Michigan No-Fault & PIP Claims

Michigan No-Fault PIP Claims: The Fight Your Own Insurance Company Doesn't Want You to Win

Here's something that shocks every client I meet for the first time: after a car accident in Michigan, the company fighting hardest against you is usually your own insurance company. Not the other driver's. Yours. That's how Michigan's no-fault system works — your insurer owes you PIP benefits, and they have a direct financial incentive to pay you as little as possible.

I've handled hundreds of PIP disputes at Koussan Law. I've seen every tactic: cutting off benefits after an "independent" medical exam (that's neither independent nor thorough), denying attendant care because a family member is providing it, refusing to cover treatment they deem "not reasonably necessary." Every one of these decisions is a calculated bet that you won't fight back. We make sure that bet doesn't pay off.

What PIP Actually Covers — and What Insurers Try to Deny

Under MCL § 500.3107, your PIP benefits cover allowable expenses for care, recovery, and rehabilitation. In practice, that means hospital stays and surgery, physician visits, prescription medications, physical and occupational therapy, cognitive rehabilitation, attendant care (including care provided by family members), and durable medical equipment like wheelchairs, hospital beds, and prosthetics.

Under MCL § 500.3107b, PIP covers 85% of your lost wages for up to three years, subject to a monthly cap that adjusts annually. And under MCL § 500.3107(1)(c), replacement services cover paying someone to handle household tasks you can no longer perform — cooking, cleaning, yard work, childcare.

Sounds comprehensive. But I can tell you from years of practice that insurance companies systematically challenge almost every category. The most common disputes I see: insurers cutting off medical treatment after their own hired doctor says you've "reached maximum medical improvement," denying attendant care hours or rates, and disputing whether a treatment is "reasonably necessary." Under MCL § 500.3157, the insurer can require you to attend an Independent Medical Examination (IME) — and these exams are conducted by doctors the insurance company pays repeatedly. The conclusions are predictable.

The 2019 No-Fault Reform Changed Everything

Before July 2020, every Michigan driver had unlimited lifetime PIP coverage. The 2019 reform under MCL § 500.3107c created a tiered system:

Unlimited PIP — the old standard. Most expensive, but covers everything for life.
$500,000 lifetime PIP — adequate for many injuries, but catastrophic cases can blow through this.
$250,000 lifetime PIP — a single surgery and hospital stay can consume most of this.
$50,000 lifetime PIP — only available if you have qualifying health insurance. A serious accident exhausts this in weeks.
PIP opt-out — available only with qualifying health insurance and specific conditions.

The problem I see regularly now: people chose lower tiers to save on premiums without understanding what they were giving up. A client comes to me with a $50,000 PIP election and $280,000 in medical bills. That $230,000 gap doesn't vanish — but there are sometimes other avenues for coverage depending on your household's insurance situation, your health insurance policy, and whether the at-fault driver has adequate liability coverage. This is where having an attorney who understands the priority rules under MCL § 500.3114 and 3115 makes the difference between being financially destroyed and being made whole.

The One-Year Deadline That Kills Claims

Under MCL § 500.3145, you have one year from the date an expense is incurred to file a PIP claim. Not one year from the accident — one year from each individual expense. This means ongoing treatment creates a rolling deadline. I've seen cases where a client's initial medical bills were timely claimed, but later bills — from the same accident, for the same injuries — were denied because they fell outside the one-year window. This deadline is unforgiving, and insurance companies know many claimants don't track it closely enough.

Frequently Asked Questions

Q: Can my insurance company cut off my PIP benefits?

They try to, constantly. Typically they'll require you to attend an IME under MCL § 500.3157, and their hired doctor will conclude your treatment is no longer reasonably necessary. If you disagree — and you often should — you have the right to dispute it. I've overturned dozens of IME-based denials by deposing the examining doctor and presenting our own medical evidence. The key is acting fast once benefits are cut.

Q: What if I chose low PIP coverage and my bills exceed my limit?

There may be other sources of coverage depending on your situation. Coordinated health insurance may pick up some costs. The at-fault driver's liability coverage may apply. Other household members' auto policies might come into play under the priority rules. Every case is different, and the analysis under MCL § 500.3114 is genuinely complex — it's one of the most litigated areas of Michigan insurance law. Don't assume you're stuck with the gap.

Q: How long do I have to file a PIP claim in Michigan?

One year from the date each expense is incurred, under MCL § 500.3145. This is not one year from the accident date — it's a rolling deadline tied to each bill. If your accident was 18 months ago and you just had another surgery related to those injuries, you have one year from the date of that surgery to claim those costs. Track every expense and every date. If you're not sure what's been claimed and what hasn't, bring your paperwork to us and we'll sort it out.