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What Is a No-Fault Auto Insurance Claim?

The Short Answer

If you’re injured in an auto accident in Michigan, your first step is to file a no-fault or first-party claim with your own insurance company. Personal injury protection (PIP) covers medical bills, partial lost wages, rehabilitation costs, attendant care, and replacement household services. Even under the no-fault system, it’s still possible to file a third-party claim against the at-fault driver if you meet the serious injury threshold.

Key Takeaways

  • Michigan is one of 12 states that has a no-fault insurance system for auto accidents.
  • No-fault car insurance includes PIP as your first source of coverage for personal injuries.
  • PIP covers medical care and up to 85% of lost wages for a maximum of 3 years or until you hit the policy limit.
  • Transportation to medical appointments and household services valued up to $20 per day are also covered.
  • You must have severe injuries to sue the at-fault driver for residual benefits, such as compensation for pain and suffering.
  • Strict filing deadlines apply. You have 1 year to file a no-fault claim and 3 years to sue the at-fault driver, if permitted.
  • PIP also covers you if you were injured while riding as a passenger. If you don’t have your own coverage, you can generally access benefits through the driver.

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What's On This Page

What Is No-Fault Car Insurance?

In Michigan, there are 2 types of insurance coverage related to automobile accidents: no-fault and traditional liability-based coverage. Your car insurance policy has 3 main components:

  1. Personal injury protection (PIP) covers medical care, lost wages, and limited household services.
  2. Property protection insurance (PPI) provides up to $1 million in coverage if you damage another person’s property, such as buildings, fences, or parked cars.
  3. Residual liability insurance protects you from lawsuits if you cause a severe accident or harm an out-of-state driver.

What Does PIP Cover?

Personal injury protection (PIP) is your primary source of coverage in Michigan’s no-fault insurance system. These benefits are paid to you regardless of who caused the crash. Here’s what’s included:

  • Medically necessary care related to your injuries
  • Up to 85% of lost wages for a maximum of 3 years
  • Up to $20 per day for replacement household services
  • Up to 56 hours of weekly personal care, such as in-home nursing
  • Physical therapy and rehabilitation
  • Travel to medical appointments
  • Funeral and survivor’s benefits, if applicable

PIP Coverage Limits After Michigan’s 2020 Reform

Recent changes to the state’s insurance laws allow drivers to choose from several PIP coverage limits. Common options per person, per accident include:

  • Unlimited
  • $500,000
  • $250,000
  • $250,000 with exclusions for qualifying health insurance
  • $50,000 (for Medicaid-enrolled drivers only)
  • PIP medical opt-out for households with qualified health coverage (rare)

Lower PIP limits generally reduce your monthly premiums, but they also limit your coverage in case you’re injured in an accident. Medical bills and lost wages can add up quickly, which may force you to use other insurance coverage or file a third-party claim against the at-fault driver.

How to File a No-Fault Car Insurance Claim

If you’ve been injured in a car crash anywhere in Grand Rapids, Grand Haven, or West Michigan, understanding how to properly file a no-fault insurance claim is essential to protect your right to compensation. Missing deadlines or skipping required steps can cost you important benefits. Here’s what you need to know:

Step 1: Notify Your Insurance Company Immediately

After a crash, contact your auto insurance carrier as soon as possible to report the accident. Michigan law requires you to file a written Application for No-Fault Benefits. This application must be submitted within 1 year of the crash. Otherwise, you will lose your right to compensation.

Step 2: Submit Documentation

Your insurance company may request several forms of documentation to validate your claim. To prevent delays and denials, be prepared to provide:

  • An official copy of the accident report
  • Medical records related to your injuries
  • Paystubs or proof of lost income
  • Proof of household service expenses
Step 3: Follow Your Treatment Plan

Attend all medical appointments, and follow your doctor’s instructions. Consistent medical care helps to show that your treatment is medically necessary. On the other hand, gaps in care can result in denials or reduced benefits.

Step 4: Track Your Expenses

PIP will reimburse you for many out-of-pocket expenses related to the accident, but only if you provide documentation. Per MCL 500.3145(2), once you have opened a claim or received payment, you have 1 year from the date of treatment (not the date of the bill) to seek reimbursement for qualifying expenses. Keep records documenting the following expenses:

  • Medical bills and co-pays
  • Mileage or transportation to medical appointments
  • Receipts for replacement household services
  • Durable medical equipment or adaptive device purchases
Step 5: File a Third-Party Claim for Serious Injuries

If the other driver was at fault and your injuries caused disfigurement or a serious impairment of body function, you may be able to pursue a third-party claim in addition to your no-fault benefits. A third-party claim can give you access to additional compensation, including:

  • Non-economic damages for pain and suffering
  • Excess coverage beyond the limits of your PIP policy
  • Wrongful death damages if a loved one died in a fatal accident

Key Deadlines for Michigan No-Fault Claims

It’s important to be aware of all deadlines when filing a no-fault insurance claim. If you miss one, you could lose your right to compensation regardless of how serious your injuries are. Below is a quick-reference guide to the most important timelines.

