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Your Rights

With rising medical care costs and increased use of managed care, more
and more insurance companies are implementing procedures designed to
decrease the costs of PIP benefits to the insurance company.
Often these insurance company procedures mislead injured persons into
believing that they have to settle for less than ideal medical treatment in order
to “qualify” for PIP benefits. The Michigan No Fault Law does not require an
injured person to use managed care cost saving procedures suggested by
the insurance company. The Michigan No-Fault Law is clearly a fee-for-
service system and not a managed care system.
Many insurance companies are using what they call case managers to
“assist” injured persons in coordinating treatment and benefits. Occasionally,
case managers provide beneficial expertise; however, they are most often
attempting to decrease costs for the insurance company. The No-Fault law
does not require preauthorization for selection of certain doctors or treatment.
Insurance companies cannot force injured persons to use the insurance
company’s “approved” doctors or “approved” treatments. Additionally, by
law, an injured person does not have to use a case manager or disclose
any confidential medical information to a case manager despite what an
insurance company may claim.
PIP benefits are required to be paid by insurance companies as long as they
are (1) necessary, (2) needed because of the motor vehicle accident, and
(3) generally reasonable. MCLA 500.3105, 500.3107.
An injured person experiencing difficulties with an insurance company in
regards to selection of doctors, treatment, or payment of PIP benefits should
contact an attorney. The Michigan No-Fault law provides for payment of
attorney fees for an injured person who has been wrongly denied the
benefits to which he or she is entitled under the law.