Michigan PIP Benefits | What No-Fault Insurance Covers After a Crash

If you’ve been injured in a Michigan car accident, Personal Injury Protection (PIP) benefits also known as No-Fault benefits or First-Party benefits help cover medical expenses, lost wages, and essential services. These benefits are available regardless of who was at fault for the crash ensuring that accident victims receive prompt medical treatment and financial support.

Understanding how PIP benefits work, who pays for them, and what they cover can be confusing. Michigan’s No-Fault insurance system has strict rules and deadlines, and insurance companies often delay or deny claims. Many accident victims struggle to get the full benefits they are entitled to especially when dealing with severe injuries or long-term medical needs.

If you’re unsure about your rights or are having trouble getting the benefits you deserve, our experienced lawyers can help.

What Are Michigan PIP Benefits?

Michigan Personal Injury Protection (PIP) benefits provide financial coverage for medical expenses, lost wages, and other necessary services after a car accident. Unlike other states where accident victims must prove fault to receive compensation, Michigan’s No-Fault insurance system ensures that injured individuals can access benefits quickly regardless of who caused the crash.

PIP benefits exist to cover essential accident-related cost including medical expenses, lost wages, attendant care, replacement services, medical mileage, home & vehicle modifications, and even survivor’s loss benefits. The goal is to help accident victims recover without the delays and disputes often seen in at-fault insurance systems. However, recent Michigan No-Fault law changes have introduced coverage limitations that can leave some victims without enough benefits. Understanding what PIP covers, how to claim it, and what to do if benefits are denied is crucial for protecting your rights.

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What Does PIP Insurance Cover in Michigan?

Michigan Personal Injury Protection (PIP) benefits are part of first party insurance and provides essential benefits for accident victims, ensuring they receive financial support for medical expenses, lost wages, and necessary services regardless of who caused the accident. However, the exact coverage depends on the level of PIP insurance selected in the policy. Below is a breakdown of Michigan PIP benefits and what they cover:

🚗 PIP Benefit	💡 What It Covers
🏥 Medical Expenses	Covers hospital bills, surgeries, rehabilitation, doctor visits, and long-term care.
💰 Lost Wages	Pays 85% of lost income (up to a monthly cap) for up to three years if injuries prevent working.
🏡 Replacement Services	Reimburses up to $20 per day for household tasks you can’t perform, like cleaning, cooking, or childcare.
👨‍⚕️ Attendant Care	Pays for in-home care services if you need assistance with daily activities due to injuries.
🚗 Medical Mileage	Reimburses travel costs for medical appointments, including fuel and public transportation expenses.
🏗️ Home & Vehicle Modifications	Covers costs for wheelchair ramps, widened doors, vehicle hand controls, and other necessary modifications.
🕊️ Survivor’s Loss Benefits	Provides financial support to the family of a deceased accident victim, including lost income, funeral expenses, and replacement services for up to three years.

The level of coverage you receive depends on the PIP coverage limit chosen in your auto insurance policy. While unlimited lifetime PIP coverage is still an option, lower tiers now exist, which may leave some accident victims responsible for excess medical bills. Understanding your PIP benefits and options is essential to ensuring you receive the full compensation you deserve.

How Long Do PIP Benefits Last?

Michigan PIP benefits provide crucial financial support after a car accident, but each type of benefit has a time limit on how long it lasts. Understanding these limits can help you plan for the future and avoid unexpected financial hardships.

Medical Benefits – If you have unlimited PIP coverage, your medical expenses are covered for life. However, if you chose a lower-tier policy ($500K, $250K, or $50K), coverage ends once you reach the selected limit.
Wage Loss Benefits – Pays 85% of your lost income (up to a monthly cap) for up to three years if injuries prevent you from working.
Replacement Services – Covers up to $20 per day for up to three years for help with household tasks like cleaning, childcare, and yard work.
Survivor’s Loss Benefits – If a loved one dies in a crash, their dependents can receive lost income and benefits for up to three years.

If your PIP benefits run out and your expenses continue, you may be able to file a third-party lawsuit against the at-fault driver for additional compensation.

Who Pays Your PIP Benefits? Understanding Insurance Priority Rules

Michigan follows a strict order of priority to determine which insurance company is responsible for paying PIP benefits after a car accident. The order depends on your situation, whether you have your own auto insurance, and if other policies may apply. Below is a table explaining Michigan’s PIP insurance priority rules:

🚗 Who Is Covered?	🏛 Which Insurance Company Pays?
🏠 Named insured on a policy	Your own auto insurance policy (primary payer)
💍 Spouse or resident relative without their own policy	The household member’s auto insurance
🚘 Passenger without household coverage	The owner’s or driver’s auto insurance
🚶‍♂️ Pedestrian struck by a vehicle	The at-fault driver’s insurance
🏍️ Motorcyclist hit by a car	The insurer of the car involved in the crash
❌ Uninsured & no household coverage	Michigan Assigned Claims Plan (MACP) (limited benefits)

If no coverage is available, the Michigan Assigned Claims Plan (MACP) provides limited PIP benefits, but these are significantly lower than what a standard auto insurance policy would provide. 💡 Important: If you’re injured in a crash, identifying the correct insurance provider quickly is essential. Delays can result in denied claims or missed deadlines.

