Not many people know about uninsured or underinsured motorist coverage.

Uninsured motorist coverage covers you when you are injured as a result of a driver who did not have insurance, a hit and run driver, or a driver of a stolen car. Uninsured motorist coverage is provided by your own insurance company. The cost of this coverage is usually nominal and should be considered when purchasing auto insurance.

Underinsured motorist coverage allows you to recover from your own insurance company, money to pay for damages incurred from an at-fault driver who does not have enough insurance to cover your damages. Not enough people elect to have this type of coverage, but it is important to consider because these situations are far too common.

With an underinsured policy (which you also get from your own insurance provider) you first are entitled to the full amount of the other person’s coverage and then on top of that, whatever your underinsured policy amount is. This is an insurance policy that makes sure that you are covered no matter what type of insurance the other person who caused the accident may have.

In order to recover your uninsured motorist coverage, you must prove that the other driver was not insured AND that the accident was their fault. To recover your underinsured motorist coverage you must take the full amount of the other person’s coverage that they do have. Then you are entitled to your own policy.

Related Posts: An Overview of the Personal Injury Process, Why You Should Report All Drivers On Your Car Insurance, No-Fault Insurance Change, One Step Closer to Justice for Grieving Family

Below is an entry from State Representative Howrylak’s newsletter from March 2014 regarding bill HB 4612.

Automobile No-Fault Insurance

I have previously written about proposed changes to Michigan’s automobile no-fault insurance system. The prior version of the bill (HB 4612) did not have support in the House. A new substitute bill has recently been floated. In this newsletter, I will explain some of the similarities and differences between the two proposals. Additionally, I want to express my concerns that these proposals will effectively decimate Michigan’s auto no-fault law and put residents, consumers and motorists at risk.

The following are some of the major points of the new proposal.

• It creates a health care fee schedule.
• Family member caregivers will be limited to working 56 hours per week as a caregiver.
• Family member caregivers will be limited to reimbursement at $15 per hour.
• It prevents the right to a trial by jury.
• It makes claims-handling inadmissible at a trial.
• It places a cap on physical, occupational and speech therapy at 24 months.
• It creates major caps on home modification.

The following are some of the differences between the two proposals:

• The original proposal created a $1 million lifetime cap on benefits (currently there is no dollar limit). The current proposal has a $10 million cap.
• The original proposal replaced the current “reasonable and necessary” care standard with a stricter “medically appropriate” standard. The latest proposal eliminates this change and keeps the status quo.
• The current proposal guarantees a two year rate reduction, although there is no guarantee that the temporary reduction will not be more than made up for in subsequent years.

I have many concerns with the current proposal. Those who support the current proposal believe that without a cap, all costs are covered and claims are never challenged. The conclusion, of course, is that costs are out of control and that this is the source of high auto insurance rates.

On the contrary. Those who are catastrophically injured and the providers of the care are constantly challenged by insurance claims adjustors. Insurers often balk at paying reasonable and necessary care. And when an insurer pays a claim, the amount paid is often discounted. If medical services resulting from an automobile accident were timely provided for and paid by the insurers, the number of attorney commercials on television would probably be reduced. There is plenty of litigation over bills and coverage.

It has also been said that the $10 million dollar cap will cover 99.99% percent of all claims. Based on the 14,245 open claims declared by the MCCA, .01 percent of 14,245 equals 1 person. In the 2009 MCCA press release, they projected a future outlay of $70 Billion on existing claims. In 2013, this expected future outlay grew to $85 billion. 2,800 new claimants in 4 years = $15 billion increase in expected payout with only 1 claim exceeding $10 million? Something isn’t adding up! Either claims will exceed $10 billion or the projected outlay is grossly exaggerated.

It should come as no surprise that future claims will reach levels exceeding claims to-date. For one thing, the longest claim is no more than 36 years old. That is because the MCCA (Michigan Catastrophic Claims Association) was established in 1978. Of course, we know how many open claims exist, but the MCCA won’t disclose how long each claim has been open. We also know that future claims will cost more due to medical inflation.