Claim TypeDeadlineRequirements
Initial PIP Claim1 year from the date of the accidentSubmit a written Application for No-Fault Benefits with your insurer
Unpaid PIP Benefits1 year from the date each expense was incurredUnder the 1-Year Back Rule, you must seek reimbursement within 1 year of each unpaid medical bill or expense.
Third-Party Lawsuit3 years from the date of the accidentTime limit to sue the at-fault driver if you meet the severe injury threshold

Can I Sue for Injuries in a No-Fault State?

Yes. Even though Michigan is a no-fault state, you can step outside this system and sue the at-fault driver in certain situations. According to MCL 500.3135, you must have experienced a “serious impairment of body function” or “permanent serious disfigurement” to recover non-economic damages for pain and suffering. To meet the severe injury threshold, the injury must:

  • Be objectively manifested and perceptible.
  • Impair a body function that has great value or significance.
  • Affect the person’s ability to lead a normal life.

In general, your injuries must affect your ability to lead a normal life. Each claim is evaluated on a case-by-case basis by comparing your quality of life before and after the accident (MCL 500.3135(5)(c)). If you qualify, you may be able to recover additional compensation through the other driver’s residential liability insurance.

How an Attorney Can Help With No-Fault Claims

Michigan’s no-fault insurance system is meant to simplify the claims process and give drivers faster access to benefits after an accident. However, claims can still be complex, especially if the accident was severe. Many drivers run into delays, denials, unpaid benefits, and confusing policy rules. An attorney can step in to protect your rights, prevent costly mistakes, and help ensure you receive full compensation.

Common Reasons Drivers Need an Attorney

  • Delays, denials, or unpaid benefits from the insurance company
  • Confusing coverage rules, including PIP limits and health insurance coordination
  • Disputes over medical necessity, wage loss, or replacement services
  • Assuming health insurance will cover everything (often it won’t)
  • Large medical bills that exceed PIP coverage limits
  • Questions about suing an at-fault driver when injuries are serious
  • Uncertainty about whether an injury qualifies as a serious impairment
  • Difficulty navigating deadlines, forms, and documentation requirements

How a Lawyer Helps You Navigate a No-Fault Claim

1. Reviewing Your Policy & Making Sure You Get All Benefits

An attorney will review your auto insurance policy, PIP coverage, health insurance, and any optional coverages to ensure you receive all the benefits you’re entitled to.

2. Handling Disputes, Appeals & Unpaid Claims

If your insurer delays, denies, or underpays benefits, a lawyer can challenge the decision, gather medical evidence, negotiate on your behalf, and file suit if necessary.

3. Helping You Move Beyond No-Fault When Needed

When injuries are severe or losses exceed PIP limits, an attorney can determine if you can file a third-party liability claim to recover compensation for:

  • Pain and suffering
  • Excess medical bills
  • Excess lost wages
  • Wrongful death damages

Get Legal Help With Your No-Fault Insurance Claim

If you need help navigating the claims process, contact Barrix Law Firm for a free consultation. We work with clients in Grand Rapids, Grand Haven, Muskegon, and communities across West Michigan. One phone call can help you understand your rights and take the first step toward justice.

Michigan No-Fault Car Insurance FAQs

Do I Need No-Fault Car Insurance in Michigan?

Yes. Michigan requires all drivers to carry no-fault insurance. It includes personal injury protection (PIP), property protection insurance (PPI), and residual liability coverage that kicks in if you’re sued. Driving without insurance can lead to fines, license suspension, and loss of certain legal rights after a crash.

Can I Sue for Car Accident Injuries in a No-Fault State?

Yes. Although PIP covers many losses, you can sue the at-fault driver if you meet the severe injury threshold. Under this standard, you must show that the injury impacts your daily life, rather than conforming to a specific diagnosis.

What if I Was Involved in an Accident Out of State?

Michigan no-fault benefits generally follow you when you travel outside Michigan. You may also be able to bring a third-party liability claim against the at-fault driver under that state’s laws. Contact an attorney who’s licensed in your state to understand your rights.

How Do Michigan’s Car Insurance Reform Laws Affect You?

Insurance reforms enacted since 2019 allow drivers to choose different levels of PIP coverage. This can result in lower premiums and lower limits, which has increased the number of lawsuits filed against at-fault drivers.

How Does No-Fault Insurance Work if I Was Injured as a Passenger?

If you were injured in a car accident as a passenger, your own PIP insurance should cover your medical care and lost wages. If you don’t have your own policy, you may be able to access benefits through the vehicle owner’s policy or the other driver. The Michigan Assigned Claims Plan may also provide coverage if no other sources are available. Speak to a qualified attorney as soon as possible to understand your rights.

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