Personal Injury Protection

The personal injury lawyers at MacArthur, MacArthur & Associates, P.L.L.C. have the knowledge and experience to help business and insurance clients with issues relating to Personal Injury Protection. Whether issues relate to coverage, excluded claimants, the priority of PIP insurers, PIP benefits, Property Protection Benefits, indemnification by the Michigan Catastrophic Claims Association, or uninsured and underinsured motorist coverage, we can provide the answers and assistance you need.

Michigan No-Fault Law

Michigan is one of the most litigious of all the states that have no-fault automobile statutes. For that reason, Michigan’s no-fault case law is very well developed. Our attorneys know the Michigan statutes and court decisions that apply to the full range of no-fault issues. We draw on our extensive experience and knowledge to find answers and solutions for clients when they encounter no-fault insurance issues or concerns.

Thorough Analysis

A thorough analysis of a first party no-fault claim includes an assessment of five essential issues:

  • Is there coverage under the Michigan No-Fault Act for the type of injury that the claimant sustained?
  • Is the injured party excluded from no-fault benefits?
  • Is there another, higher priority PIP insurer who is responsible to pay the plaintiff PIP benefits?
  • What type of PIP benefits is the injured individual entitled to, in what amount, and for how long?
  • Are there any reductions, setoffs, or reimbursements that will limit the claimant’s PIP benefits?

Without specifically considering all these critical issues, viable cost-saving defenses are missed, and opportunities are lost. Our attorneys conduct comprehensive, economically efficient discovery that enables us to provide you with a thorough and complete analysis of no-fault claims. Our comprehensive analysis enables you to make the right decisions on your claims.

Coverage Questions

If a claimant suffered an injury arising out of the ownership, operation, maintenance or use of a motor vehicle, the answer to no-fault coverage questions may be clear cut. But in some circumstances, the answers require more than superficial legal analysis. Our attorneys guide you through the complex coverage claims when the answers are not so clear. We provide you with the case law that relates to your coverage questions, develop strategic approaches for coverage defenses, and assess the probabilities of prevailing at trial and on appeal.

Excluded Claimants

Even if a claimant has suffered an injury arising out of the ownership, operation, maintenance or use of a motor vehicle, some claimants are specifically excluded from coverage or only get limited coverage. Examples of circumstances in which exclusions or limitations apply include a claimant whose uninsured vehicle was involved in an injury-producing event, an out-of-state motorist in an out-of-state motor vehicle insured by an insurance company that has not filed a certificate of compliance, a claimant who suffers injuries that they intentionally caused, a plaintiff who is injured from an accident with a parked vehicle, and a claimant who had a work-related injury.

Our lawyers have the expertise to identify the exclusions and limitations that apply to your claims. When an exclusion applies, we can bring your litigated case to a quick conclusion, which saves you money on indemnity and medical payments and reduces your litigation costs.

Priority of Insurers

In most cases, a no-fault claimant who suffers an injury arising out of the ownership, operation, maintenance or use of a motor vehicle, whether they were an occupant of the vehicle at the time or not, will recover no-fault benefits under their own insurance policy or the policy of their spouse or other relatives residing in the claimant’s household. But if the no-fault claimant didn’t have his or her own insurance policy at the time, the No-Fault Act priority provisions apply.

Depending on whether the injured person was an occupant of a motor vehicle or a nonoccupant, the insurer of the occupied vehicle or insurer of the striking vehicle is responsible for benefits. Other priority rules also may determine which insurer has to pay no-fault benefits. Employer-furnished vehicles, vehicles used in the business of transporting individuals, and motorcycles have special priority rules as well.

Determining the responsible insurer under the priority rules can be very complicated in some situations. Our lawyers help you navigate through these complex priority provisions of the No-Fault Act. When a claimant doesn’t have his own insurance, we conduct discovery that is specifically designed to find higher priority insurers. If we identify a higher priority insurer, that gets you out of the litigation.