Additional changes, such as caps on attendant care, physical therapy, occupational therapy and speech therapy, as well as other rehabilitative care and treatment, may control costs, but it will hurt our citizens. And we don’t know if it will lower our auto premiums in the long run.

Past behavior is often indicative of future behavior. In 1998, then-Governor Engler stated on record that the MCCA assessment reduction should remain intact for years. The insurance industry proved him wrong soon after he left office. After the 3 year assessment reduction to $5.60, the annual assessment was again over $100 within four short years. Temporary insurance rate roll-backs are just that – temporary. In order to gain passage of HB 4612, there may be promises and commitments to reduce auto insurance rates for two years. But that is it. Indeed, there is nothing to say that these temporary reductions will not be more than made up for in subsequent years.

We all would like to see lower auto insurance rates in Michigan. Indeed, our friends in cities like Detroit and Flint are paying ghastly high auto insurance rates. However, real reform takes shape in detailed policy objectives that truly reduce accidents and auto theft and provide transportation alternatives for those who cannot afford safe vehicles with proper auto insurance. Such true reforms will thus reduce auto insurance claims, reduce the number of un-insured motorists on the road and reduce traffic accidents. “Saving” money by reducing care and quality and by decimating Michigan’s automobile no-fault insurance is not an option.

Related Posts: An Overview of the Personal Injury Process, Why You Should Report All Drivers On Your Car Insurance, No-Fault Insurance Change, One Step Closer to Justice for Grieving Family

Last week the Senate rushed SB 248 and 249 through the insurance committee. The bills were voted out of committee and passed by the Senate. These bills significantly affect our current automobile no-fault insurance system, including, most significantly, the Michigan Catastrophic Claims Association (CAT Fund). The bills have been sent to the House Insurance Committee. Obviously the plan is for these bills to be presented to the House of Representatives for their vote. WE urge you to contact your representative and tell them to VOTE NO on these bills.

Lets start by asking why are any changes needed to the CAT Fund based on the following FACTS:

Although the CAT fund system was devised by the insurance industry, make no mistake – it is the insured drivers in Michigan who always have and continue to fund that system – not the insurance industry. In other words, WE funded the catastrophic claims fund – not the insurance companies.

The fact is that WE all pay $145 per year per vehicle into the catastrophic claims fund. This adds 500 million dollars per year into the fund from these policy fees alone.

The increase in the money in the fund was 2.4 billion from 2010 to 2011 meaning that as of 2011 there was 13.8 billion dollars in the fund.

According to a recent report from a republican state senator who appeared on WJR promoting the use of the interest from the fund to pay for road repairs in Michigan, there is now 16.8 billion dollars in the fund. This represents a 3 Billion dollar increase in only three years without any changes or limitations on our system and in spite of the payments made on these claims which represent a minor portion of the no-fault claims in our state.

Quite simply, WE, meaning the insured drivers in Michigan, put the money in this fund. Therefore, when the benefits are paid to catastrophically injured accident victims, the benefits are being paid with our money – not the insurance company’s money. Their adjustors simply administer the claims and then they get every penny back from the CAT Fund. So why are they trying to change the system? MORE IMPORTANTLY, WHY ARE THEY ATTEMPTNG TO DISSOLVE THE CURRENT MICHIGAN CATASTROPHIC CLAIM ASSOCIATION WITHOUT STATING WHERE THE 16 PLUS BILLION DOLLARS THAT IS CURRENTLY IN THE CAT FUND WOULD GO? Because they are looking for a way to turn our money into their money at the expense of the relatively few catastrophically injured victims who desperately need this care and assistance. There is a cash grab going on here at the expense of our catastrophically injured citizens.

Furthermore, the consequences of these bills are not good for our state and most importantly, our citizens.

