Typically, health insurance pays “primary” to no-fault, meaning that the health insurer pays first, and any remaining unpaid accident-related expense should then be paid for by no-fault. This is called “coordination of benefits”. There are exceptions to this for “ERISA-qualified plans”, discussed below.
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I cannot stress enough the importance of cooperating with your insurance company, before you have to hire me as your attorney. If you do have to hire a lawyer, he/she (or I) will be your contact with the insurance company.
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Sometimes, there are potentially more than just one insurance company, who might be responsible to pay your no-fault benefits. Specific rules, allocating this responsibility are set forth in MCLA §500.3114, in order, more or less as follows:
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While the actual Michigan No-Fault Act does not limit medical benefits by time, or dollar amount, very few claims are actually paid for anything more than a few months.
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Michigan’s No-Fault law allows benefits to be paid to uninsured injury victims, as long as they were not driving their own uninsured vehicle at the time of the accident. If that is the case, under MCLA §500.3113, there will be no recovery for medical bills, wage loss, or other benefit categories.
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Apart from the time limitations for wage loss, survivors loss and household service claims, the most significant limitations on No-Fault benefit claims, are the following:
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Under MCLA §500.3109(1), benefits provided or required to be provided under a state or federal government program must be deducted from No-Fault coverage otherwise payable. That means the No-Fault carrier gets to deduct whatever is paid by a state or federal insurance program. They also get to deduct those benefits payable under one of these programs, even if it is not actually paid.
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In any event, the "Defense Medical Examinations", called "Independent Medical Examinations" by the insurers, are usually the prelude to you having your insurance benefits terminated. These doctors and their staffs are frequently hired by insurance companies, and they know that if they do not write the report the insurance company wants, they will not get any more of these referrals, which are quick, easy money for the doctors.
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Saving Michigan No-Fault
Back in April of 2015, Detroit Mayor Mike Duggan proposed an auto insurance plan that he said would save his constituents, the citizens of the City of Detroit, significant money on their auto insurance... Continue reading.
In April 2015, Detroit Free Press writer Mitch Albom (of "Tuesdays with Morrie" fame) wrote an article about the then-coming money grab by Michigan Legislators, financed by the insurance industry. A link to Mitch Albom's article is here. The insurance cabal, and their henchmen in the State Legislature have laid low for about a year, but faced with uncertainty about the outcome of the 2016 election, and the near certainty that voter turnout will be high this year, this legislative excrement is being resurrected. Mitch Albom's piece is as true today, as it was almost exactly one year ago today. Nonetheless, the Legislators we elect to look out for our interests, do nothing of the sort. Instead, they continue on with their effort to steal from Michigan citizens, the auto insurance they have paid for... Continue reading.
Auto insurance companies make good money in our State, selling and managing no-fault insurance, and that is obviously good for everyone. However, despite years of solid profits here in our State, auto insurance companies, evidently not satisfied with just doing phenomenally, want even more, even though the economy has been tough for just about everyone else.
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Eliminate No-Fault Insurance Uncertainty and Frustration