Michigan No-Fault After Reform: Why Date of Loss Matters
Updated: 4 hours ago
The first question on any Michigan auto claim is not who the carrier is. It is when the accident happened. The date of loss decides which set of No-Fault rules applies, and that decides how much the provider can recover.
Before July 1, 2020: unlimited medical benefits
For decades, Michigan auto policies carried unlimited lifetime personal injury protection (PIP) for allowable medical expenses. For accidents before July 1, 2020, that is still the rule. A patient injured in 2018 can have lifetime coverage for reasonable, necessary care related to the accident.
The Michigan Supreme Court confirmed in 2023, in Andary v. USAA, that the reform's fee schedule does not apply to people injured before the reform took effect. For providers, that means pre-reform claims are paid at reasonable charges, not capped rates.
On or after July 1, 2020: the coverage level matters
The 2019 reform let drivers choose their PIP medical coverage. Policies now carry one of several levels:
Unlimited
$500,000
$250,000, with or without exclusions for people who have qualifying health coverage
$50,000 for people enrolled in Medicaid
An opt-out for people with Medicare Parts A and B
The reform also set a fee schedule for provider charges, tied to a percentage of Medicare rates for most services.
What this means for providers
Two patients with the same injuries can carry very different coverage. One may have unlimited benefits at reasonable charges. The other may have a $250,000 limit at fee-schedule rates, or no PIP medical coverage at all.
That is why every auto claim should start with three facts:
The date of loss
The carrier and claim number
The PIP coverage level on the policy
Get those right at the front end, and the provider knows who to bill, how much to expect, and when benefits may run out. Get them wrong, and the account can sit for months with the wrong payer.
MARS confirms date of loss, carrier, claim, and coverage level for Michigan providers, then follows each auto account through to payment. To talk about your auto accounts, contact Stacey Jewett at stacey.jewett@miautors.com or 248-846-8546.
This article is general information, not legal advice.
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