What injury information must be in an application form for Michigan Car Insurance Benefits

Michigan Auto Law

Court rules that a car accident victim’s Michigan insurance application must describe the nature of the injury, which may include symptoms traceable to an injury

Every person injured in a car accident in Michigan who will be filing a claim through his or her No-Fault insurance must submit an application for Michigan car insurance benefits. But just how specific must the injury information be in that No-Fault application for benefits?

The answer to this question about the Michigan auto No Fault Law’s “notice of injury” rule has long been a thorny issue for auto accident victims — and for the car accident lawyers who help them.

The law hasn’t always been clear on how specific personal injury information must be. Insurance companies have exploited and continue to fight over alleged “insufficiencies” in car accident victims’ notices to avoid paying PIP (personal injury protection) benefits.

What is Michigan’s Notice of Injury Rule?

Under the “notice of injury” rule, an auto accident victim must provide “notice” to his or her auto insurer of the “injury” for which he or she may seek No-Fault benefits. This “notice” or “application” must be filed within one (1) year of the crash or the victim will forfeit the right to collect benefits and will be barred from suing for them. The Michigan Supreme Court issued an important and unanimous ruling about this crucial, often-controversial No-Fault procedural issue.

In Dillon v. State Farm Mutual Automobile Insurance Company, the Court ruled:

A car accident victim cannot satisfy the No Fault law’s notice-of-injury rule “by merely providing notice that she was physically injured.”

The rule’s requirement that the victim “indicate in ordinary language the … nature of his injury” “refers to an injury’s inherent characteristics.”

“A description of symptoms that are traceable to a diagnosed injury is sufficient to constitute” the “notice” required by the No Fault law.

No Fault “does not require” a victim “to provide a precise medical diagnosis, as this would not constitute ‘ordinary language.’”

In so ruling, the justices in Dillon tweaked the Michigan Court of Appeals holding (when it was deciding the case) that a car crash victim “can satisfy the [No Fault Law’s notice-of-injury rule] by merely providing notice of a physical injury” — without “demand[ing] anything more specific” about the injury or injuries.

As explained below, what’s even more intriguing for Michigan auto accident attorneys who are reading the Supreme Court’s ruling weighing in on the “notice-of-injury” rule’s specificity

requirements is the justices’ practical application of their interpretation.

How did the Court determine whether a hip injury was covered by a victim’s application for Michigan car insurance benefits?

In Dillon, State Farm tried to get out of paying No Fault benefits for Jessica Dillon’s hip injury by claiming it wasn’t specifically identified as an “injury” in her application for Michigan car insurance benefits — which she provided to State Farm more than two years before claiming benefits related to her hip injury.

Based on its interpretation that the No-Fault law’s “notice-of-injury” rule does not require an auto accident victim to “identify the specific injury for which the insured later seeks coverage,” the Court of Appeals in Dillon concluded the victim’s application for Michigan car insurance benefits covered her hip injury and, thus, State Farm had to cover it.

However, once the case reached the Michigan Supreme Court, the justices unanimously voted to “vacate that part of the Court of Appeals judgment analyzing MCL 500.3145 and concluding that a claimant can satisfy the statute by merely providing notice of a physical injury.”

But — and this is the intriguing part for Michigan auto lawyers — the justices agreed with the Court of Appeals that the victim’s hip injury was covered by the application for Michigan car insurance benefits and, thus, No-Fault PIP benefits were still owed:

“[A]fter being involved in a motor vehicle accident, the claimant provided timely notice of injuries causing pain to her left shoulder and lower back.”

“Years later, the claimant sought treatment for an injury to her left hip that, according to the jury, was caused by the same accident.”

“Because, as the claimant’s doctor pointed out, the hip injury could have created the lower back pain, her initial notice can be traced to the eventual injury and was sufficient for the purposes of MCL 500.3145(1) …,” i.e., the No-Fault Law’s notice-of-injury rule.

How does Michigan’s notice of injury rule apply to an application for Michigan car insurance benefits?

Michigan’s No-Fault insurance law has the following “notice of injury” rule that applies to a victim’s application for Michigan car insurance benefits:

A victim must provide a “written notice of injury … to the insurer within 1 year after the accident” in order to preserve his or her right to sue for unpaid No Fault auto insurance benefits.

So long as the “written notice of injury” is given to the auto insurance company within a year of the accident, a lawsuit for unpaid No-Fault benefits can “be commenced at any time within 1 year after the most recent allowable expense, work loss or survivor’s loss has been incurred.”

The “notice of injury” must include “the name and address of the claimant and indicate in

ordinary language the name of the person injured and the time, place and nature of his injury.” (MCL 500.3145(1))

It is important to remember that in order to receive benefits under Michigan’s auto law after a crash, you must: (1) file your application for Michigan car insurance benefits within one year of your auto accident; and (2) describe the “nature of your injury,” which may consist of a “description of symptoms that are traceable to a diagnosed injury”

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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