My firm handles many very complex Michigan N0-Fault Insurance claims for clients who suffered traumatic brain injuries, spinal cord injuries, and other catastrophic car and motorcycle accident cases.  A tremendous benefit that these injured clients can receive are  Medical Payment Benefits, which include prescription expenses. 

Attorney Daniel L. Buckfire in my office authored “The Ultimate Michigan Car Accident Handbook,” a book that explains the no-fault insurance laws in plain English.  His book has been called the “best book ever written for Michigan consumers on car accident cases.” The book has a great section on Medical Expense Payment Claims and I have pasted that section below for your review.  For a free copy of the book, just visit www.buckfielaw.com/getbook.cfm and fill out the request.  We will send it out right away for you.  answered. Our website also has free Michigan N0-Fault Insurance Forms that you can download for free if you wish to file your claims on your own with your insurance company.  In the meantime, you can call anytime to have your questions.

Type of Benefit

What do I do if the insurance company refuses to pay these benefits?

If your insurance company refuses to pay these benefits, your only recourse is to file a lawsuit against the company that demands payment for the benefits.

How much time do you have to file your lawsuit? 

If the claims are presented within one year but are not paid by the insurance company within one year of the date of expense or claim, it will be necessary to start a lawsuit within that one year period in order to protect your claim.  If you choose to begin a lawsuit against your insurance company for No-Fault benefits, you must file a lawsuit within ONE YEAR of the date on which the last unpaid No-Fault benefit was incurred.

If you fail to file your lawsuit within this one year period, you will lose the right to have the benefit or expense paid.

As you are approaching the one year anniversary of your car accident, and there are any outstanding claims that have not been paid by the insurance company, we recommend that you file a lawsuit prior to the one year anniversary of the accident.

Author Daniel L. Buckfire is recognized as a legal expert on Michigan Car Accident cases and the Michigan No-Fault Laws.  He frequently speaks to groups of lawyers and medical providers on these issues.  The firm website is www.buckfirelaw.com

       Under the Michigan No-Fault, law a person cannot sue a negligent driver for non-economic damages (pain and suffering etc.) unless his or her injury results in: (1) serious impairment of body function; (2) death; or (3) permanent serious disfigurement. MCL 500.3135.   In recent years, Michigan car accident victims have had their cases dismissed due in large part to the Michigan Supreme Court’s misinterpretation of the “serious impairment” element in this statute in Kreiner v Fischer, 471 Mich 109; 683 NW2d 611 (2004).  These cases have become known as “Kreiner Casualties” because many people with very serious injuries, (e.g. broken bones requiring surgery), have had their cases dismissed before they even get to a jury. 

            However, in Donovan v. Metro Plant Service, Inc., unpublished opinion per curiam of the Court of Appeals, decided March 6, 2008 [Docket No. 275373], the Michigan Court of Appeals reversed a trial court’s dismissal of  an injured person’s case involving a serious shoulder injury sustained in an auto accident.  The Court stated that Mr. Donovan’s injuries affected  his “ability to lead his normal life”  which is part of the test under the “serious impairment of body function” threshold.  In making this determination, the Court applied the standards set forth in Kreiner, supra and cleared up many of the inconsistencies in which Kreiner, supra has been applied. 

      In that case, Mr. Donovan required arthroscopic surgery after he injured his shoulder in an auto accident. After the surgery he underwent four weeks of physical therapy. In the one- to two-month period immediately after the surgery, he could not, work, drive, groom and dress himself, perform chores around the house and he was unable to raise his left arm more than six inches away from his thigh. He was generally unable to engage in normal daily activities or his usual routine. Further, he had to sleep in a reclining chair because he could not sleep laying flat. Also, he was also forced to rely on his fiancée, father, and friends to assist him with basic tasks associated with daily living, including the simple task of buttoning his clothes.             

