Claim Processing

PIP Claim Processing

When a person is injured in an auto accident in Michigan, he or she may be entitled to collect certain benefits under the Michigan No-Fault Law. However, to obtain those benefits, the victim must file a claim and notify his or her insurer of both the circumstances surrounding the incident and the type of injuries the victim has sustained.

Proof Requirements for PIP Claims

Although the actual filing of the claim is relatively straight-forward, there are two principle requirements which a victim of an accident must be ready to prove to establish his or her entitlement to these benefits.
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Who Pays No-Fault PIP Benefits?

No-Fault PIP benefits are generally received from his or her own no-fault insurance company, or from a No-Fault insurance policy issued to the injured person’s spouse or a relative.  However, there are a few exceptions.
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PIP Claim Time Limitations

The No-Fault Act contains two very strictly enforced time limitations for processing claims for No-Fault PIP benefits. These rules must be carefully followed in order to properly protect the claim.
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Statutory Priority Rules

The Michigan No-Fault Act contains a “priority of payment” system that determines which no-fault insurer has primary liability for payment of PIP benefits.
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Government Setoffs

Depending upon the facts of the case, there are different kinds of governmental benefits that can be deducted from PIP benefits.
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Coordination of Benefits

If the insured purchases an uncoordinated benefits policy, the no-fault insurance company is obligated to pay no-fault benefits even though similar benefits may be payable under another health insurance policy.
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The Independent Medical Examination (IME)

The No-Fault Act provides that when the mental or physical condition of a person is at issue, the no-fault insurance company can request to have the claimant examined by a physician of its choice.
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Penalties for Non-Payment of Benefits

The No-Fault Act contains specific penalties that can be assessed against no-fault insurance companies who do not honor their legal obligations to pay claims as required by the law.
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