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Communication & Cooperation With Your Insurance Company

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.

However, before you do hire me, make sure that all of your communications are in written form, and that you have retained a copy of your letters, faxes or emails to the insurance company. If there is one thing insurance representatives fear, it is "the paper trail". Not only that, but when you do retain counsel, you will have documents to share with them that will help them in their work. Request mailing addresses, fax numbers, and email addresses from your insurer, and use them!

Make Written Record of Phone and Face-to-Face Conversations

Do not reject phone calls from your insurer, and if you need to have a face-to-face meeting with your claim rep, then don’t refuse that contact, either. You will only alienate your insurance representative, and make them suspicious. However, if you must field a phone call, or have a personal visit with your claim rep, write them a follow up note, starting something like this: "Thanks for talking with me (or meeting with me) on August 23, 2020. I wanted to writ to confirm our conversation (by phone/in my home/in your office), on June 16, 2019, when we discussed the following…."

Two Forms of Cooperation with Your Insurer

There are two main forms of cooperation you will be called upon to provide your insurer. The first is to provide authorizations to the insurer, that will allow them to access your medical, wage and other records. You are required to cooperate with your insurer's reasonable requests, and it is very reasonable for them to want to review your current and past medical records. Sign authorizations as requested, send it in with a covering letter, and keep a copy for your file.

The other form of cooperation you may be required to provide is to submit to a physical examination by a doctor of their choosing. Do not refuse reasonable requests for a physical examination; most insurance policies have provisions requiring you to cooperate. If you fail to cooperate in any manner whatsoever, you may find your benefits terminated.

Learn more about Michigan No-Fault Insurance Laws & Protections.

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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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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