Michigan No-Fault Reform: Understanding Ongoing Benefit Disputes

The firm’s earlier commentary raised concerns about access to care and payment disputes following Michigan’s 2019 no-fault reforms. For an individual claim today, the useful next step is to identify the particular benefit, governing rules, and written reason for a denial or reduction.

Different disputes require different responses

A disagreement about a provider’s bill is not necessarily the same issue as a dispute over coverage, medical necessity, attendant-care hours, or a policy election. Keep the insurer’s explanation and the supporting records together. General criticism of reform cannot replace proof for the service being claimed.

Similarly, a provider’s statement that it will not accept a particular payment does not by itself establish what the insurer legally owes. Ask what service, rate, documentation, and legal provision are at issue.

Accident and policy dates can matter

The Michigan Supreme Court’s Andary opinion addresses the nonretroactive application of challenged restrictions to the vested contractual rights at issue. Do not assume every older and newer claim is governed identically.

For coverage elections, the state’s insurance FAQs provide background. The applicable statutory version and policy still need individual review.

Organize a disputed-benefit file

• The policy, relevant dates, claim number, and written coverage decisions.
• Provider orders, medical support, itemized bills, and service records.
• Requests for information and proof of each submission.
• Payments, reductions, formal denials, and proposed care agreements.
• A list distinguishing unpaid services from future services not yet provided.

Review an agreement before relying on it

An attendant-care or payment agreement can affect rates, hours, documentation, and other obligations. Read the actual terms and obtain advice about their effect rather than assuming a standard form resolves every future issue.

See attendant-care records and responding to a PIP denial. Our no-fault practice page covers representation in benefit disputes.

Talk with Logeman & Iafrate

Request a free consultation or call (734) 994-0200 to discuss your situation with our Ann Arbor office. Bring the relevant records and any insurer correspondence. Advice about your claim depends on the facts, coverage, and applicable deadlines.

General information only; this article is not legal advice for an individual case.

Does a general reform criticism prove my claim?

No. Identify the specific service, evidence, policy, and legal requirement.

Do all accident dates follow identical care restrictions?

Do not assume so. The dates and governing legal provisions require review.