WHICH INSURANCE COMPANY PAYS?

If you or a member of your household are injured in a motor vehicle accident, you should immediately contact the responsible auto insurance company, request a no-fault benefit application form, complete it and file it as notice of your claim for PIP Benefits

Auto insurance companies are responsible for the payment of benefits in the following order:

If an occupant of a private vehicle:

1. Your own auto insurer, and if none
2. The auto insurer of your husband or wife or relative living under the same roof, and if none
3. The auto insurer of the owner of the occupied vehicle, and if none
4. The auto insurer of the driver of same, and if none
5. The Assigned Claims Fund (See address on Page 71).

PENALTIES – NON PAYMENT  PIP BENEFITS

PIP benefits are overdue if not paid within 30 days after the auto insurer receives reasonable proof of the fact and the loss sustained.

1. An overdue payment bears simple interest at the rate of 12% per annum
2. Reasonable attorney fees – You can also recover reasonable attorney fees for advice and representation in a lawsuit for PIP benefits which are over due if the insurance company’s acts were “unreasonable.”
3. Additional damages – You may also recover additional damages known as exemplary damages if the insurance company, through its agents or employees, intentionally inflicted emotional distress upon you. However, the Supreme Court has yet to rule against a no-fault insurance company on that theory.

YES—YOU CAN STILL SUE

While your right to sue for a motor vehicle accident has been limited by No-Fault, you can still file suit as follows:

1. When the negligent or responsible party has caused you to suffer a “serious injury” or “death.”
2. When the responsible or negligent party is not insured.
3. When your insurance company fails to pay all or part of the PIP benefits due you.
4. Where the responsible or negligent person has intentionally caused the accident and resulting injury.
5. If married and your injury is “serious,” your spouse may also sue for loss of consortium which is the society, companionship, services, and all other incidents of the marriage relationship.
6. As of March 1981, a child may recover for loss of a parent’s society and companionship caused by a negligent injury to the parent. However, as of May 1988, a parent may not recover for loss of society and companionship caused by the negligent injury to a child.
7. When your motor vehicle is “legally parked” and damaged by another person.
8. When your motor vehicle is moving or otherwise not legally parked and the other person is more than 50% at fault or responsible for the damage ($400.00 maximum).

ABOLITION OF INTRA-FAMILY TORT IMMUNITY

Because many motor vehicle accidents involve related victims (examples: husband-wife, mother-child, child-parent), Michigan has joined a majority of states and abolished legal suit immunity between such persons. More recently, in 1979, the Michigan Supreme Court struck down insurance companies’ exclusion clauses relating to such intra-family injuries or deaths.

The rationale of justification for allowing a wife to sue a husband or a child to sue a parent is that the negligent spouse or parent owes the same duty of care to a family member as he or she would to a total stranger.

Example:

A father (“A”) is operating a motor vehicle with his son (“B”) and a neighborhood child (“C”) as passengers. “A” negligently crosses the center line and strikes another motor vehicle, causing severe injuries to both “B” and “C.” Both “B” and “C” would have separate causes of action against “A,” because of his negligence, resulting in their respective injuries.

Example:

“A,” while backing his motor vehicle out of his driveway, negligently strikes “B,” his retired father, and “C” (A’s wife). Both “B” and “C” have a cause of action for their injuries against “A,” the negligent person, despite the relationship.

CHILDREN – INJURED PARENTS

The Michigan Supreme Court case of Berger vs Weber, 411 Mich 1 (1981) held that a child may recover money damages for the loss of a parent’s society and companionship caused by a negligent (tortious) injury to the parent. Although the Court did not limit it to instances of a “severely” injured parent, it would be logical to presume that it must be a “serious” injury if occurring in a motor vehicle accident.

LIQUOR LIABILITY

If a person who is at fault in a motor vehicle accident is intoxicated, a seriously injured victim may have a cause of action not only against the intoxicated person, but also against the establishment and sometimes the person who furnished the alcoholic beverages consumed. The liability of a bar, cocktail lounge, party store, etc., will depend upon whether the person to whom the intoxicants were sold or served was visibly intoxicated at the time, or whether the person to whom sold or served was a minor. (Note: Under the age of twenty-one, the legal drinking age.)

In 1986 Amendments to the law have generally eliminated a cause of action for the intoxicated person or his family unless a minor, and now, the liquor establishment must be notified in writing of the claim within 120 days after you have retained a lawyer.

Michigan has not yet adopted “social host” liability (alcoholic beverages served in the home) except when served to a minor.

RESIDUAL LIABILITY insurance company

Residual liability insurance is that portion of your policy that insures you when the injured person has suffered because of your negligence, one of the following:

1. A serious impairment of a body function, or
2. A permanent serious disfigurement, or
3. Death.

You can sue, or be sued, as an owner, operator, passenger, or pedestrian when on of the above occurs. The suit is based upon the non-economic loss of the injured person (pain and suffering, disability, loss of companionship, etc.) and wage loss extending beyond the 36-month PIP limit.

A serious impairment of a body function is normally a fact issue to be decided by a jury and generally will vary from person to person depending on the injury, extent of treatment, effect on occupation, effect on physical activities, etc. The body function that is impaired may, by way of example, be walking, running, bending, reaching, or lifting. The impairment may be either temporary or permanent.

A permanent serious disfigurement can be a scar, burn or other cosmetic injury which is unsightly. The seriousness, of course, often depends upon its location and appearance; it is also normally a fact issue for a jury to decide.

Death needs little explanation, of course, but under the law your heirs can recover for your conscious pain and suffering, the funeral expense, their loss of companionship, and in some situations, their loss of investment.

What is Workers’ Compensation?

Workers’ compensation is an insurance system, mutually beneficial to both employees and their employers. It serves two basic purposes:

1. To provide benefits to employees who have suffered a work-related injury or illness; and
2. To protect employers from costly litigation over claims of work-related injuries and illnesses.

Michigan’s workers’ compensation program is regarded as one of the strongest in the nation.

Employee benefits can include one or more of the following:

Appropriate medical treatment

Partial replacement of lost income in cases where an employee is unable to work for more than seven days (or death benefits paid to dependent survivors in the even of a fatal injury or illness); and

Workers’ compensation is the oldest form of no-fault insurance. First established in Germany in 1856 and adopted soon after by England and most of Western Europe, workers’ compensation insurance was enacted in Michigan in 1912. By 1920, all but eight of the other states had passed workers’ compensation laws. The last state mandated workers’ compensation coverage in 1947.

Workers’ compensation is “no fault’ in the sense that benefits are paid without regard to who or what caused or contributed to an injury or illness that “arises out of, or in the course of, employment.” Before this insurance system was established, an employer could be sued for negligence and could only defend himself/herself against such lawsuits by proving that the employee was at least partially at fault, that a fellow employee contributed to the injury, or that the employee assumed the risk of potential injury by accepting the job.