Insurance industry bills SB 249 and SB 240 are a clear confirmation that the auto insurance industry aims to effectively repeal Michigan’s model no-fault insurance system to line their own pockets. If these bills are enacted, the consequences would be dire:

• Reduced access to medical care -Trauma centers and clinics and smaller hospitals will close as a result of unfunded essential medical and rehabilitation services.
• Forcing injured people out of their homes and into Medicaid institutions. – drastic cuts and caps for critically-needed attendant care would make it all-but impossible for family members to provide care for loved ones, forcing them into higher-cost institutions. These bills would place a cap on payment for family attendant care payments of $15 per hour. Even worse, the bill would limit care to 24 hours per day, even when the injured individual needs, and has, more than one caregiver. This means that people who have been catastrophically injured in a collision, including paralyzed individuals, who need more than one round the clock caregiver to keep hem safe and care for them would only be reimbursed for one caregiver. Apparently they will be forced to find a second person who is willing to and who has the means to volunteer their time to be there to ensure their safety. Of course, if a paralyzed individual cannot find a second person to do this for free, there is no explanation for how they would be safely extracted from their home in an emergency. One must presume that the Senate and the insurance industry has decided that these people are expendable because, since we have no idea when things like a home fire will break out, it is now apparently ok to expose these people who choose to live at home to significant safety risks such as burning to death.
• Increased insurance premiums – these bills will result in the need for consumers to additional insurance coverage. Health care premiums would also increase due to a massive cost shift of health care coverage.
• Increased taxes – resulting from a massive cost shift from no-fault insurance to Medicaid and Medicare. Taxpayers could be on the hook for up to an extra $800 million dollars and at a time when our state is still recovering from a critical budget crisis.
• A loss of jobs – these bills will force the shuttering of medical facilities all over the state, and the firing of critically needed nurses and doctors and specialists. Michigan’s doctors and nurses and other care providers will be forced to leave the state to make a living. People would lose the closest and best medical care when they need it the most-after a catastrophic auto accident.

The insurance industry refuses to guarantee any premiums reductions, none at all. No benefit for the consumer. The best the insurance industry can offer is that there might be a small reduction in the mere 15% of the insurance premium related to these insurance bills, but they offer no guarantees of a reduction and no promise that rates won’t go back up again in a few months.

The losses to the policy holders are guaranteed however. Every driver in Michigan is required by law to buy auto insurance and will lose essential insurance benefits they are still forced to pay for under mandatory No-Fault. However, the state will lose medical care and jobs. The consumers will pay for these losses many times over in higher taxes and additional hidden insurance costs, and the industry will keep the money they have paid for coverage the Insurance companies will no longer provide.

asdWe are certain that most people who have a family member, loved one or friend who has been the victim of a catastrophic accident, such as former Republican Senator Jim Howell who, along with his wife, provides 24/7 attendant care to his son, would have no problem explaining that this bill would destroy their family unit. I am sure that Oakland County Executive L. Brooks Patterson would similarly explain, once again, why these changes are so harmful to injury victims.asd

Senator Rebekah Warren already told the Senate about her sister who was catastrophically injured in a traffic crash and the critical role the state’s insurance system played in her recovery. We have a number of similarly situated clients whose parents and family members would do the same thing given the chance.

With these facts in mind, it is clear that these ‘insurance welfare’ bills are bad for Michigan and WE URGE EVERYONE TO CONTACT THEIR HOUSE OF REPRESENTATIVES MEMBER AND TELL THEM TO VOTE NO ON THSES BILLS!

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We previously discussed the dangers of distracted driving. Recently, AAA released another study that suggests that falling asleep while at the wheel is also a more common danger than you might think.

In the study AAA found that 2 out of 5 drivers admitted to having fallen asleep or nodded off while driving. A staggering 26.6% of those questioned in the survey admitted to having been “so sleepy that they had a hard time keeping their eyes open” within the last 30 days. Even scarier, 41% explained that they had “fallen asleep or nodded off” while driving at some point.

The study also looked at accidents that occurred as a result of drowsiness or sleeping. It was estimated that 16.5% of fatal crashes involved a driver that was driving while drowsy. This study suggested a higher percentage than studies done before and suggests to me that this is something where more research is necessary.
This study was done to show just how prevalent this problem is. A study correlating sleeping and car accidents had not been done in 15 years. Instead, studies looking at speeding, drinking and driving and not using a seat belt have been more popular. Statistics like this suggest that perhaps we really need to be looking into the implications of sleeping while driving as a more common problem than previously thought.

