If you are owed Michigan No-Fault benefits, waiting too long to file a lawsuit can cost you money. Under Michigan’s one-year-back rule, a claimant generally cannot recover PIP benefits for losses incurred more than one year before the lawsuit was filed, although Michigan law provides an important tolling rule for certain claims submitted to an insurer.
This deadline is commonly confused with Michigan’s separate one-year notice requirement and the general three-year limitation period that applies to many personal injury claims. They are not the same rule.
If your insurance company has delayed, reduced, or stopped paying benefits, understanding the difference can be critical.
For a broader explanation of PIP coverage and deadlines, visit our Michigan No-Fault Insurance Lawyer resource.
Legally reviewed by Attorney Koro E. Khamo
Founder & Managing Attorney, Khamo Law
Michigan Bar No. P80994
What Is Michigan’s One-Year-Back Rule?
Michigan’s one-year-back rule appears in MCL 500.3145.
The statute generally provides that when a lawsuit seeks Personal Injury Protection benefits, the claimant cannot recover benefits for losses incurred more than one year before the date the lawsuit was filed, subject to the statute’s tolling provision.
That can affect benefits such as unpaid:
- Medical expenses
- Rehabilitation expenses
- Attendant care
- Wage-loss benefits
- Replacement services
- Other qualifying PIP losses
The important point is that the rule can affect how far back you can recover unpaid benefits.
It is not simply a rule saying, “You have one year after the accident to sue.”
Example of the One-Year-Back Rule
Consider someone who continues receiving accident-related medical treatment while an insurance dispute remains unresolved.
If unpaid qualifying expenses continue accumulating and no applicable tolling protects those claims, waiting to file a lawsuit can potentially place older losses outside the recoverable period.
That is why someone can still have a PIP claim but face a dispute over how much of the unpaid benefits remain recoverable.
The dates on which expenses were incurred, claims were submitted, denials were issued, and litigation was commenced can all matter.
The One-Year-Back Rule Is Different From Michigan’s One-Year Notice Requirement
This distinction causes a great deal of confusion.
Michigan’s No-Fault statute contains a separate rule concerning notice of the accident and injury.
Under MCL 500.3145(1), an action for PIP benefits generally cannot be commenced more than one year after the accident unless written notice of injury was provided to the insurer within one year or the insurer previously made a PIP payment for the injury.
The required notice must contain certain basic information, including information identifying the claimant and injured person and describing the time, place, and nature of the injury.
So there are two different concepts:
One-Year Notice Requirement
This concerns whether appropriate notice was provided following the accident or whether the insurer previously paid benefits.
One-Year-Back Rule
This concerns how far back a claimant may recover particular PIP losses when a lawsuit is filed, subject to statutory tolling.
A person should not assume compliance with one rule automatically satisfies the other.
The One-Year-Back Rule Is Also Different From Michigan’s Three-Year Personal Injury Deadline
Another common mistake is assuming that because someone may have three years to pursue a personal injury claim against an at-fault party, the same deadline controls unpaid No-Fault benefits.
It does not.
Michigan law generally provides a three-year limitation period for many actions involving injury to a person under MCL 600.5805.
A liability claim against an at-fault driver and a claim for unpaid PIP benefits against a No-Fault insurer are different claims and can be governed by different timing rules.
For more information about the broader claims that may arise after a crash, visit our Michigan Car Accident Attorney page.
Does the One-Year-Back Period Stop While the Insurance Company Reviews a Claim?
Potentially, and this is one of the most important parts of the current law.
MCL 500.3145(3) provides that the applicable limitations period is tolled from the date a specific claim for payment of benefits is made until the date the insurer formally denies the claim.
In other words, qualifying time can stop running while a specific claim is pending with the insurance company.
However, the statute also says this tolling does not apply if the person claiming benefits fails to pursue the claim with reasonable diligence.
That means someone should not assume that simply telling an adjuster, “I am still treating,” or generally discussing an injury necessarily protects every unpaid expense.
The details of what was actually submitted to the insurer matter.
What Does a “Specific Claim for Payment” Mean?
The wording matters because the statute does not merely refer to notice that an injured person might need benefits.
It refers to a specific claim for payment of the benefits.
Michigan courts have distinguished a specific claim for payment from merely telling an insurer that assistance or treatment might be needed.
For that reason, documentation can become extremely important.
