Michigan Motorcyclists’ No-Fault Claim

No-Fault Claim: The No-Fault Claim is also referred to as the PIP (Person Injury Protection or Personal Protection Insurance) or First Party Claim. Those three terms mean the same thing.

No-Fault Benefits are payable to anyone who suffers an injury “arising out” of the ownership, operation, maintenance or use of a “motor vehicle” as a motor vehicle”.  For our purposes, just ask the question, “Was a ‘motor vehicle’ involved in the crash?” 

A ‘motor vehicle’ basically means a car, truck or van.  A motorcycle is not a motor vehicle under our No-Fault Law. There are many crashes that do not involve a ‘motor vehicle.’  If a biker hits a pothole, a dog, a deer, loose gravel, goes wide or is hit by another motorcycle, there is no ‘motor vehicle’ involved; therefore, no No-Fault benefits will be paid.  

Even if the accident was your fault you may be entitled to No-Fault benefits.   That’s why we call our vehicle insurance system, “No-Fault.”  We do not have to figure out or prove who was at-fault in an accident to obtain payment for certain damages.

WHAT ARE THE NO-FAULT BENEFITS?

When No-Fault benefits are payable, they include:

1.  Medical Bills: Allowable medical expenses up to the amount of PIP Medical coverage chosen by the insured driver of the No-Fault insurance company responsible to pay your No-Fault benefits.  To put it more simply, you figure out which insurance company is responsible to pay your No-Fault benefits and the amount you have for medical bill payment is the amount the insured driver chose for his/her PIP Medical coverage.

To figure out which insurance company is responsible to pay the No-Fault Benefits, we look at the law’s Order of Priorities for Motorcyclists.  It simply is a listed order to follow.  See below for details and the order of priorities.  

For any medical expense to be allowable it has to be:

a.    Reasonably necessary for the victim’s care, recovery or rehabilitation;
b.    Reasonable in amount; and
c.    Actually incurred (usually meaning services already provided*).

Attendant Care is also part of allowable medical expenses.  It is where an individual or company is paid by the hour to care for the patient.  We have had family members paid $200 per day for this caregiving. Effective July 1, 2021, the law will restrict Attendant Care provided by family and/or friends to 56 hours per week. This is drastically different from 168 hours per week available under the old law.  If Attendant Care is required more than 56 hours per week, the excess must be provided by a professional facility or other professional caregiver or it does not have to be paid.

2.  Wage Loss is the second potential No-Fault benefit.  A person must have had a job or a legitimate expectation of employment.  85% of your gross lost wages are payable per month and there is monthly maximum, presently of about $5,800.  No-Fault wage loss can be paid for up to three years.

The typical proof needed for an insurance adjuster to pay wage loss is a doctor’s disability slip saying you restricted from work because of the injuries or impairments from the crash and documentation from your employer proving you had a job and how much you made before the crash.  Pay stubs and payroll printouts from your employer’s human resources department are proof of how much you made.

3.  Medical Mileage: Expenses for travel to and from medical appointment.  This can be mileage reimbursement if you or a family member drove or the payment of a driving service.*  

4.  Replacement services: Payment of replacement services of up to $20.00 per day is the fourth No-Fault benefit.  Replacement services is just a fancy phrase for household chores.  They are payable only if the injured motorcyclist did those chores before the crash that he or she cannot do them now because of the injuries from the crash.  Using an example, if the injured person only cut the grass and took out the trash before the accident, those are the only two chores that are payable.  The other requirement is that someone else (a family member, friend or service) did those chores and payment was promised.

Which insurance company pays the No-Fault Benefits for a MOTORCYCLIST?

If you are operating or riding on a MOTORCYCLE, you are involved* in an accident with a motor vehicle*(typically a car, truck, van, but not another motorcycle) and you suffer injury as a result, the automobile insurance company that is responsible for paying your No-Fault benefits is determined by the following order of priority: 

1.  Owner or Registrant of the Motor Vehicle Involved – an injured motorcyclist goes first to the automobile insurance company of the owner or registrant of the involved motor vehicle (not motorcycle) for payment of benefits.  If the owner or registrant does not have auto insurance, proceed to the next level.
2.  Operator of the Motor Vehicle Involved – If the operator or the involved motor vehicle (not motorcycle) has automobile insurance, that company pays benefits.  If not, proceed to the next level.
3.  Insurance Company of the Motor Vehicle (not motorcycle) of the Operator of the Motorcycle – If none, proceed to the next level. 
4.  Insurance Company of the Motor Vehicle (not motorcycle) of the Owner or Registrant of the Motorcycle – If none, proceed to the next level.
5.  Spouse or Resident Relative – if the injured motorcyclist lives with a spouse or relative that has an insured motor vehicle, that insurance company pays benefits. If not, proceed to the next level.
6.  Assigned Claims Facility – If there is no insurance available at any of the levels described above and there are no exclusions that bar a claim, the Assigned Claims Facility will assign the claim to an insurance company for payment of benefits.  The PIP Medical amount is $250,000.

An application for benefits must be made with the correct auto insurance company within one year or benefits do not have to be paid. 

Horrible New Law for Motorcyclists!

We only touched upon this earlier.  It is very important, so here are some details: PIP Medical choice was implemented July 1, 2020 and again, the company first in line for a motorcyclist’s No-Fault benefits (including PIP Medical) is the insurer of the motor vehicle involved in the crash.  

The motorcyclist’s coverage for his or her medical bills is the amount chosen by the driver of the car involved in the crash.  Now, that same motorcyclist may only have $50,000 of his/her medical bills paid if that is the amount of coverage the negligent driver chose.  

Advice to Motorcyclist: 

1.  Have health insurance.   Motorcycle wrecks often happen without a ‘motor vehicle’ involved which would provide PIP Medical coverage.  PIP Medical does not pay for wrecks with deer, road defects (potholes), loose gravel, or other motorcycles.
2.  Purchase as much Uninsured Motorist coverage and Underinsured Motorist coverage as possible on your motorcycle.
3.  Choose unlimited (or as much as you possibly can afford) PIP Medical on YOUR CARS, TRUCKS, and VANS (your ‘motor vehicles’).  Why? Because if you get in a motorcycle wreck and the at-fault driver is uninsured or unknown (hit & run), your No-fault benefits will come from insurance on YOUR motor vehicle (car, truck or van, never your motorcycle).