Michigan’s no-fault law allows those who suffer a car accident injury caused by another person’s negligence to bring certain claims against the at-fault driver. This is known as an “auto negligence claim,” and is handled separately from the injured person’s claim for no-fault benefits with his or her own auto insurance carrier.
Oftentimes, persons injured in motor vehicle collisions will retain a Michigan auto accident attorney who only provides legal representation in the auto negligence claim against the at-fault driver. However, some car accident lawyers in Michigan aren’t interested (or equipped) to also handle the victim’s claim for no-fault PIP benefits, which typically occurs simultaneously with the auto negligence lawsuit. In these situations, auto accident victims are then forced to retain another attorney from another law firm to pursue the claim for no-fault PIP benefits, which can be frustrating and costly.
Because of the complexities involved in pursuing no-fault PIP benefits, auto negligence victims need what is called a “unified litigation strategy,” where one lawyer handles both the claim for car accident damages and the claim for no-fault coverage. Why is this “unified litigation strategy” so crucial? Because it’s the only realistic way for Michigan car crash victims to be fully compensated — in other words, “made whole” — for their injuries.
Auto negligence victims will never come close to being “made whole” if the claim for no-fault PIP benefits is not properly pursued. That’s why persons injured in a car accident should be advised by an attorney who understands that the victim’s entitlement to no-fault insurance benefits is as equally important as pursuing damages in an auto negligence lawsuit.
At the Sinas Dramis Law Firm, our Lansing car accident lawyers and Grand Rapids auto accident attorneys provide clients with this all-important “unified litigation strategy.” Our legal professionals are recognized as leaders in handling all aspects of a car accident: 1) the claim for no-fault PIP benefits with the insurance company and 2) the claim for damages against the negligent driver.
Auto Negligence Suits And No-Fault Benefits: Potential Pitfalls
Certain rules have developed over the years that can create pitfalls for people injured in auto accidents and their ability to claim no-fault benefits. By retaining a car accident lawyer who can address any PIP benefit concerns, auto negligence victims have the best chance to avoid these pitfalls.
Some of the threats endangering the recovery of no-fault PIP benefits include, but are not limited to:
- Failing to timely to provide the insurance company with notice – Strict rules require the proper no-fault insurance company be given notice within one year from the date of the crash. If these time limitation rules are not followed, the injured person will forever forfeit their claim for no-fault benefits.
- Failing to notify the proper insurance company – The general rule is that a claim for no-fault benefits is made through the individual’s own insurance company. However, there are exceptions — and these exceptions can make it difficult to determine, especially within the one-year notice period, the insurance company that’s responsible for paying no-fault benefits. If this analysis is performed incorrectly, an injured person may forever lose the right to claim no-fault PIP benefits.
- Failing to properly pursue coordination of health insurance benefits – Specific rules apply when an injured person is claiming coordinated benefits. In Michigan, most people who buy auto insurance purchase coordinated no-fault policies, under which a health insurer pays first. Unfortunately, there can be many nuances to proving that a claim was not fully covered by health insurance in order to then compel an auto insurer to cover the unpaid expenses. If these nuances are not properly addressed, medical expenses may go unpaid and ultimately become the injured person’s personal liability. Also, an injured person with coordinated benefits must receive appropriate advice about handling situations where their health insurance coverage has denied payment for services as not being medically necessary or otherwise needed. In addition, health insurance policies governed by the federal Employee Retirement Income Security Act (ERISA) must be interpreted to determine whether health or no-fault insurance should pay first. If ERISA health insurance is not handled correctly, a lien can be asserted by the health insurer that takes money away from the injured person’s auto negligence claim against the at-fault driver.
