Michigan No-Fault PIP Benefits Dispute Attorney

Michigan’s no-fault system is supposed to pay for your medical care and a share of your lost wages after a crash, no matter who caused it. Often it works that way. But when the bills get large, insurers start to push back. They delay payments, send you to their own doctor to justify a cutoff, and deny treatment that should be covered. You are left fighting your own insurance company while you are still trying to heal.

Our auto-accident attorneys represent injured people in Livonia and across Michigan in disputes over personal injury protection (PIP) benefits. We have seen how carriers build a denial, and we know how to take it apart with medical records, your treating doctors’ opinions, and the no-fault act. If your benefits have been reduced or shut off, that decision is not the final word.

What PIP Benefits Cover

PIP benefits are the first-party, no-fault benefits payable after a motor vehicle crash, regardless of fault. Under the no-fault act, they can include reasonable and necessary medical treatment, 85% of the wages you lose because of your injuries for up to three years, attendant care, replacement services, and mileage to medical appointments.

The dollar figures are specific, and they change. Wage-loss benefits are capped at a monthly maximum that the Michigan Department of Insurance and Financial Services (DIFS) sets each year; for accidents in the period October 1, 2025 through September 30, 2026, the maximum is $7,201 per 30-day period. Replacement services, the help you need with tasks like cooking and cleaning that you can no longer do, are limited to $20 per day for the first three years. If you were between jobs when the crash happened, you are not automatically shut out: the law lets a “temporarily unemployed” person base wage loss on earnings from the last month worked full time. And if a crash is fatal, surviving dependents may be entitled to survivor’s loss benefits. Insurers do not always volunteer the full amount the law allows, so the current numbers matter.

Who Actually Pays Your PIP Claim

People assume their own auto policy always pays. Sometimes it does not. Michigan’s priority rules under MCL 500.3114 decide which insurer is responsible, and the answer depends on the facts: your own policy, a resident relative’s policy, or, for many passengers, pedestrians, and people with no available coverage, the Michigan Assigned Claims Plan. The Assigned Claims Plan pays PIP benefits when no other policy applies, but its medical coverage is capped at $250,000. Figuring out the right insurer early prevents a claim from being bounced between carriers, each pointing at the other.

How the 2019 Reforms Changed the Stakes

The 2019 amendments reshaped these cases. Drivers now choose a level of PIP medical coverage when they buy or renew a policy. There are six options: unlimited, $500,000, $250,000, a $250,000 level with PIP medical exclusions for those with qualifying health coverage, a $50,000 level for certain Medicaid recipients, and a full opt-out reserved for people with qualifying Medicare. If a driver makes no selection, the policy defaults to unlimited coverage. That choice governs PIP medical benefits and can decide how much is available after a catastrophic injury, which is why we review your policy declarations at the start of every case.

The reforms also creatd a medical fee schedule for treatment rendered after July 1, 2021. It limits what providers can be reimbursed, with many services tied to a percentage of Medicare rates and other formulas for care Medicare does not cover. The resuelt is a steady stream of disputes over how much a provider is owed and whether care can continue when reimbursement is cut.

The accident date is the first thing we check. In Andary v. USAA (2023), the Michigan Supreme Court held that the fee schedule and the cap on family-provided attendant care do not apply to people injured before the reforms took effect on June 11, 2019. If your crash predates that date, an earlier and often more generous version of the law may control your benefits.

Why Insurers Deny or Cut Off Benefits

Most denials use a handful of familiar moves. An insurer may argue treatment is not reasonable or necessary, send you to a medical examination with a doctor it selected, and use that report to stop paying, dispute your wage-loss documentation, or claim a coordination-of-benefits issue with your health insurer. Whether your health plan is coordinated or uncoordinated, and whether it qualifies as health coverage that covers auto injuries, can change who pays first and how much.

Attendant care is a common flashpoint. When a family or household member provides in-home care, the no-fault act limits the insurer’s obligation to 56 hours per week, even if a doctor orders round-the-clock supervision, unless the insurer agrees to pay for more. That cap applies to care by relatives, household members, and people with a prior relationship to the injured person; professional agency and facility care are treated differently. For pre-reform injuries, Andary may mean the 56-hour cap does not apply at all. Families often discover these distinctions only when a payment arrives far smaller than expected.

It is worth being precise about what an insurer actually cuts. It terminates payment of benefits, not your medical treatment. Your provider may stop treating you because the bills go unpaid, but the underlying care is still necessary, and the insurer’s refusal can be challenged with supporting medical proof.