Remember, in Michigan even if there is a single car accident, the driver (or anyone else injured) is entitled to make a claim for PIP benefits including Wage Loss, Replacement Services, Attendant Care and medical bills.

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As the law stands right now 90% of all slip and falls on another person’s property, commercial, private or otherwise, are not compensable. There is simply no liability. The growing concept known as open and obvious, expands to every hazardous condition that can be seen upon causal inspection, including the presence of ice and snow.

If you slip and fall on ice and snow, regardless of the condition or your injury you will likely have no cause of action. There is no duty by the premises owner to clean up the ice and snow in order to make it safe for public travel. However, there can be some exceptions to this law.

So, if you encounter snow and ice, even if the sidewalk is completely covered and you fall you will likely have no recourse for your pain and suffering and even payment of your medical bills. However, before making any decision give our experienced Attorneys here at SMDA a call for your free evaluation!

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If you were hit by an underinsured motorist, please note that you are not out of luck!
The plaintiff is allowed to recover from his or her own auto insurance carrier for the damages sustained in an auto accident with an underinsured driver. You will know when the at-fault driver is underinsured when your third party tort damages exceed the at-fault’s insurance policy limits.

A claimant entitled to underinsured motorist coverage insures himself or herself against at-fault drivers who carry only minimal third-party tort insurance coverage which is the statutory minimum $20,000 for one person/ $40,000 for more than one person when causing serious injury or death.

If this is the scenario, you are entitled to claim underinsured motorist coverage with your own auto insurance carrier! Your insurance carrier will then cover the difference between what is recovered from the at-fault driver’s auto insurance carrier and the policy limits of the underinsured motorist coverage of which you purchased with your policy.

If you were involved in a motor vehicle accident and the at-fault driver has coverage of the statutory minimum, call The Law Offices of Serafini, Michalowski, Derkacz & Associates to ensure that you recover your damages to the fullest amount possible!

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The Michigan No-Fault Act mandates insurance coverage as a prerequisite when registering your vehicle. However, many people choose not to insure their vehicle, thus are driving Uninsured. Michigan State Legislature ensures that the victims of a negligent uninsured motorist have a source of recovery for their third-party claims.

Michigan law requires minimum liability insurance coverage of $20,000 for one person and $40,000 for more than one person for bodily injury or death. However, many drivers secure their annual license plates by only paying the minimum amount of an insurance premium and then choose not to renew the next year, of which would cause their policy/coverage to lapse leaving them uninsured.

Uninsured Motorist coverage was designed to provide a source of recovery when uninsured motorists are at fault. Under this coverage, your auto insurance provider agrees to pay you the damages of which you would have been entitled to recover from the owner or operator of the uninsured vehicle if that person had been insured at the time of the accident, up to the uninsured motorist policy limits.

If you have been involved in an auto accident of which the at-fault driver was uninsured, remember that there are alternative routes. Call the law firm of Serafini, Michalowski, Derkacz and Associates for a FREE consultation and will be more than happy to speak to you about your rights!

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The Michigan No Fault law provides that if the motor vehicle involved in an accident is a parked vehicle, the injury will not be viewed as arising out of the ownership, operation, maintenance, or use of a motor vehicle unless one of the following 3 circumstances exists:

• The vehicle was parked in a way that caused an unreasonable risk of the injury that occurred.
• The injury occurred either as a direct result of physical contact with the equipment permanently mounted on the vehicle or while the equipment was being operated or used, or the injury occurred while property was being lifted onto or lowered from the vehicle in the loading or unloading process. OR
• The injury occurred while a person was occupying, entering, or alighting from the vehicle.

However, the parked vehicle exclusion does not apply in cases in which the injury occurred while maintenance was being performed on a motor vehicle or that arose from contact between a parked vehicle and a moving vehicle.