- Failing to properly claim no-fault PIP benefits and the risk of insurance fraud accusations – People often get confused about the nature of no-fault benefits and how they should be claimed. Without advice from an attorney who is knowledgeable about the no-fault law, many car accident victims end up claiming no-fault benefits in an incomplete or flawed manner. In turn, this leads to the denial of their claim. Moreover, no-fault insurers have recently been successful in terminating insurance coverage on the basis that a claim was submitted in a fraudulent manner. This has emboldened insurance companies to argue that any misstatements or inaccuracies constitute fraud that should terminate the person’s coverage entirely. Ultimately, persons injured in an auto accident are better protected against these situations if they consult with an attorney before filing a claim for no-fault benefits.
- Failing to make sure all benefits are paid before one year from the date expenses are incurred – The no-fault law includes the “one-year-back” rule, which is strictly enforced and says that, if an auto insurer fails to pay a benefit, a lawsuit must be filed on behalf of the injured person within one year from the date the underlying expense was incurred. Importantly, if this suit is not brought within one year, the no-fault insurer will never have to pay the benefit. Persons injured in a car accident have a better chance of avoiding the pitfalls of the one-year-back rule if they have a lawyer who helps monitor their no-fault claim.
Protecting The Uninsured Or Underinsured Motorist Claim
An auto negligence claim can often be brought against a driver who does not have liability insurance or who does not have enough liability coverage to fully compensate the auto accident victim for non-economic loss damages and excess economic loss damages. Therefore, in order for the victim to recover any additional compensation, he or she will have to pursue that compensation from any uninsured or underinsured motorist coverage that was purchased from his or her own insurance company.
Even though insurance companies should adjust and review a claim for no-fault benefits separately from any claims for uninsured or underinsured motorist benefits, insurance companies often use information from one type of claim when examining the other type of claim. Therefore, it is extremely important that the information conveyed in a claim for no-fault benefits is accurate, complete and representative of the full extent of the victim’s post-crash injuries and condition. This is best accomplished when the victim has an auto accident attorney in Michigan who communicates with the insurance company about the claim for uninsured or underinsured motorist benefits and the claim for no-fault PIP benefits.
Lien Dangers In Auto Negligence Lawsuits
A lien basically takes money away from the amount the injured person recovers in the auto negligence suit. Each lien needs to be independently analyzed and addressed, in order to determine whether it is enforceable against the accident victim’s recovery in the auto negligence lawsuit.
If a lien is determined to be enforceable against an auto negligence claim, there may be ways to pursue payment of the lien through the injured person’s no-fault insurance coverage. Examples of this include liens assessed by health insurance plans covered by the federal ERISA law, as well as liens assessed by Medicare and Medicaid.
However, existing case law is complicated regarding whether liens should be paid by no-fault insurance companies. That is why an auto negligence victim has the best chance of successfully resolving any lien issues by retaining a Michigan car accident lawyer who is skilled and knowledgeable in all aspects of the auto no-fault law.
A Unified Litigation Strategy Helps Protect The Injured Person’s Legal Rights And Interests
Persons injured in a car accident may need to take legal action against a no-fault insurance company within a year from the crash, or may need to quickly take legal action against the at-fault driver who caused the collision. Even though a victim’s claim for no-fault benefits and claim against the negligent driver are separate and distinct, litigation in one claim may have significant implications for litigation in the other claim.
For example, testimony the victim provides in one case can be used against the victim in the other case. There are also ways in which any finding of fact or law in one case could bind the person in the other case. Therefore, in the event either the negligence or no-fault claims of the victim must be litigated, it is critically important for the victim to have unified legal representation from the same law firm. This allows a big-picture strategy to be developed and pursued that best protects the rights and interests of the injured person.
In addition, having a Michigan auto accident attorney who addresses a victim’s claims for no-fault benefits helps prevent unnecessary litigation from arising with respect to any medical providers seeking payment. When medical providers are not being paid, they may be able to take legal action against the no-fault insurance company or against the injured person. By retaining a car accident lawyer in Michigan who addresses the no-fault claim, this helps prevent medical bills from going unpaid and unnecessary legal action being taken by the medical providers.