victim
- author a report used by the adjuster to either pay or terminate benefits
Additionally, if a person is making a wage loss claim, the State Farm representative will usually require a Wage, Salary and Verification form to be completed by the employer. This document details the injured person’s wage information, such as hourly pay, usual hours per week, overtime pay, and other employee information. If an injured person is also claiming replacement services or attendant care, State Farm will provide its own forms that the injured person and his service provider must complete. These forms tend to be confusing and don’t always accurately reflect the law or follow the necessary steps required to pay out the full benefits.
Currently, there is no limit to a Michigan medical no-fault claim. However, beginning on July 2, 2020, there will be caps depending on the policy purchased.
- Pain and Suffering, Bodily Injury Claim
Another type of claim a State Farm adjuster will review is for pain and suffering, or a bodily injury claim that demonstrates a car accident has altered the general ability to lead a normal and healthy life. The team that handles bodily injury cases is not the same as those who review PIP claims. To receive compensation for pain and suffering following a crash or prove a “threshold” injury, the injured person must provide:
- medical records
- deposition testimony
- disability slips; and other documentation
Further, it is the opinion of Steinberg Law Firm, P.C. that this insurer is known to depend on a computer database and algorithm to determine the amount of money owed. This algorithm is based on several various factors, including the amount of treatment, the severity of injuries, vehicle damage, age of the victim, or whether the victim has an attorney. This lazy review tactic is not practical and has forced many Michiganders into filing a lawsuit in court to legally demand what they are owed.
- Vehicle Damage Claim
If insured with State Farm at the time of an accident, and covered by collision insurance, State Farm will assist in handling and investigating the damage claim. It should also help organize vehicle repairs or present a fair cash value of a vehicle that has been totaled in a wreck. Because Michigan is a no-fault state, each operator is responsible for purchasing collision coverage to cover vehicle damage caused from a car crash. Without collision coverage, there is not much the State Farm adjuster will do.
Under Michigan law and a mini-tort claim, the most an at-fault driver must pay for causing vehicle damage is the deductible, up to $1,000. This amount will increase to $3,000 in July 2020. Again, this is money paid by the insurance company for the person who caused the crash, not your own insurance company.
The Challenges in Working with State Farm Adjusters in Michigan
State Farm claim workers, like all insurance adjusters, tend to assign a lower value to a case if a lawyer does not represent a claimant, and are quick to deny a claim or terminates benefits otherwise. State Farm is also not afraid to hire defense attorneys to defend benefit decisions. This is part of the insurance industry’s tactic of delaying, denying and defending the payment of otherwise valid claims in hopes an injured person will give up and not oppose the decision.
Very few, if any, State Farm adjusters remain in Michigan, but that doesn’t mean they are uneducated in Michigan car accident injury law or well-versed in navigating the legal system on the company’s benefit. Currently, State Farm uses the same handful of insurance defense firms to handle their cases, including a group of in-house staff attorneys located in Southfield, Michigan.
After a lawsuit is filed, it is crucial to have an attorney who is not afraid to push hard during discovery and will work to find out the exact reasons for a denial or reduced offer of benefits. The key to combatting State Farm’s aggressive tactics is having an experienced legal team with the resources and readiness to fight fire with fire on behalf of you. Please contact our law offices in Southfield, Flint, Saginaw, or Detroit if you have any questions about a State Farm claim.
Request Legal Help in Fighting a Michigan State Farm Insurance Claim
For decades, we have successfully led thousands of State Farm Insurance cases throughout Michigan. We know what they are searching for and what buttons to push to ensure full compensation for your injuries. Call us toll-free at 1-800-LEE-FREE (1-800-533-3733). There is never a fee until we win your case, and we will always stand side-by-side with you.
Also read: Michigan Pain and Suffering Lawyers