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When filing a No-Fault Complaint in Michigan, there are typically two main claims that arise. The injured has No-Fault rights between a claim against the no-fault insurer also known as a First Party Claim, and a claim against the negligent at-fault driver also known as a Third Party Claim.

A First Party Claim derives under contract law by an individual against their no-fault insurance carrier of which they are required to pay no-fault benefits to the claimant. These benefits include payments for medical expenses, wage loss, replacement services, survivor’s loss, medical mileage, or funeral expenses.

A third-party claim is the typical automobile negligence claim. In a third-party claim, a plaintiff sues the driver or owner of a vehicle, that resulted in serious injury. If the driver or owner of the vehicle has no-fault insurance, the injured person may bring a claim against the at-fault driver for noneconomic damages as long as the claimant’s injuries meet the threshold requirement of death, permanent disfigurement, or serious impairment of a body function.

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Work Loss Benefits are available to you following missed work due to your motor vehicle accident. Wage loss benefits are provided to replace lost employment income. This requires your first-party insurers to pay work loss benefits in the event of injuries causing disability from employment. The reason for this is to be compensate injured persons for the employment income that would have received if the accident had not occurred.

If you are temporarily unemployed at the time of your motor vehicle accident, work loss benefits are still available to you so long as you can show that you would have returned to work if the injury sustained in the accident had not occurred.

Keep in mind that when a claim is made for wage loss, you will be entitled to at least 85% of your income. Depending on the tax bracket you fall in, there is potential you may even receive 100% of your income! At SMDA, we will try very hard to maximize every dollar you are entitled to, call our office for a free consultation with one of our Auto Accident Attorneys!

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Michigan No-Fault law entitles an injured claimant to recover up to $20 per day in benefits during the first three years after the date of the accident. This is known as replacement services.

Replacement services are used to replace those services that the injured party used to do for himself or herself but can no longer do because of the injuries sustained in the accident.

Services generally include common household tasks such as cleaning, laundering, caring for the lawn, snow shoveling, household and vehicle repairs, shopping, and grocery shopping

However, Replacement Services expense are treated by the courts’ as reasonably incurred. These services can be provided by family members of which will be compensated for his or her services.

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The following are practical steps to keeping yourself and your family safe during the summer:

-LOOK TWICE FOR MOTORCYCLES:

Motorcycles are much more exposed to potential dangers so that most accidents result in death or very serious injury. They also happen to be the hardest to see. The glare of the sun can make them much harder to see. Check your blind spots to your left and right before changing lanes. Look twice for motorcycles coming at you from the opposite direction before turning left. It could save a life.

-BICYCLISTS AND PEDESTRIANS:

If you are getting ready to turn right at a stop light or pulling out of a driveway, always check the side walk to your left before moving your vehicle forward. Bicyclists and pedestrians are out during the summer and can approach your vehicle to your right very quickly. Your attention may be focused on to your left for a break in traffic or the roadway for a break in traffic. Do not forget to look up and down the sidewalks for bicyclists and pedistrians, which may by moving nearby.

-CONSTRUCTION BARRELS:

Slow down and pay attention to the construction signs. As a rule of thumb, traffic conditions can change quickly in a construction zone, so SLOW DOWN and leave extra room between you and the vehicle in front of you.

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If you are fortunate enough to have primary health insurance you and you are involved in an auto accident, you have the unfortunate responsibility of making sure you stay within your primary plan’s coverage zones and obtain medical care by providers who subscribe to your primary health care insurance plan. If you do not do this, your no-fault carrier may have a good reason to deny payment of those bills.

However, there are some exceptions to staying within your coverage plan. One of those exceptions would be if your primary health care plan does not provide for the specialty care or services needed in connection with your auto related injuries. This is an intricate analysis and usually involves injuries which are catastrophic.

If you have been injured in an auto accident and are faced with inadequate health care service choices call our office for guidance so that we can explore getting you the treatment that is reasonably necessary and not necessarily that which is connected to your primary health care plan. If faced with this type of scenario, you need an expert no-fault lawyer. Our office has lawyers who are expert no-fault attorneys who have dealt with these issues. We can help you get the treatment you need and make your recovery less stressful so that you do not have to maneuver the complicated no-fault law on your own.

