Clients will often ask me about how Michigan’s car accident law, or no-fault law system works. The following is a basic primer.
The central tenant of the Michigan no-fault law is the actual “no-fault” provision found in the law. In almost all situations, a person is entitled to no-fault benefits, even if they caused the accident, so long as the person was involved in a motor vehicle accident.
These no-fault benefits are sometimes called first-party benefits or PIP (personal injury protection) benefits.
At the outset, Michigan auto law is really divided into two separate categories, first-party litigation and third-party litigation. First-party litigation is a claim against an insurance company for no-fault benefits. No-fault benefits pertain to economic damages, such as lost wages and medical bills. A third-party claim is a claim against an at-fault motorist for pain and suffering damages only.
It is important to understand that just because you do not personally have automobile insurance coverage does not mean you are not entitled to first-party benefits. Passengers, pedestrians, bicyclists, and drivers are examples of people entitled to no-fault first-party benefits. Even without auto insurance, in almost all situations you are still entitled to PIP benefits, as long as a motor vehicle is involved.
The no-fault benefits accident victims are entitled to are extensive. They include, but are not limited to, reimbursement for medical expenses such as doctor and hospital visits, lost wages, household replacement services, attendant (nursing) care, survivor’s loss benefits and reimbursement for travel expenses related to medical care.
When opening a first-party claim for no-fault benefits, one must first determine which insurance company is responsible for the payment of these no-fault payment. This is called the order of priority. The order changes, depending on if the person is injured while an occupant of a motor vehicle or a non-occupant – such as a pedestrian or bicyclist. Either way, the first place to start is the injured person’s own insurance. If that person carries auto insurance, that auto insurance company is responsible for no-fault payments. The search ends there.
However, if that person doesn’t have auto insurance, one next looks to the accident victim’s spouse or a resident relative who is domiciled with the accident victim and see who their insurance is with. If auto insurance exists at this level, that insurer is responsible for the payment of no-fault benefits. If no insurance exists at this level, the search continues. Ultimately, all persons who sustain an injury in a motor vehicle accident are protected by the no-fault act, even if this requires the State of Michigan to assign an auto insurer to the accident victim to cover the applicable no-fault benefits.
There is one lone exception to this rule. A claimant who has not purchased insurance for his or her owned vehicle involved in an accident is disqualified from receiving no-fault benefits, because under the law, each vehicle owner must insurer his or her vehicle.
To receive first-party benefits, an accident victim must first complete an Application for No-Fault Benefits. This application must be completed and returned to the automobile insurance company handling the first-party claim within 12 months of the date of the accident. This deadline is compulsory and an accident victim will not be entitled to receive no-fault benefits if the application deadline is not met.
Under Michigan law, a third-party claim is the typical negligence claim in which an accident victim seeks money damages because of the negligence, or fault, of another vehicle operator or owner. Although auto accidents happen for any number of reasons, typically they involve a driver who was not paying proper attention or was not using due care in operating the vehicle.
In a third-party negligence claim, the plaintiff may sue for pain and suffering damages as long as he or she meets the statutory threshold of death, permanent serious disfigurement, or serious impairment of body function.
The most common and litigated threshold requirement is the serious impairment of body function. This term has undergone numerous legal changes over the years, but essentially the phrase means that a plaintiff must show an objectively manifested impairment of an important body function that affects the plaintiff’s ability to lead his or her normal life. An objective manifested impairment requires the plaintiff to show medical proof there is a physical basis for subjective complaints of pain and suffering. As a result, it is difficult to obtain pain and suffering damages for soft tissue injuries.
In addition to pain and suffering, negligent defendants are responsible to accident victims for excess economic loss, regardless of whether or not the accident victim meets the statutory threshold. Thus, even if a plaintiff does not have a serious impairment of a body function, he or she can still recover loss wages and replacement services that exceed the statutory maximum amount available in a first-party no fault claim, or lost wages and replacement services that last beyond the 3 years paid by the PIP no-fault insurance company.