Denied PIP Benefits in Michigan
If your insurance company has denied PIP benefits in Michigan, you still have options. Many injured people face delayed, underpaid, or completely denied Michigan No-Fault (PIP) benefits after a car accident. You do not have to accept their decision.
At Khamo Law, we help clients fight improper denied PIP benefits in Michigan and push for the medical care, wage loss, and other coverage they are owed.
Free consultation. No fees unless we win. We provide services in English, Arabic, and Chaldean.
Call us today at (248) 466-0606.
Why Insurance Companies Deny PIP Benefits
Michigan’s no-fault system is supposed to pay benefits after a car accident no matter who caused it. In practice, however, insurance companies dispute and deny claims constantly. The reasons we see most often include:
- Claiming the treatment is not “reasonable and necessary”
- Disputing whether the injury came from the accident at all
- Using a medical examination to cut off benefits
- Arguing that a different insurance company is responsible
- Delaying payment while demanding excessive paperwork
- Misapplying the one-year-back rule
- Disputing attendant care or replacement services
A denial does not mean you have no case. In many situations, these denials can be successfully challenged.
The “Independent” Medical Exam Is Not Independent
If your benefits were cut off after an examination, you should understand what that exam actually was.
Michigan law lets your insurance company require you to be examined by a doctor. However, the insurer chooses that doctor, pays that doctor, and decides whether to keep sending that doctor work. Insurance companies call the result an “independent medical exam.” In reality, the statute simply calls it a medical examination.
We regularly see the same small group of examining physicians appear again and again in cutoff reports across Michigan. Their opinions can be challenged. We do this by obtaining the examining doctor’s history, comparing their report against your actual imaging and treatment records, and putting your own treating physicians on the record.
If a report you have never seen was used to stop your benefits, you are entitled to know what it says.
What PIP Benefits Can Be Denied
Insurers may try to reduce or cut off any of the following:
- Medical treatment and rehabilitation (surgery, therapy, injections, imaging, specialist care)
- Prescription medications
- Wage loss benefits (up to 85% of lost income, for up to three years after the crash, subject to a monthly maximum set by the state)
- Attendant care (family members can be paid to provide it, though Michigan law limits family-provided attendant care to 56 hours per week unless the insurer agrees otherwise)
- Household replacement services (up to $20 per day for tasks you can no longer do yourself)
- Medical mileage (travel to and from medical appointments)
When these benefits stop, the financial pressure on an injured person and their family builds quickly.
What To Do If Your PIP Benefits Are Denied
- Do not ignore the denial. Deadlines matter. The longer you wait, the harder it becomes to protect your claim.
- Keep the denial letter. It should state a reason. That stated reason is what we work from.
- Keep all medical records and bills. Documentation is what wins these disputes.
- Keep treating if you can. Gaps in treatment are routinely used against injured people.
- Write down your losses as they happen (mileage, missed work, who is helping you at home and for how long).
- Talk to a Michigan no-fault attorney. An attorney can review the denial, gather the evidence, and take action against the insurer.
How Khamo Law Fights PIP Denials
We take several concrete steps when benefits are denied:
- Reviewing the denial letter and the insurer’s full claims file
- Gathering medical records and written support from your treating providers
- Challenging improper medical examinations and the reports behind them
- Formally demanding payment of overdue benefits
- Filing suit when the insurance company still refuses to pay
- Pursuing penalty interest and attorney fees where Michigan law allows
Michigan law gives injured people real leverage. Under the No-Fault Act, benefits become overdue if the insurer does not pay within 30 days of receiving reasonable proof of the loss. Overdue benefits carry 12% simple interest per year. Separately, if a court finds the insurer’s refusal or delay was unreasonable, the insurer can be ordered to pay your attorney fees on top of the benefits themselves.
We handle both the fight with your own insurance company and, where appropriate, a claim against the at-fault driver.
Frequently Asked Questions
Can I sue my insurance company for denying PIP benefits? Yes. If your insurer improperly delays or denies benefits, you can file a lawsuit to recover what you are owed. Depending on the circumstances, you may also recover interest on the overdue benefits and, if the refusal was unreasonable, your attorney fees.
What is the one-year-back rule? Michigan generally does not let you recover no-fault benefits for losses that occurred more than one year before you file your lawsuit. Since 2019, that one-year period pauses while your claim is sitting with the insurer awaiting a decision, and starts running again once the insurer formally denies it. Because the timing depends on the specific dates in your file, do not assume you are too late. Have someone look at it.
How long do I have to notify my insurance company after a crash? This is a separate deadline from the one-year-back rule. In general, written notice of the injury must reach the insurer within one year of the accident, or a claim must be filed within that year. Missing it can end a claim entirely, so if you are near the anniversary of your crash, treat it as urgent.
My doctor says I need this treatment. Do I still need a lawyer? Usually yes. Insurance companies reject treating physicians’ recommendations routinely, often on the strength of a single exam by a doctor they hired. A lawyer can force the issue and put your doctor’s opinion where it carries weight.
How long does it take to resolve a PIP denial? It varies. Some cases resolve once we send a demand backed by additional medical support. Others require litigation and take considerably longer. What does not work is letting the denial sit unchallenged.
Contact a Michigan PIP Denial Lawyer
If your auto insurance company has denied or cut off your PIP benefits, do not wait. The longer a denial goes unchallenged, the harder it becomes to recover everything you are owed.
Call Khamo Law today at (248) 466-0606 for a free consultation. We offer services in English, Arabic, and Chaldean.