Bicycle Accident Claims - Michigan No-Fault Law Basics

The laws that govern Michigan bicycle accidents involving motor vehicles are long and complex. Often, the terms used by insurance agents and lawyers can be confusing.

Two of these terms are:

First-Party Benefits
Third-Party Benefits

Michigan is a No-Fault State. This means that your own insurance company pays most of the economic damages you suffer in a motor vehicle accident, whether or not you were at fault in the accident. These economic benefits are called First-Party Benefits.

At the same time, Third-Party Benefits usually cover non-economic losses, including damages for pain and suffering. Both of these types of benefits are described in detail below.

Michigan First-Party Basics

The Michigan law defining First-Party benefits states:

First-Party 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.

The following analysis looks at:

Who is responsible for paying your Michigan No-Fault Benefits?
What are the specific benefits you may be entitled to receive?

Michigan First-Party Order of Priority

Although your own insurance is first in line to pay First-Party benefits, there are occasions when an uninsured individual is an innocent victim of a bicycle/motor vehicle accident. Under these circumstances, determining who is responsible to pay Michigan No-Fault Benefits can be complex.

You need to consult an attorney to make sure that the proper insurance company is paying your claims and that you are getting all the benefits you deserve.

Michigan Bicyclist Order of Priority

• 1st priority is to your own Michigan auto insurance, if none then...
• 2nd priority is to the Michigan auto insurance company of a resident relative (i.e. spouse, parent, or sibling), if none then...
• 3rd priority is to the insurer of the owner of the motor vehicle involved in the accident, if none then...
• 4th priority is to the insurer of the operator of the motor vehicle involved in the accident, if none then...
• 5th priority is to the State of Michigan Assigned Claims Facility.

The Michigan Assigned Claims Facility

The Michigan Assigned Claims Facility is a State Agency with the power to assign an insurance company to provide benefits, if an injured party could not obtain benefits from other sources. Remember that uninsured drivers, who were driving vehicles they owned, do not qualify for Michigan Assigned Claim Facility assistance. To apply for Assigned Claims Benefits, call the Michigan Assigned Claim Facility directly at 517-322-1875.

Specific Michigan First-Party Benefits

The First-Party No-Fault Benefits that you can claim from your own Michigan insurance company as a result of a Michigan bicycle/auto accident include:

Medical Bills for Life

Michigan auto accident law requires that medical coverage continue for life, or for as long as you need treatment for injuries suffered in the accident.

There are many complicated factors to getting your medical bills paid, if you are in a Michigan auto accident. We strongly recommend that you contact an experienced personal injury lawyer to preserve all your legal rights.

To qualify for medical expense reimbursement, a bill must be reasonable (in cost and necessity) and the bill must actually be incurred. Michigan law does not provide for guaranteed pre-payment of bills for treatment of injuries suffered in a car accident. Sometimes an insurance company will try to avoid its responsibility, by disputing the need for a medical test or procedure ordered by your physician, or the amount of the medical bill.

Insurance companies in Michigan provide two types of medical coverage in the event of an accident:

1. Uncoordinated benefits
2. Coordinated benefits

The terms of your policy state which benefits you should receive. An uncoordinated policy pays benefits regardless of the presence of other health insurance. A coordinated policy requires that your other health insurance pays first, and that the automobile insurance only pays amounts that your primary insurer does not cover.

It is common for a primary health insurance policy and a Michigan auto insurance policy to contain contradictory language about which one has the first obligation to pay medical bills. If you have questions about this, or find that neither insurance company is paying your medical bills in a timely manner, it is important to consult an attorney promptly. An automobile insurance company may escape its obligation to pay a bill, if it did not receive it within one year of the date that you got the medical treatment.

Wage Loss

Michigan No-Fault law allows an injured bicyclist to receive 85% of his or her lost wages, if a doctor found the victim disabled from work due to injuries suffered in a motor vehicle accident. This benefit cannot exceed a period of 3 years. The wage loss benefit is set at 85%, rather than 100%, of lost earnings because the benefit is tax-free. The law also sets a monthly cap on the amount of lost wages that the insurance company must reimburse.

In some cases, these and other rules create many complicated issues. If you have questions about whether you are getting the correct amount of wage loss benefits, you need to consult an attorney.

Attendant Care

Michigan law requires the no-fault insurance company to pay for attendant care (also known as nursing services) for an injured victim who needs supervision or assistance while recovering at home. Sometimes, a physician determines that a person with severe injury needs around-the-clock supervision.

A caregiver who is a member of the victim's family is entitled to attendant care reimbursement. Although the law does not set a specific hourly rate for the caregiver, the reimbursement should reflect the type and complexity of the services that the injured person receives.

Frequently, insurance companies refuse to pay for adequate attendant care. If this happens, contact our office for help securing the benefits that you or your family need.

Replacement Services

This term refers to reimbursement for services that you would have performed on your own, if you were not injured in a bicycle/auto accident. If you paid or promised to pay for household services, chores, errands, etc. that you usually did yourself, then you may be entitled to reimbursement for these expenses.

A physician usually needs to provide a written statement that you are unable to do these tasks on your own. Your insurance company also may require documentation of who performed what services.

Michigan law provides that an insurance company is obligated to reimburse up to $20 per day for replacement services and that these benefits last for up to three years.

Mileage Reimbursement

Often an injured person has to travel long distances to get proper medical tests, treatment, and physical therapy. Michigan No-Fault law provides for the reimbursement for mileage traveled to and from medical appointments.

Third-Party Basics

While First-Party Benefits cover most economic losses, Third-Party Benefits provide damages for pain and suffering, scarring or disfigurement, death, and wage loss in excess of 3 years. The Third-Party claim is filed against the at-fault driver in a motor vehicle accident. With the exception of excess wage loss, a Third-Party lawsuit seeks non-economic damages.

In Michigan, to prevail in a claim against a careless driver for non-economic damages, the injured victim must show that he or she suffered a "threshold injury." Michigan law defines this as:

A serious impairment of an important body function, serious disfigurement or scarring, or death.

It is common for insurance company adjusters to assert that an injury is not a "serious impairment of a body function." However, if you have an objectively documented injury to an important part of your body, and this affects your life, then you should contact our office to fight for your rights.

The Statute of Limitations (or time limit) for filing a Third-Party lawsuit is 3 years. Minors have until one year past their 18th birthday to take formal legal action. There are other exceptions for military personnel and those judged mentally incompetent.

However, it is not wise to delay, because important evidence could be lost or witnesses could forget or move away. If you are hurt in a motor vehicle accident, we advise contacting our office immediately.

If you or a loved one suffered a serious injury in a bicycle accident, talk with an experienced Michigan bicycle accident lawyer today. Please submit a simple, free, and confidential legal consultation form now.

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