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You are Involved in a Michigan Auto Accident – Who Pays My Medical Bills?

Being involved in an automobile accident is scary enough.  The pain and mental anguish that goes along with being injured can be overwhelming.  Another major source of stress for victims of auto accidents in Michigan is the stress associated with the payment of the medical bills from the accident.  Some of the common medical costs associated with automobile accidents include:

Ambulance or Emergency Medical Services

The emergency services at the scene of the accident and the accompanying ride to the hospital usually costs between $350 to $3,000 depending upon the circumstances of the injury and the proximity of your accident to the hospital.

Emergency Room

Your trip to the emergency room will likely cost at least $1,750.

In-patient Hospitalization

This category of post-accident services can be one of the most expenses with daily rates averaging $3,000 per day to over $50,000 per day for Intensive Care Unit treatment.

Surgery

Another highly expensive and highly variable cost associated with an automobile accident is surgery.  The amount of the cost of the surgery will depend on the length of the surgery, the use of objects that may be installed to stabilize your injuries and the number of other medical professionals needed during the surgery.

Who Will Pay My Bills From My Automobile Accident?

Michigan is a no-fault insurance state.  That means, generally, that your auto insurance will cover the cost of your medical bills from the accident.  Medical expenses, under Michigan law, are called “allowable expenses” pursuant to MCLA 500.3107.

Allowable expenses are benefits payable under MCLA 500.3107(1)(a) of the statute and are considered to be the principle benefit under the Michigan no-fault system.  However, since the major Michigan no-fault law change of 2019/2020, Michigan has gone from an unlimited lifetime medical benefit system to a capped and limited medical benefit system.

In Michigan you have been given a choice as to the amount of medical benefits you can purchase from your auto insurance company.  You can choose to keep the previously mandated “unlimited” medical expenses option.  Or, you can choose as little as ZERO medical coverage as long as you can show proof that your auto accident related injuries would be covered by your regular personal medical insurance policy.

Please look to your declarations or coverages page of your auto insurance policy to find out what level of coverage you purchased.

What Medical Bills Will Be Considered by My Auto Policy?

Michigan Law: “Section 3107(1)…..personal protection insurance benefits are payable for the following: (a) allowable expenses consisting of all reasonable charges incurred for reasonably necessary products, services, and accommodations for an injured person’s care, recovery and rehabilitation.”

The standard that is usually mentioned when bills are being considered by an auto insurance company is whether or not the bills are “reasonable, necessary and related to the auto accident at issue”.

The question of whether a bill is “reasonable” is now less controversial since the passage of the 2019/2020 no-fault law change.  Now, certain fees schedules and caps must be adhered to for auto accidents that occurred AFTER July 1, 2020.  There are now limits on costs for certain procedures and services that are normally associated with automobile accidents.  Therefore, the amount your insurance company can be billed is now less “at issue”.

Whether or not an incurred medical bill is “necessary” is a battle that is often waged by insurance companies.  They will insist, and THEIR doctor (commonly known as an Independent Medical Examiner or “IME”) has the final say as to whether or not a bill is “necessary”.  This IME doctor will be paid to opine that your injuries are not related to the auto accident and are, instead, related to a pre-existing condition or related to your age.

The question of whether or not a bill is “related” to the automobile accident is one of the most litigated issues in the no-fault system. It is imperative that your bills must be related to the automobile accident in order to be paid.  Some situations are obvious (a broken arm following an accident).  Some situations are less obvious (aggravation of pre-existing conditions).  You can usually count on two things.  First, your doctor will likely relate your injuries to your recent automobile accident….after all, you did not have this condition before the accident or your condition has been made substantially worse by the automobile accident.  Second, the doctor hired by the insurance company (the Independent Medical Examiner) will likely find that your injuries are not related to the automobile accident.  Thus, the controversy over the payment of your medical bills will exist.

The insurance company will seek every avenue they can to deny your claim thereby denying payment for the medical bills that you incur as a result of your automobile accident.  As a result, you may be stuck with a mountain of unpaid medical bills that you cannot pay.  Unpaid medical debt accounts of 66% of all personal bankruptcies (spendmenot.com).  At Femminineo Law, we fight the insurance company and we stand up for what we know is right.  We will make sure that your medical bills are paid and that you get the care and rehabilitation necessary to help you recover following your accident.