      The Court held that these facts were sufficient enough to show that the impairment affected his “general ability to lead his normal life.”  Notably, the Court held that the No-Fault statute “has no express, and we believe no implicit, time component.”  This decision is important because it reaffirms that a period of impairment of short duration can satisfy the serious impairment test, if the impairment is extensive with respect to the limits it places on an injured persons life.   In this regard the Court stated that “the course or trajectory of a person’s life can be affected, if even momentarily, by a devastating, yet short-lived impairment…”       

This well written decision is a much needed victory for persons injured in auto accidents in Michigan, because it clarifies prior misinterpretations and misapplications of the No-Fault Statute and the Kreiner, supra. decision.

On February 19, 2008, the Michigan Court of Appeals issued a unanimous, published opinion, holding that a child’s injury claim against her insurance comapny is not time barred. In  Klida v. Farm Bureau Ins. et al., ___ Mich App. ____, ___ NW2d___   (2008) the Court held that the Michigan statute which tolls the time limitations period until a minor’s 19th birthday (MCL 600.5851), applies to all civil claims, including claims based on statute, common law, or contract.

 In Klida, supra the plaintiff, Katie Klida, was seriously injured in a Michigan car accident when she was fifteen years old. At that time, she was insured under an insurance  policy with the Defendant Farm Bureau Insurance Co. which provided coverage for underinsured motorist benefits (insurance benefits that cover an injured person when they are injured by someone who’s liability insurance coverage is inadequate to fully compensate the person for his or her injuries).

Shortly after the Katie’s 18th birthday, she brought a lawsuit against Farm Bureau to recover underinsured motorist benefits. Farm Bureau filed a motion to dismiss her case, arguing that her claim was untimely because of a one-year limitations provision in their insurance contract. The trial court held that Katie’s claim was protected by the one-year tolling provision of §5851, and denied Farm Bureau’s motion to dismiss.  Farm Bureau appealed and the Michigan Court of Appeals held that the trial court properly concluded that Katie’s claim was timely.The Court held that the purpose of statutes tolling the period of limitations for persons to whom a legal disability is attributed “is to allow protected classes of persons an opportunity to be made whole once their disabilities have been removed.”The Court was mindful of the law which holds that contracts should be interpreted according to their plain terms. However, the Court eloquently stated that: 

 “[C]ontracts may also not grant a right and then burden that right with a condition that cannot be met. Minors whose right of action accrues and expires, without legal proceedings, while they are laboring under their disability are permanently precluded, through no fault of their own, from exercising their legal rights under the contract in violation of the clear public policy that such minors are to be protected.”

            The Klida, supra decision is an intellectually honest and cogent opinion that protects the rights of injured children and incapacitated adults, while at the same time adhering to the tenets of statutory interpretation.  The lawyers at Buckfire & Buckfire P.C.  handles Michigan car accident cases involving these types of issues.  Please feel free to contact us to discuss your case.

At one time or another, all of us have purchased a rental car while on vacation, on a business trip, when our car is being serviced, etc..  Some rental car companies charge an extra fee if more than one person will be driving the car, such as a spouse. It is very important that all persons who will be driving the car, be listed on the rental agreement.  This is because in many situations, if the car is involved in an accident, only those persons listed on the contract will be insured. 

A recent Michigan Court of Appeals decision, Robinson v. Titan Ins. Co, unpublished opinion per curiam of the Court of Appeals, decided February 7, 2008 [Docket No. 275360] should act as a warning to all consumers that every person who drives a rental car should be listed on the rental contract. In that case, the Plaintiff went to rent a car. After filling out the paperwork, the rental agent informed him he had to place a deposit on the vehicle with a credit card. The Plaintiff advised that he did not have a credit card, but his friend, who had driven him to the rental facility, did. The Plaintiff’s friend came into the rental facility and, using her credit card, filled out the rental paperwork for the vehicle in her name.  The Plaintiff was not named on the rental contract.  However, the rental company knew that the Plaintiff was going to be the primary driver and handed him the keys.  The Plaintiff thereafter left the rental facility, driving the rental vehicle.  A few days later, the Plaintiff was involved in an accident with an uninsured motorist and was seriously injured. Following the accident, the Plaintiff made a claim for uninsured motorist benefits with his insurance company, Titan Insurance Co. Titan denied the claim, arguing that because the Plaintiff was not listed on the rental agreement, he was driving the rental car without the permission of the Rental Company. Thus, Titan argued that he was not covered under the insurance policy.

