Michigan No-Fault Law, section by section › MCL 500.3173a
Eligibility for benefits; initial determination; denial; notice; false statement.
In plain terms
The MAIPF makes the initial eligibility determination, may suspend benefits for failure to cooperate (including refusing an examination under oath after 21 days' notice at a reasonably convenient location), and must give written reasons for a denial. A knowingly false statement in support of a claim is a fraudulent insurance act that makes the claim ineligible.
How this section works in practice
Since 2012 the Michigan Automobile Insurance Placement Facility, not an assigned insurer, makes the first decision on eligibility for the assigned claims plan, and it must give written reasons when it denies a claim. Claimants must cooperate with that review, which expressly includes submitting to an examination under oath and complying with the medical examination rules of sections 3151 through 3153. The 2019 amendment added a rebuttable presumption of cooperation for a claimant who filed a complete application, supplied reasonable proof of loss, and attended an examination under oath after at least 21 days' notice at a reasonably convenient location with reasonable rescheduling honored.
Failure to cooperate leads to a suspension of benefits, not an outright denial, and the suspension ends when cooperation resumes. Fraud is treated differently: a knowingly false statement in support of a claim is a fraudulent insurance act, and a claim that contains or is supported by one is ineligible for benefits from the plan altogether. The examination under oath is the point at which most disputed assigned claims are won or lost; treat it as testimony, because it is.
Text of MCL 500.3173a
Sec. 3173a.
(1) The Michigan automobile insurance placement facility shall review a claim for personal protection insurance benefits under the assigned claims plan, shall make an initial determination of the eligibility for benefits under this chapter and the assigned claims plan, and shall deny a claim that the Michigan automobile insurance placement facility determines is ineligible under this chapter or the assigned claims plan. If a claimant or person making a claim through or on behalf of a claimant fails to cooperate with the Michigan automobile insurance placement facility as required by subsection (2), the Michigan automobile insurance placement facility shall suspend benefits to the claimant under the assigned claims plan. A suspension under this subsection is not an irrevocable denial of benefits, and must continue only until the Michigan automobile insurance placement facility determines that the claimant or person making a claim through or on behalf of a claimant cooperates or resumes cooperation with the Michigan automobile insurance placement facility. The Michigan automobile insurance placement facility shall promptly notify in writing the claimant and any person that submitted a claim through or on behalf of a claimant of a denial and the reasons for the denial.
(2) A claimant or a person making a claim through or on behalf of a claimant shall cooperate with the Michigan automobile insurance placement facility in its determination of eligibility and the settlement or defense of any claim or suit, including, but not limited to, submitting to an examination under oath and compliance with sections 3151 to 3153. There is a rebuttable presumption that a person has satisfied the duty to cooperate under this section if all of the following apply:
(a) The person submitted a claim for personal protection insurance benefits under the assigned claims plan by submitting to the Michigan automobile insurance placement facility a complete application on a form provided by the Michigan automobile insurance placement facility in accordance with the assigned claims plan.
(b) The person provided reasonable proof of loss under the assigned claims plan as described in section 3172.
(c) If required under this subsection to submit to an examination under oath, the person submitted to the examination, subject to all of the following:
(i) The person was provided at least 21 days' notice of the examination.
(ii) The examination was conducted in a location reasonably convenient for the person.
(iii) Any reasonable request by the person to reschedule the date, time, or location of the examination was accommodated.
(3) The Michigan automobile insurance placement facility may perform its functions and responsibilities under this section and the assigned claims plan directly or through an insurer assigned by the Michigan automobile insurance placement facility to administer the claim on behalf of the Michigan automobile insurance placement facility. The assignment of a claim by the Michigan automobile insurance placement facility to an insurer is not a determination of eligibility under this chapter or the assigned claims plan, and a claim assigned to an insurer by the Michigan automobile insurance placement facility may later be denied if the claim is not eligible under this chapter or the assigned claims plan.
(4) A person who presents or causes to be presented an oral or written statement, including computer-generated information, as part of or in support of a claim to the Michigan automobile insurance placement facility, or to an insurer to which the claim is assigned under the assigned claims plan, for payment or another benefit knowing that the statement contains false information concerning a fact or thing material to the claim commits a fraudulent insurance act under section 4503 that is subject to the penalties imposed under section 4511. A claim that contains or is supported by a fraudulent insurance act as described in this subsection is ineligible for payment of personal protection insurance benefits under the assigned claims plan.
(5) The Michigan automobile insurance placement facility may contract with other persons for all or a portion of the goods and services necessary for operating and maintaining the assigned claims plan.
History: Add. 1984, Act 426, Eff. Mar. 29, 1985 ;-- Am. 2012, Act 204, Eff. Sept. 1, 2012 ;-- Am. 2019, Act 21, Imd. Eff. June 11, 2019
Source: MCL 500.3173a at legislature.mi.gov (official text). Text as published in the 2025 Michigan Compiled Laws; reviewed by Koussan Law on September 15, 2026.
Sections this one refers to
- MCL 500.3151: Insurer Medical Examinations
- MCL 500.3153: Orders for Refusing an Examination
- MCL 500.3172: Claiming Through the Assigned Claims Plan
Practice pages
Important: This is not legal advice
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