Michigan’s No-Fault system no longer provides the same automatic, unlimited lifetime medical protection that applied before the 2019 reform. After a crash, the coverage available, the deadlines that apply, and whether another driver can be held liable all depend on the facts of the case and the insurance coverage involved. A prompt review with an experienced Michigan car accident lawyer can help identify benefits, preserve evidence, and avoid costly gaps.
The Pre-Reform Unlimited PIP Baseline
For accidents that occurred before June 11, 2019, Michigan’s No-Fault law generally provided unlimited allowable-expense benefits through Personal Injury Protection, commonly called PIP. Subject to the facts and applicable law, this coverage could pay reasonable and necessary medical care, rehabilitation, attendant care, and other qualifying expenses arising from a motor-vehicle accident.
That pre-reform baseline still matters in older claims. However, it should not be used to describe the benefits available after the law changed. Michigan injury claims arising from more recent crashes require a close look at the policy in effect, the injured person’s circumstances, and the date of loss.
Today’s PIP Choices and the Consequences of Limited Coverage
For policies issued or renewed after the reform took effect, Michigan drivers may select different levels of PIP medical coverage, including unlimited coverage or specified limits. In certain situations, a person may elect to coordinate PIP medical benefits with qualifying health coverage or opt out of PIP medical coverage entirely if statutory requirements are met.
Lower premiums can make limited coverage appealing, but the practical risks can be significant after a serious collision. Once a selected PIP medical limit is exhausted, ongoing accident-related medical expenses may depend on health insurance, other available coverage, or the injured person’s own resources. Health plans can have deductibles, networks, exclusions, authorization requirements, and coverage terms that do not align neatly with accident-related care.
This is one reason an auto accident attorney should review the declarations page, endorsements, household policies, health coverage, and the circumstances of the crash early. The answer is not always found in one insurance card.
The 56-Hour Rule for Family-Provided Attendant Care
Attendant care can be essential when a person needs help with bathing, dressing, mobility, medication routines, meals, safety supervision, or other daily needs after a catastrophic injury. Under Michigan’s current No-Fault framework, an insurer generally is not required to pay more than 56 hours of attendant care per week when the care is provided directly or indirectly by an individual related to the injured person, domiciled in the same household, or with a business or social relationship with that person.
That limitation is not necessarily the end of the discussion. The statute permits an insurer and insured to contract for more than 56 hours a week. Care needs, provider arrangements, policy language, and the nature of the relationship between the caregiver and injured person all deserve careful attention. Families should not assume that necessary care will automatically be paid at the level recommended by a medical provider.
How the Medical-Provider Fee Schedule Affects Care
The reformed law also established a reimbursement structure for many medical providers treating people injured in motor-vehicle accidents. In general terms, the fee schedule limits what providers may charge and what insurers must reimburse for covered services, subject to statutory rules, percentages, exceptions, and annual adjustments.
For patients, this may affect whether a provider will accept No-Fault billing, how treatment is arranged, and whether disputes arise over charges or coverage. The fee schedule does not eliminate the need for medically necessary care, but it can change the financial and practical path to obtaining it. A knowledgeable Southfield personal injury lawyer can help evaluate the coverage issues without making assumptions about what a provider or insurer will do.
First-Party PIP Benefits and Third-Party Auto Claims Are Different
A first-party claim seeks No-Fault benefits from the applicable insurer, often for qualifying medical expenses, wage-loss benefits, replacement services, and certain other losses. It focuses on benefits connected to the injured person and the relevant insurance priority rules rather than proving the other driver caused the crash.
A third-party claim, by contrast, is a negligence claim against an at-fault driver or other responsible party. In a qualifying case, it may seek noneconomic damages, commonly described as pain and suffering, and certain economic losses not otherwise payable under No-Fault. Michigan law places threshold requirements on third-party auto claims, and these cases require proof of fault and legally compensable injury.
For a closer look at the distinction, read our guide to No-Fault benefits and bodily-injury claims after a car accident. The same crash can involve both types of claims, but they are not interchangeable.
Deadlines Can Change the Outcome
Michigan No-Fault claims have notice and lawsuit deadlines that can be unforgiving. In general, a person must give written notice of injury to the responsible insurer within one year of the accident, and a lawsuit for overdue PIP benefits generally must be filed within one year after the insurer received written notice of the specific loss. The recoverable period may also be limited, so waiting can put older unpaid expenses at risk.
Third-party claims have different deadlines. A negligence action arising from a motor-vehicle collision is generally subject to Michigan’s limitations period, but special rules, tolling issues, governmental entities, minors, wrongful death matters, and policy-based claims can change the analysis. Do not rely on a general deadline when a specific deadline may apply to your case.
Common Coverage Gaps After a Michigan Crash
Coverage gaps can emerge when PIP limits are selected, when health coverage does not fully address accident-related treatment, when a driver is uninsured or underinsured, or when the at-fault driver has limited liability coverage. A hit-and-run crash can create additional complications. Uninsured and underinsured motorist coverage may be crucial, but these benefits depend on the policy terms and available limits.
Law Offices of Todd J. Stearn, P.C. helps injury victims in Southfield, Oakland County, Wayne County, Macomb County, and Genesee County examine the complete insurance picture. Our review may include PIP, bodily-injury liability, uninsured/underinsured motorist coverage, excess coverage, and potential third-party responsibility. Learn more about working with a Michigan auto accident lawyer
after a serious crash.
Why Early Legal Review Matters
Early legal review helps protect more than a claim number. It can help preserve crash evidence, identify all possible coverage, document medical needs and wage loss, respond to insurer requests carefully, and calendar important deadlines. It also provides an opportunity to discuss whether another party’s negligence contributed to the injuries.
For more than 30 years, Law Offices of Todd J. Stearn, P.C. has represented people facing serious Michigan injury claims. Our firm has recovered more than $100 million in settlements and verdicts for clients. We offer free consultations, and there are no fees unless we recover compensation for you; past results do not guarantee a similar outcome.
FAQ
Does Michigan still have unlimited No-Fault medical coverage?
Unlimited PIP medical coverage remains an available option for many Michigan drivers, but it is no longer the automatic default for all policies. The coverage available after a crash depends on the policy selection and other facts.
Can a family member be paid for attendant care after a car accident?
Potentially, yes. However, current Michigan law generally limits an insurer’s required payment for certain care provided by relatives, household members, or people with specified relationships to 56 hours per week unless the insurer and insured contract for additional hours.
Can I bring both a PIP claim and a claim against the at-fault driver?
Possibly. A first-party PIP claim and a third-party negligence claim address different losses and have different legal requirements. A careful review is needed to determine which claims may be available.
What if my PIP medical limit is not enough?
Other health coverage or other insurance may help, but benefits can involve limits, exclusions, coordination provisions, and disputes. It is important to review the policies and available options as soon as possible.
How soon should I speak with a Metro Detroit injury attorney?
It is wise to seek legal guidance promptly after a crash, particularly when injuries are serious, benefits are denied or delayed, a family member provides care, or you are unsure about the coverage in place. Early action can help protect evidence and deadlines.
This article provides general information about Michigan law and is not legal advice. Every case is different, and reading this information does not create an attorney-client relationship.
If you or someone you love was hurt in a Michigan crash, you do not have to sort through these issues alone. Call Law Offices of Todd J. Stearn, P.C. at (248) 744-5000 for a free, reassuring conversation about your options.