Fortunately for the Plaintiff,  the trial judge, and the three judges on the Court of Appeals’ panel, looked beyond the rental contract and held that the Plaintiff’s case against Titan should not be dismissed. The Court held that a jury should decide whether the rental company gave the Plaintiff verbal permission to drive the car.

Although the Plaintiff in Robinson, supra will have his day in Court, the result could have been very different depending on the facts. Moreover, there is no guarantee that the jury will agree with Mr. Robinson’s argument and find in his favor. Also, this issue (and the trouble and expense of litigating it) could have been avoided if the Plaintiff had only been listed as a second driver on the rental contract. 

Too often, people are seriously injured in auto accidents in Michigan and are denied certain rights and insurance benefits because of innocent mistakes like the one in Robinson, supra.  Even if there is an extra charge to list a second driver on a rental car contract, it is better to pay the fee than to run the risk of being deemed uninsured and liable for much greater costs in the event an of an accident. This is because, when it comes to reviewing claims, there is no such thing as a harmless “technicality” from an insurance company’s perspective .

A recent Michigan Court of Appeals case upheld the award of attorney’s fees in a No-Fault Insurance case.  The case was tried before a jury by Daniel Buckfire and the appeal was written by Thomas Economy, both members of the law firm of Buckfire & Buckfire, P.C.In Tillman v. State Farm, unpublished opinion per curiam of the Court of Appeals, decided January 24, 2008 [Docket No.  271702].  Our client suffered a torn rotator cuff and other injuries in a West Bloomfield, Michigan car accident.  Her own insurance company at the time was State Farm Insurance Company.

State Farm refused to pay for medical expenses and loss wages due to the rotator cuff tears in the Plaintiff’s right and left shoulders. State Farm claimed that the injuries were not related to the accident.   Our firm sued State Farm on behalf of Ms. Tillman. At trial, Daniel Buckfire obtained a verdict in favor of the Plaintiff in the amount of $39,552.00 (plus interest and costs) for medical expenses, wage loss benefits an no-fault penalty interest. Following trial, the court awarded the Plaintiff an additional $30,250.00 in penalty attorney fees under § 3148 of the No-Fault Act. State Farm appealed the decision arguing that the denial of Plaintiff’s No-Fault benefits was not unreasonable because there was a “bona fide dispute” as to the nature and extent of the Plaintiff’s injures. Thomas Economy handled the case on appeal for the Plaintiff.            

The Court of Appeals held that the trial court was correct when it awarded the Plaintiff attorney fees under MCL 500.3148 of the Michigan No-Fault Act (MCL 500.3101 et seq.)  The Court disagreed with the Defendant, and found that State Farm did not attempt to resolve the contradictory opinions of Plaintiff’s doctors and the doctors hired by State Farm to examine the Plaintiff. 

In addition, the Court held that it was improper for an insurer to deny coverage when the insurer knew, or should have known, that the opinion of its doctors was based on an inaccurate or incomplete review of plaintiff’s medical records, which were also in the insurer’s possession. Further, the Court noted that State Farm’s adjuster made no effort to reconcile the conflicting medical reports in plaintiff’s records. Moreover, at trial, defendant’s adjuster demonstrated a very limited understanding of plaintiff’s medical condition, including how and where rotator cuff injuries occur or how they are diagnosed. Based on the forgoing, the Court found that State Farm acted unreasonably when it denied Plaintiff’s no-fault benefits.

This case is a perfect example of an insurance company accepting premiums and issuing a policy, but then refusing to pay the benefits that were promised in the policy.  The award of attorney’s fees is necessary in these cases because the insurance companies would have nothing to lose by denying every claim if they could not be penalized for improperly denying claims.