When Do PIP Benefits Stop?

Michigan PIP benefits provide essential financial support after a car accident, but they don’t last indefinitely. Understanding when and why they may be cut off is critical to protecting your rights. Many accident victims assume their benefits will cover them indefinitely, only to face unexpected denials or terminations. PIP benefits can end for several reasons, including reaching policy limits, missing important filing deadlines, or insurance disputes over medical necessity. Below are the most common reasons PIP benefits may be stopped:

Coverage Limits Are Reached – Your benefits end once your selected PIP coverage cap is exhausted.
Wage Loss & Replacement Services Expire – These benefits are limited to three years from the accident date.
Missed Filing Deadlines – Claims must be filed within one year of the accident, and insurers require medical expenses to be submitted within one year of treatment.
Insurance Denial – Insurers often try to reduce payouts by arguing that treatment is unnecessary or unrelated to the accident.
Independent Medical Exam (IME) Disputes – If an insurance-appointed doctor claims you no longer need care, your benefits may be cut off.

How to File a PIP Claim in Michigan

Filing a Personal Injury Protection (PIP) claim correctly is essential to securing the benefits you’re entitled to after a car accident. Strict deadlines apply, and missing even one step can result in delays or denials. Below is a table outlining the key steps to file a Michigan PIP claim and the deadlines you must meet:

📝 Step	📅 Key Deadline	🔍 What to Do
Notify Your Insurance Company	Within 1 Year of the accident	Report the accident and file a formal Application for No-Fault Benefits (Form 257).
Submit Medical Bills & Expenses	Within 1 Year of treatment	Provide itemized medical bills, prescriptions, and therapy costs to your insurer.
Provide Proof of Wage Loss	Ongoing, up to 3 years	Submit pay stubs or employer verification to claim lost wages.
Request Replacement Services	Ongoing, up to 3 years	Document household or personal care assistance (e.g., childcare, cleaning).
Respond to Insurance Requests	As Soon As Possible	Insurers may request medical records, exams, or statements to process your claim.
Appeal a Denied Claim	Within 1 Year of denial	File a lawsuit against your insurer if benefits are wrongfully denied.

What If Your PIP Claim Is Denied? Appealing a Denial

If your PIP claim is denied, you still have options to challenge the decision. Insurance companies may reject claims for reasons such as missing paperwork, disputed medical treatment, exceeding policy limits, or allegations that injuries are unrelated to the accident. Understanding why your claim was denied is the first step in getting the benefits you deserve. These are the steps to appealing a PIP Claim denial:

Review the Denial Letter – Carefully read the insurer’s explanation to identify the reason for denial.
Gather Supporting Documents – Collect medical records, wage loss verification, and doctor statements to strengthen your case.
Request Reconsideration – Submit additional evidence and ask the insurer to review your claim.
File a Complaint – If you believe your denial was unfair, report the issue to the Michigan Department of Insurance and Financial Services (DIFS).
Take Legal Action – If the dispute remains unresolved, you have one year to file a lawsuit against your insurer to recover unpaid benefits.

If your claim was denied, working with an experienced attorney can help you navigate the appeals process and fight for the benefits you are entitled to.

Frequently Asked Questions About Michigan Personal Injury Protection (PIP) Benefits

How do I know if I have PIP coverage?

If you have auto insurance in Michigan, you are required to carry PIP benefits unless you opted out under specific conditions. Your policy declarations page will list your coverage level.

What if I don’t have auto insurance?

If you don’t have auto insurance, you may still be eligible for PIP benefits through a relative’s policy or the Michigan Assigned Claims Plan (MACP) if no coverage is available.

Do PIP benefits cover pain and suffering?

No, PIP benefits only cover economic losses like medical expenses, lost wages, and replacement services. Compensation for pain and suffering requires filing a lawsuit against the at-fault driver.

Can my insurance company deny medical treatment?

Yes, insurers often challenge treatments they consider unnecessary or unrelated to the accident. If this happens, you can appeal the denial with additional medical evidence.

How long do I have to file a PIP claim?

Michigan law requires you to notify your insurer within one year of the accident and submit medical bills within one year of treatment to be eligible for reimbursement.

What happens if my PIP benefits run out?

If your medical costs exceed your PIP coverage limits, you may have to use health insurance or file a lawsuit against the at-fault driver for excess damages.

Contact a Michigan PIP Benefits Lawyer Today

Navigating Michigan’s PIP benefits system can be frustrating, especially when insurance companies deny claims or delay payments. If you’re struggling to get the medical care, wage loss, or other benefits you’re entitled to, you don’t have to handle it alone.

At The Clark Law Office, we believe accident victims should receive every dollar of their PIP benefits that’s why we don’t charge legal fees for handling PIP claims. Unlike other law firms that take a large percentage of your benefits, we fight for you without taking money that should be used for your recovery.

If your PIP claim was denied, delayed, or underpaid, call us today for a free consultation at 517-347-6900. We’ll review your case, explain your rights, and help you get the benefits you deserve!

Learn how PIP benefits compare to other types of coverage in our car accident insurance guide.

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