First-Party Benefits and a Separate Injury Claim

PIP is your first-party claim against an auto insurer. It is not the same as a third-party claim against the driver who caused the crash. The two often run together. When your losses exceed what PIP pays, for example, wages above the monthly cap or beyond three years, that excess economic loss and your pain and suffering may be pursued against the at-fault driver if your injury meets Michigan’s serious-impairment threshold. We look at both tracks so nothing is left on the table.

The Deadlines That Can End Your Claim

No-fault claims carry firm deadlines. You generally must give your insurer written notice of injury within one year of the crash, unless the insurer has already paid PIP benefits for that injury; miss that, and a lawsuit for benefits can be barred. A separate rule, the one-year-back rule, limits how far back you can recover: you generally cannot collect benefits for expenses incurred more than one year before you file suit.

A 2019 change to MCL 500.3145 pauses the one-year-back period from the date you submit a specific claim until the insurer formally denies it, but only if you pursue the claim with reasonable diligence. And the Michigan Supreme Court held in Spine Specialists of Michigan v. MemberSelect Insurance Co. (2025) that this tolling provision does not apply retroactively to claims that accrued before the amendment. These are different clocks with different triggers, and a single missed deadline can quietly erase benefits you would otherwise recover. That is the practical reason to talk to a lawyer early.

How Vahdat Weisman Law Pursues Your Benefits

We build PIP claims on evidence. We gather your medical records and your treating providers’ opinions on why care is necessary, and we document wage loss with pay records, tax returns where needed, and employer statements. Then we present the insurer with organized proof of each loss, because the no-fault act makes a benefit “overdue” if it is not paid within 30 days after the insurer receives reasonable proof.

That standard gives us leverage. Overdue PIP benefits carry simple interest at 12% per year, and when an insurer unreasonably refuses or unreasonably delays payment, a court can order it to pay your attorney fees on top of the benefits. We pursue the benefits your policy and the law support, along with that interest and those fees where the facts justify them. From our Livonia office, attorneys Jordan S. Vahdat and Kara E. Weisman handle these disputes for clients throughout Metro Detroit and the rest of Michigan, on a contingency-fee basis, so there is no attorney fee unless we recover for you.

Frequently Asked Questions

• What are PIP benefits? Personal injury protection benefits are the no-fault benefits an auto insurer pays after a crash, regardless of fault. They cover reasonable medical care, a portion of lost wages, attendant care, replacement services, and mileage to medical appointments.
• Can my insurer really cut off my treatment? An insurer can stop paying, often after a medical exam it arranged. That is not the last word. With opinions from your treating doctors, a cutoff can be challenged.
• What is the one-year-back rule? It generally limits recovery of no-fault benefits to expenses incurred within one year before you file a lawsuit, so waiting can shrink what you can collect.
• How much can I recover for lost wages? No-fault pays 85% of the income you lose because of your injuries for up to three years, capped at a monthly maximum DIFS sets each year. For accidents in the October 1, 2025 to September 30, 2026 period, that maximum is $7,201 per 30-day period.
• What does it cost to hire you? Nothing upfront. We handle no-fault PIP disputes on a contingency-fee basis, so you owe no attorney fee unless we recover benefits for you.

Why Injured Michiganders Trust Vahdat Weisman Law

Vahdat Weisman Law is a personal injury firm based in Livonia, Michigan, representing injury victims and their families across the state. Our attorneys, including Jordan S. Vahdat and Kara E. Weisman, bring courtroom experience, a record of meaningful results, and a hands-on approach to investigation and case strategy. We prepare every matter as if it will go to trial, which positions clients for stronger settlements and protects their rights if litigation becomes necessary.

We handle a no-fault PIP benefits dispute on a contingency-fee basis, which means there is no attorney fee unless we recover compensation for you. From our Livonia office, we serve clients throughout Metro Detroit and the rest of Michigan, and we explain every step in plain language so you can make informed decisions about your case.

Speak With a Michigan Personal Injury Lawyer

If your no-fault PIP benefits have been denied, delayed, or cut off, contact Vahdat Weisman Law in Livonia today at
(734) 469-4994 for a free, confidential consultation. Reach out through our contact page to tell us what happened and learn about your options. There is no cost to speak with us about your potential claim.

Disclaimer: This information is for educational purposes only and does not constitute legal advice. Every case is unique, and prior results do not guarantee future success.