Michigan No Fault Auto Reform Update

MICHIGAN PIP
Michigan’s auto no-fault law provides individuals with the following benefits under the Personal Protection Insurance also commonly known as Personal Injury Protection (PIP) portion of the policy:

• Medical/Allowable Expenses – consists of medical benefits, attendant care, and other benefits for individuals, who are injured in an automobile accident.
• Wage Loss – consists of loss of income from work for individuals, who are injured in an automobile accident. Limitations apply to this benefit.

    ·  Essential Services – consists of reimbursement to individuals, who are injured in an                   automobile accident, for routine household services they would have done had they not           been injured. Limitations apply to this benefit.
    ·   Funeral and burial expenses – limitations apply.
   ·  Survivor’s loss – consists of benefits paid to survivors and dependents of an individual              who dies as a result of an automobile accident. Limitations apply to this benefit.

CHANGES TO MICHIGAN MEDICAL/ALLOWABLE EXPENSE COVERAGE
For policies issued or renewed beginning on July 2, 2020, Michigan drivers will be able to select their preferred level of Medical/Allowable Expense coverage under PIP. Based on an individual’s eligibility and specific needs, the individual will be able to select from the following options:

OPTIONS AVAILABLE TO EVERYONE
> Unlimited (with Michigan Catastrophic Claims Association involvement)
> $500,000
> $250,000

OPTIONS AVAILABLE TO ELIGIBLE INDIVIDUALS WITH QUALIFIED HEALTH COVERAGE.
WHAT IS QUALIFIED HEALTH COVERAGE (QHC)?
Qualified health coverage is health or accident insurance coverage that does not exclude or limit coverage for injuries related to auto accidents and has a deductible of $6,000 or less per person.

​> $250,000 PIP Exclusion
WHAT IS IT? If an individual qualifies for and chooses this option, and they are injured in an automobile accident, their medical benefits will be covered by their QHC provider. Individuals who purchase this option will  not be eligible for any PIP medical/allowable expenses.
WHO IS ELIGIBLE? Insureds who have QHC (see red note above) and their spouse and/or resident relative(s) in the same household, who have QHC or are enrolled in Medicare Parts A and B. If not all household residents are eligible, it is still possible to elect this option, with the exclusion applying only to eligible individuals.

OPTION AVAILABLE TO ELIGIBLE INDIVIDUALS WITH MEDICAID
> $50,000 Medical/Allowable Expense - Medicaid Only
WHAT IS IT? $50,000 Medical/Allowable Expense coverage option for Medicaid recipients.
WHO IS ELIGIBLE? Insureds who are enrolled in Medicaid. However, a spouse and/or resident relative(s) in the same household must also be enrolled in Medicaid, be enrolled in Medicare Parts A and B, have other PIP Allowable Expense coverage, or have QHC.

OPTIONS AVAILABLE TO ELIGIBLE INDIVIDUALS WITH MEDICARE
> Medical/Allowable Expense Opt-Out – Medicare Only
WHAT IS IT? Complete opt-out of Medical/Allowable Expense coverage for Medicare recipients.
WHO IS ELIGIBLE? Insureds who are enrolled in Medicare Parts A and B. However, a spouse and any resident relative(s) in the same household must also be enrolled in Medicare Parts A and B, have other PIP Medical/Allowable Expense coverage, or have QHC. Insureds will be required to provide documentation showing that they, their spouse, and any resident relative(s) are eligible in order to elect this option.

*Please see the No-Fault Act for complete details. This summary is being provided for general information purposes only. Subject to regulatory approval. Coverage is subject to all policy terms, conditions, exclusions and limitations.