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Grand Rapids, Michigan

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Tim Smith
Tim Smith
Attorney • 231-946-0700

Handling Auto Insurance Claims

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Michigan has a No-Fault Auto Insurance system. Essentially, this means that if someone runs a stop sign and hit’s you, nobody is at fault. Your auto insurance covers the damage to your car, your hospital bills, your wages [if you’re off work] and other expenses related to your injuries. The same is true for the driver who ran the stop sign – his company covers his losses.

So, if you are involved in an auto accident, contact your auto insurance company to start the property damage component of your claim so that you can get your car fixed. If you require a visit to the Emergency Room or other medical treatment, you will need to file an “Application for Benefits” to set up the medical pay/work loss component of your claim. Your auto insurance company will be required to pay all ‘reasonable and necessary” medical expenses including mileage to and from the appointments. This is a lifetime benefit and there is no cap on the dollar amount no matter how much medical treatment you require or how many years after the accident your doctors perform it.

If the doctors tell you to stay off-work, then your auto insurance company will have to cover your work loss. The insurance company is required, by law, to pay 85% or your gross wage from prior to the accident. Unlike medical benefits which are lifetime in duration, work loss benefits are only good for the 3 years immediately following the accident.

The only time you are allowed to make a claim against the driver that ran the stop sign or caused the accident is when you suffer a serious injury. Then, and only then, can you bring a claim against that other driver. It will not be a claim for damage to your vehicle or medical costs or wages. Rather, it is a claim for pain and suffering and any wage loss that continue after the 3 year anniversary of the accident.

So, what’s a serious injury? Michigan courts have been struggling with this concept for some time now. It’s safe to say that the injury needs to be objective – broken bone or visible on an x-ray or MRI; it needs to be to an important body part; and it needs to seriously alter your life for a number of months.

If you’re off work for 6-12 months, if you’re hospitalized for a number of weeks following the accident or if you can’t participate in the recreational activities you did prior to the accident then you might want to consult with an attorney to determine your legal rights.

For a great little synopsis prepared by the Michigan Office of Financial and Insurance Services, click here: