Short answer: A PIP denial is not the final word. Your own no-fault insurer generally owes your accident-related medical bills, lost wages and household help no matter who caused the crash. But Michigan has strict one-year deadlines, so get the denial reviewed quickly.

You were hurt in a car crash, you filed a claim with your own auto insurer, and now a letter says your benefits are denied, reduced or cut off. That is one of the most common calls we get. Here is what a denial usually means and what you can do about it.

What PIP is supposed to pay

Personal Injury Protection (PIP) is the part of Michigan no-fault insurance that pays for your own injuries. It generally covers:

Medical and rehab expenses that are reasonable and related to the crash, up to the medical coverage level on the policy
Lost wages, generally 85% of your gross pay for up to three years, subject to a monthly maximum
Replacement services, up to $20 a day for household help you can't do yourself
Mileage to and from treatment, and attendant care your doctor orders

Since the 2019 no-fault reform, the medical coverage level depends on what was chosen on the policy: unlimited, $500,000, $250,000, or lower options for people with qualifying Medicaid or Medicare coverage.

Why insurers deny PIP claims

An "independent" medical exam (IME) by a doctor the insurer chose says you are healed or your treatment isn't necessary
The insurer says your injury is not related to the crash, or was pre-existing
Bills are cut down under the fee schedule
The insurer claims you misstated something on the application and tries to cancel (rescind) the policy
A priority dispute: the insurer says another company should pay
The insurer says you missed a deadline or didn't send paperwork

Some of these are legitimate. Many are not. A denial based on a short IME often doesn't hold up against your own treating doctors' records.

The deadlines that matter

Don't wait. Under Michigan's no-fault act (MCL 500.3145), you generally must give your insurer written notice of your injury within one year of the accident, or the claim can be barred. And when you sue for unpaid benefits, you generally can only recover losses from the year before the lawsuit, although that period can be paused while a claim is pending and hasn't been formally denied. These rules are technical. A lawyer should look at your dates.

What to do after a denial

Get the denial in writing and keep the envelope. Note the date you received it.
Ask for your policy declarations page so you know your coverage level.
Keep treating if your doctor says you need it. Gaps in treatment are what insurers point to.
Ask your doctor to document how your symptoms connect to the crash.
Keep every bill, letter and wage record in one folder.
Don't sign anything or give a recorded statement about the denial before talking to a lawyer.

The insurer may owe more than the bill

Michigan law penalizes insurers who pay late. Benefits are generally overdue if not paid within 30 days after the insurer gets reasonable proof of the loss, and overdue benefits can carry 12% interest (MCL 500.3142). If a court finds the insurer unreasonably refused or delayed payment, the insurer can also be ordered to pay your attorney fees (MCL 500.3148).

Is it worth calling a lawyer?

If benefits have been denied or cut off, usually yes. PIP cases are handled on a contingency fee, so there's no attorney fee unless money is recovered for you. Your written fee agreement explains the fee and how case costs are handled. We'll review the denial letter and tell you honestly whether it's worth fighting.

Learn more about our car accident and PIP cases, or read who pays your medical bills after a Michigan car accident.

PIP denied? Call us before the deadline.

Free consultation. Send us the denial letter and we'll tell you your options. نتكلم العربية.

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Attorney responsible for this content: Ali Moubarak (P81729), Moubarak Law Firm, P.C., 1 Parklane Blvd., Ste 729 E, Dearborn, MI 48126 · (313) 566-4802.

Attorney advertising. This article is general information, not legal advice, and laws change. Every case is different, and results in past cases do not guarantee a similar outcome. Contacting us does not create an attorney-client relationship.