Depending on the benefit involved, relevant records may include:
- Medical bills
- Treatment records
- Attendant-care statements
- Wage-loss documentation
- Replacement-service records
- Written benefit requests
- Proof showing when documents were provided to the insurer
- Correspondence from the insurance adjuster
- Formal denial letters
Keeping copies of what was submitted and when it was submitted can become important if the timing of the claim is later disputed.
What Happens When the Insurance Company Formally Denies the Claim?
Under the statute, tolling generally lasts until the insurer formally denies the specific claim.
Once a formal denial occurs, the timing question can change significantly.
That is one reason a denial letter should not be put aside or ignored.
If your insurer has denied, reduced, or terminated PIP benefits, see our dedicated guide to Denied PIP Benefits in Michigan.
Can an Insurance Company Benefit From Delay?
The current statute provides important protection against an insurer simply holding a properly submitted specific claim indefinitely: the limitations period may be tolled while that claim is pending until formal denial.
But delay can still create serious problems when:
- A specific claim for payment was never actually submitted
- There is no proof showing when the claim was submitted
- Bills or other losses were never sent to the insurer
- The claimant fails to pursue the claim with reasonable diligence
- The parties disagree about whether the insurer formally denied the claim
- Someone assumes an ongoing insurance discussion means every unpaid benefit is protected
That is why the safest approach is not to rely on an insurer’s continued investigation or informal communications as proof that every deadline has stopped.
The actual dates and documents should be reviewed.
What If My Accident Was More Than a Year Ago?
Do not automatically assume that you lost your entire No-Fault claim.
MCL 500.3145 contains several separate timing provisions, and the outcome can depend on facts including:
- When the accident occurred
- Whether proper notice was provided
- Whether the insurer previously paid PIP benefits
- When each particular loss was incurred
- When specific claims for payment were submitted
- Whether and when the insurer formally denied those claims
- Whether the claimant pursued the claims with reasonable diligence
- When a lawsuit was filed
Two claims arising from the same accident can therefore have very different deadline issues.
What Should I Do If I Just Learned About the One-Year-Back Rule?
If you have unpaid PIP benefits, start by gathering the documents that establish the timeline.
Look for:
- The date of the accident.
- Your original No-Fault application or written notice.
- Medical bills and treatment dates.
- Wage-loss documentation.
- Attendant-care or replacement-service records.
- Emails, letters, and portal submissions to the insurance company.
- Proof showing when claims or bills were submitted.
- Any explanation-of-benefits documents.
- Any denial, termination, or reduction letters.
Do not assume that an insurance adjuster continuing to communicate with you means every deadline is protected.
The timeline should be evaluated using the actual documents.
Michigan One-Year-Back Rule FAQs
Is Michigan’s one-year-back rule a one-year statute of limitations?
Not exactly. The one-year-back rule generally limits recovery of PIP benefits for losses incurred more than one year before an action was commenced, subject to statutory tolling. MCL 500.3145 contains additional rules governing when an action may be commenced.
Do I have only one year after a Michigan car accident to file every claim?
No. Different claims can have different deadlines. Michigan No-Fault PIP claims have rules under MCL 500.3145, while a liability claim against an at-fault driver may be governed by a different limitations period.
Does submitting a PIP claim stop the one-year-back period?
MCL 500.3145(3) provides tolling from the date a specific claim for payment is made until the insurer formally denies the claim, provided the claimant pursues the claim with reasonable diligence.
What if the insurance company never formally denied my claim?
The absence of a formal denial can be important under the tolling provision, but the analysis also depends on whether a specific claim for payment was submitted and whether the claim was pursued with reasonable diligence.
What if my insurance company has been delaying my bills for months?
Preserve every bill, submission confirmation, email, letter, and other record showing what was sent to the insurer and when. The timing of a specific claim and any formal denial may directly affect application of MCL 500.3145.
Can I still recover benefits if treatment occurred more than one year ago?
Potentially. The answer depends on the particular dates and whether statutory tolling applies. Do not assume an older expense is automatically unrecoverable without reviewing the claim history.
Talk to Khamo Law About an Unpaid Michigan PIP Claim
Michigan’s No-Fault deadlines can be unforgiving, and the one-year notice requirement, one-year-back rule, statutory tolling provision, and deadlines for other personal injury claims should not be treated as interchangeable.
If medical bills, wage loss, attendant care, replacement services, or other PIP benefits remain unpaid, Khamo Law can review the claim timeline and determine what options may remain available.
Khamo Law Accident & Injury Lawyers
1120 E. Long Lake Road, Suite 250
Troy, MI 48085
248-466-0606
KHAMOLAW.COM