[fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][fusion_text]If an individual is injured in a Michigan car accident, that person is entitled to Michigan no-fault benefits. These benefits include the payment of medical expenses (Including hospital bills, rehabilitation and doctor’s bills), lost wages (85% of gross wages), reimbursement for prescriptions, medical mileage and other benefits.
However, most car insurance companies will require the claimant complete what’s called an Application for Benefits. Under the law, a claimant must provide notice of a claim for no-fault benefits – also known as PIP benefits – within one year from the date of the accident. Usually, this will be accomplished through the Application for Benefits.
Although there is no standard Application for Benefits, and most insurance companies have their own form, most applications are very similar.
It is important to complete these forms accurately. Insurance companies will often use inconsistencies against you later on to deny benefits or to terminate all benefits all together. As a result, it is important to contact an experienced no-fault Michigan car accident lawyer to help you complete the application.
However, in this article I will go through a typical Application for Benefits and describe how to complete the form.
General Section:
The first section of most Applications for Benefits asks for background information. Make sure you complete these general questions, including where it asks for a current address, date of birth, phone number and social security number.
Next, the application will ask for information about the car accident itself. Give the date and time of the accident and approximate location.
Where it asks for a brief description of the accident, do not provide a full narrative on how the accident occurred. Instead, simply write: “see enclosed police report.” Make sure you include a copy of the police report prepared following the accident with the application. This will give the insurance company a complete explanation of how the accident occurred.
Next, it will ask for the motor vehicles owned by you, your spouse or a relative living with you on the date of the accident. This is very important – make sure you include ALL vehicles; even a vehicle was not insured or operating at the time of the accident. Include the name of the owner, license plate number, insurance carrier and policy number. Again, don’t forget to include all vehicles.
Medical Section:
After that, the application will ask for all injuries resulting from the car accident. Again, make sure you include ALL injuries for all parts of the body. Forgetting to include neck pain or right leg weakness can result in the insurance company declining to extend benefits for treatment related to those injuries at a future date.
The next section deals with medical treatment. Include the names and addresses of the doctor and/or hospital you visited following the accident. Where it asks if you expect to have more medical treatment, always answer yes. You never know what the future brings and it’s better to be safe than sorry. Include your health insurance information, whether it is a private plan (Blue Cross/Blue Shield, HAP) or government plan like Medicare or Medicaid.
Remember, Medicare or Medicaid don’t pay for auto accident related medical treatment. But the car insurance company is still entitled to know what health insurance you have.
An important box asks whether or not you “have received any medical treatment for the same or similar symptoms prior to the accident?” It is important to be accurate here. If you are reporting low back pain from the accident, and you treated for low back pain before the accident, mark “YES.” If you are inaccurate in this box, the insurance company will not find you credible and use it as a reason to decline benefits in the future.
Lost Wages:
The next section deals with lost wages. If you were employed at the time of the accident, write down the name of your employer, work address, occupation and start date. Include your weekly salary or hourly wage rate and weekly hours worked. If you were working at the time of the accident, make sure you state so because your claim may be covered under a worker’s compensation claim rather than a no-fault claim.
Also, don’t forget to include when your disability from work began. Often this is the date of the car accident. If you are still off-work when completing the application, include that information in the application.
IMPORTANT NOTE – although most Applications for Benefits don’t ask for proof of lost wages, it is a good idea to include a few pay stubs from the time of the car accident when sending back the application to the car insurance company. That way they have proof of how much you were earning at the time of the accident and will speed up the payment of your lost wages.
Expenses:
Last, there is a small box that asks a very important question – “As a result of your injury, have you incurred any other expenses, such as transportation costs or expenses you would have performed for yourself or your dependents?” This section is asking if you have incurred out-of-pocket expenses, transportation costs (medical mileage), replacement services (household chores completed by friends or family) and/or attendant care.
In almost all cases, this box should be marked “YES.” Almost inevitably you will have at least some out-of-pocket costs following a car accident. Again, it is better to error on the side of caution.
When answering this question for the application, be brief. There is no need to give an entire narrative as to what expenses you have incurred. Remember, this is just an application and the insurance will require more proof to pay these benefits anyway.
At the end, make sure you sign and date the application where it asks you to do so. On some applications, you will be asked to sign and date 3 different times. Make sure you do this. The last two signatures are authorizations allowing the insurance company to order your medical records and obtain wage loss information. This is fine and granting the insurance company the right to obtain this documentation will speed up the benefit process.
The Application for Benefits is an important document. Completing it accurately is very important to ensure the claimant receives the benefits he or she is entitled to in a timely and efficient manner.
If you or a loved one has a question about filling out the Application for Benefits, please call the Michigan no-fault lawyers at the Lee Steinberg Law Firm, P.C. The call is free and we will walk you through the process. There is no fee unless we win your case. Call us at 1-800-LEE-FREE (1-800-533-3733).[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]