PIP Benefits

The No-Fault Act provides for certain benefits to qualified claimants, including medical expenses, wage loss benefits, and replacement services. You may wish to pay the benefits a claimant is entitled to, but sometimes things just don’t add up. Pre-existing injuries, injuries that are alleged long after the accident, prolonged medical treatment, excessive replacement services, unreasonable home modifications, and extended restrictions from work are just some of the scenarios where further investigation is required. Our personal injury defense lawyers have the knowledge required to navigate through the sea of medical records and the expertise to separate fact from fiction.

Medical Experts and Benefits

In Michigan no-fault cases, having the right medical expert is key. The tired medical expert from the national IME service won’t cut it. We work with a team of physicians who have extensive treating practices and teach at local medical schools. Our experts conduct thorough evaluations of plaintiffs that enable them to find the truth. Their expertise provides credible medical defenses as well as cost savings.

Even when you’re dealing with legitimate no-fault claims, determining a claimant’s benefits can be complex. Medical coordination, wage loss benefit calculations, statutory maximums, setoffs, reductions, and reimbursements all come into play. Our personal injury defense attorneys steer you through these complexities and give you the assurance that the benefits paid are the benefits due.

Property Protection Benefits

Many times, no-fault claims involve property damage. Most of these claims are straightforward, but others aren’t. Scope of coverage issues, the involved-in-the-accident requirement, arising-out-of and use problems, and environmental contamination considerations are all issues that are relevant to property protection benefits.

In addition, there are various exclusions that apply to certain types of vehicles, activities, and insured property. There are also priority, reimbursement, and indemnification issues. Our lawyers have the experience and expertise to guide you through all these legal issues, so you can determine whether you should be paying any benefits at all.

Finally, when you’re the responsible insurer and the property damage is extensive, you need to ascertain the actual property damage, as distinguished from the claimed property damage. We work with property damage experts who will cut through the excesses and arrive at the actual damages, so you have the confidence that you aren’t paying too much.

Indemnification by the Michigan Catastrophic Claims Association

When a serious injury claim arises, PIP benefits may exceed the statutorily specified catastrophic level. The Michigan No-Fault Act established the Michigan Catastrophic Claims Association (MCCA) to give relief to insurers in these situations. However, legal issues still arise. If the MCCA refuses to indemnity, our defense attorneys can identify the pertinent case law, give you strategic advice, and get you the indemnification that was intended under Michigan No-Fault Act.

Uninsured and Underinsured Motorist Coverage

Michigan law requires that applicants of automobile registration have auto insurance. But some people drive without the required auto insurance. When uninsured drivers cause injuries to others, the injured individual does not have the source of recovery against the negligent tortfeasor that the legislature intended.

Many insurers offer uninsured motorist policies that allow injured individuals to seek compensation from their own insurer for damages that they would otherwise be entitled to recover from the driver, such as pain and suffering. Many auto insurers also offer underinsured motorist coverage. When an injured individual has this coverage and suffers damages beyond the tortfeasor’s policy limits, they may file a claim with their own insurance carrier for the difference between the actual damages and the policy limits of the tortfeasor’s policy limits.

Since the No-Fault Act does not require uninsured or underinsured coverage, the legal issues relating to uninsured and underinsured motorist coverage arise from the contract of insurance. The provisions within the policy have specific requirements for coverage to apply, as well as various exclusions. Our defense lawyers provide coverage opinions in these situations, so you can make an informed decision about providing or denying coverage.

Even when a claimant is eligible for uninsured or underinsured coverage, there may be issues relating to the extent of the injuries suffered. In this situation, our attorneys conduct thorough yet efficient discovery to provide the insight necessary to determine the real extent of the injuries suffered, so you don’t overpay on a claim.

Schedule a Free Consultation

Our personal injury defense lawyers at MacArthur, MacArthur & Associates provide assistance to clients on the full range of matters that arise under the Michigan No-Fault Act, including Personal Injury Protection issues. From our offices in Metro-Detroit, Lansing, and Gaylord, we provide legal services to businesses throughout Michigan’s lower and upper peninsulas. We invite you to contact us for a free consultation to discuss your personal injury protection defense needs with us.