Michigan auto insurance is fast changing. Because of the new no-fault law in Michigan, there are now different questions that people have about the law as well as how it applies to them and their scenario.
Here at Haque Legal, the goal of our Southfield car accident attorneys is to make sure that our clients and potential clients know every bit of information as they come. With that, we have created this article to help answer some burning questions that you may have about the no-fault coverage versus other health plans debate in Michigan.
What does coordination mean in the first place?
As we have discussed in another article, coordination is the term used to show that there is proper communication between two insurance companies – mainly one that is your health plan and the other that is your no-fault accident insurance.
When two insurance providers coordinate, the ultimate payer of the insurance proceeds would be the primary payer. This is often the health insurance that you get. The secondary payer is your no-fault insurance coverage.
Who is required to make the “coordination of benefits”?
According to the Michigan auto insurance law, it is the car accident victim, or his legal representative, who can claim the coordination of benefits. You must make reasonable efforts to seek the payment of your medical expenses through the health insurance company first before the no-fault auto insurance company.
If you have been in an accident, it can get frustrating for you to try and make the coordination while you are recuperating. With that, you must get a lawyer who can help you do the reasonable efforts required of you to show that there is indeed a medical necessity for the health insurance to pay for your medical bills.
What happens when the coordinated insurance providers do not want to pay?
If you want to get your claims properly addressed, in case of dispute, you should get a lawyer who can help you file your complaint and get the insurance proceeds that you are looking for. Make sure that you will always get the right lawyer who will listen to you and your needs. What specifically is the problem that you are facing? What can the lawyer do to help you out?
Here at Haque Legal, we listen to your problems and make sure that you hear out the solutions that we have to offer.
Coordinated No-Fault Coverage and ERISA Health Plans
You may have some questions about the application of the no-fault coverage coordinated benefits clause to your ERISA Health Plans, let us look at them one by one.
Will my No-Fault Coverage affect my Employee Retirement Income Security Act (ERISA)?
Yes, the Michigan courts have already ruled that in case an employee has an ERISA coverage and at the same time a coordinated no-fault plan, it would be the no-fault plan that would be the primary payer or the plan and the ERISA plan will only be secondary.
This case was reiterated in the case of Auto Club Ins Ass’n v Frederick & Herrud, 443 Mich 358 (1993). In this case, however, the court in Michigan clarified the following:
“…the primacy of health care coverage over that in a no-fault policy continues in Michigan jurisprudence in all cases, not within the purview of this narrow holding. We also conclude that the existence of stop-loss insurance has no bearing on the outcome here because discretion to pay or deny claims remains in the ERISA plan and was never delegated to the insurers.”
What does this mean?
This means that while the courts in Michigan should recognize that the no-fault coverage is only secondary to any other health insurance, this ruling does not apply to an ERISA health plan. If the employee has an ERISA Health Plan that is paid for by their employer, and they also have a coordinated no-fault coverage, it is the coordinated no-fault coverage that takes the primacy over the ERISA health plan.
Does Medicare Coordinate With Auto Insurance?
No, generally Medicare cannot become the primary payer in an auto accident in Michigan. This is the rule that applies based on federal law. The Medicare Secondary Payer rules apply here and prohibit drivers from making Medicare the primary payer of auto accident insurance.
Can I coordinate with Medicaid then?
No, the rules that apply to Medicare also apply to Medicaid.
What would you suggest I get?
Insurance is something that you want to get as protection. While the protection that you need would vary depending on a lot of specific things and while we want to provide you with different information we still need to talk to you to discuss your circumstances properly. Hence, we will only provide you with our suggestions during our consultation.
What we can suggest, however, is that you get unlimited or no-limit no-fault insurance coverage for every single one of your vehicles. This will make sure that you get the right protection coming from the no-fault insurance rule in Michigan. You need to follow this now given the new no-fault law in Michigan and all of its changes.
Contact Your Lawyer Today
If you have an insurance claim that you need assistance with, you should contact our Southfield personal injury lawyers today. A lawyer can help you get started with your claim. A lawyer at Haque Legal will see to it that your needs are met from beginning to the end of the proceedings. You are always in good hands with Haque Legal and what it has to offer.
The article that you have read is based on general applications of the law. It is not legal advice and it is not to be construed as any legal consultation with the firm. No client-attorney relationship is created when you read the articles we have provided.
Let us help you out.
If you are having trouble with filing an insurance claim, call us immediately. If you have any problem with the law or are seeking justice and truth, our numbers are standing by to take your call.
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