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MICHIGAN HAS THE BEST NO-FAULT SYSTEM:

The purpose of the Michigan No-Fault System is to put an injured person in the position they would have been in had the accident not occurred. As a general rule, every person injured in an auto accident is entitled to the payment of certain no-fault benefits. This is true regardless of fault and even if you do not own your own automobile. Some of the benefits include; all reasonably necessary medical treatment for life, wage-loss, attendant care and chore services.

The benefits available in Michigan are unprecedented to any other no-fault system in the U.S. While you may be led to believe that our no-fault system results in higher insurance premiums, this is not true. Insurance companies have found ways to remain extremely profitable in Michigan, even in these extremely dark economic times.

No matter what the injury; from bumps and bruises, to traumatic brain injuries and quadriplegia, this no-fault system allows access to nation-wide, state-of-the-art medical treatment facilities for a person’s care, rehabilitation and recovery for an entire life-time. Statistically almost everyone will be involved in at least one auto accident within their lifetime. As a result, it is important to know about these important benefits if an auto related personal injury occurs.

If you are injured and do not make a timely claim, you could be forever barred from making a claim for injuries arising out of the accident. If you are involved in an auto accident and sustain personal injury, please do not hesitate: Call us first………Act second.

-Suzanne M. Kalka, Attorney -Specializing in aggressively obtaining the best no-fault benefits for the catastrophically injured.

TOP FIVE THINGS TO DO IF YOU ARE INVOLVED IN AN AUTO ACCIDENT:

1. Immediately, make a police report. (even if you have limited information).
2. Seek medical treatment, if you are injured. Follow your doctor’s advice.
3. If you own a motor vehicle, call your agent and report that you were injured. If you do not own a motor vehicle, contact our office and we will help get you started.
4. Get expert legal advice from an attorney specializing in Michigan No-Fault law. Do not assume that you are getting all the benefits you may be entitled to receive. Our firm specializes in obtaining no-fault benefits for individuals who sustain personal injuries arising out of auto related accidents.
5. Don’t wait. Move quickly, as you only have one year to make a claim and to get your bills paid.

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In 2006 the Michigan Supreme Court changed the law to limit children and incompetent people (like someone in a coma) from collecting No-Fault benefits from their own insurance company in the case of Cameron v Auto Club.

In a 4-3 ruling just issued by the Michigan Supreme Court, the Cameron decision was reversed. The Court found in Regents of the University of Michigan v Titan that the one-year-back rule for insurance claims has taken on new meaning for incompetents and minors. The one-year-back rule in MCL 500.3145(1) states that a claim for personal protection insurance must be brought within one year of an accident. The July 31, 2010 opinion in Regents of University of Michigan v. Titan Ins Co explains that the one-year-back rule in does not prevent a minor or incompetent from bringing suit when they reach the age of responsibility or become competent.

MCL600.5851(1) explains that incompetents and minors have one year from when the disability is removed to file a lawsuit. This means that a minor would have a year after their 18th birthday to file suit. These laws seem to conflict as to when someone can bring a claim against an insurance company and the Michigan Supreme Court now says that the law that deals with incompetents and minors is what ultimately governs.

In the 2006 opinion Cameron v. Auto Club Ins Ass’n, case the court changed decades of case law by saying that incompetents and minors were subject to the same one-year-back rule provisions as the general public. The court has now reversed that case and reinstated the previous law, which now means that under MCL 600.5851(1), incompetents and minors have one year from the date the disability is removed to file a claim.

The court has reinstated a standard that was good law in Michigan for at least 24 years before the Cameron decision. A rightful outcome when it comes to people like incompetents and minors who lack the capacity to know if they should be filing a lawsuit. Time is always critical when it comes to filing a lawsuit against an insurance company, contacting an attorney is always your best bet to make sure that your case is handled properly.

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