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Personal Injury Protection Attorney Rochester Hills

You’ve Got Questions and We’ve Got Answers

Michigan is one of the most litigious of all the states that have no-fault automobile statutes. For this reason, Michigan’s no-fault case law is very well developed. That means you can get answers to your claims handling questions.

Whether it’s a question regarding coverage, excluded claimants, the priority of PIP insurers, PIP benefits, Property Protection Benefits, indemnification by the Michigan Catastrophic Claims Association, or uninsured and underinsured motorist coverage, the attorneys at MacArthur, MacArthur & Associates, P.C. can give you the answers you need.

Thorough Analyses

A thorough analysis of a first party no-fault claim includes an assessment of five, essential issues:

  • Is there coverage under the No-Fault Act for the type of injury that the claimant sustained?

  • Is the injured party excluded from no-fault benefits?

  • Is there another, higher priority PIP insurer who is responsible to pay the plaintiff PIP benefits?

  • What type of PIP benefits is the injured individual entitled to, in what amount and for how long?

  • Are there any reductions, setoffs, or reimbursements that will limit the claimant’s PIP benefits?

Without specifically considering these critical issues, viable, cost-saving defenses are missed and opportunities are lost. The attorneys at MacArthur, MacArthur & Associates, P.C., conduct comprehensive - yet economically efficient - discovery that allows us to provide you with a thorough and complete analysis of your no-fault claims. That thoroughness allows you to make the right decisions on your claims- and to succeed.

Coverage Questions

Has your claimant suffered an injury arising out of the ownership, operation, maintenance or use of a motor vehicle? In many cases, the answer is clear cut- but in other circumstances, it’s not. The attorneys at MacArthur, MacArthur & Associates, P.C., can guide you through those complex coverage claims where the answers are not so clear. We’ll provide you with the case law that relates to your coverage questions, we’ll help you develop strategic ideas for developing coverage defenses, and we’ll give you the probabilities of prevailing at trial and on appeal.

Excluded Claimants

Even if a claimant has suffered an injury arising out of the ownership, operation, maintenance or use of a motor vehicle, some claimants are specifically excluded from coverage or only get limited coverage. A claimant whose uninsured vehicle was involved in the injury-producing event, an out-of-state motorist in an out-of-state motor vehicle insured by an insurance company that has not filed a certificate of compliance, a claimant that suffers injuries that they intentionally caused, a plaintiff who is injured from an accident with a parked vehicle, a claimant who had a work-related injury – these are just some of the circumstances where exclusions or limitations apply. The lawyers at MacArthur, MacArthur & Associates, P.C. have the expertise that you can count on to find the exclusions and limitations that apply to your claims. Where an exclusion applies, we can bring your litigated case to a quick conclusion. That saves you money on indemnity and medical payments and reduces your litigation costs.

Priority of Insurers

In most cases, a no-fault claimant who suffers an injury arising out of the ownership, operation, maintenance or use of a motor vehicle, whether they were an occupant of the vehicle at the time or not, will recover no-fault benefits under his or her own insurance policy or the policy of his or her spouse or other relatives residing in the claimant’s household. But what if the no-fault claimant didn’t have his or her own insurance policy at the time? The No-Fault Act has provisions for this. Depending on whether the injured person was an occupant of a motor vehicle or a nonoccupant, the insurer of the occupied vehicle or insurer of the striking vehicle will be responsible for benefits. But these are only a few of the priority rules that determine which insurer has to pay no-fault benefits. Employer-furnished vehicles, vehicles used in the business of transporting individuals, and motorcycles have special priority rules as well. Determining the responsible insurer can be very complicated. But the law firm of MacArthur, MacArthur & Associates, P.C. can help you navigate through these complex provisions of the No-Fault Act. When a claimant doesn’t have his own insurance, we’ll conduct discovery that is specifically designed to find higher priority insurers. When a higher priority insurer is identified- that takes you off the hook and gets you out of the litigation.

PIP Benefits

The No-Fault Act provides for certain benefits to qualified claimants- medical expenses, wage loss benefits, and replacement services – just to name a few. You desire to pay the benefits a claimant is entitled to but sometimes things just don’t add up. Pre-existing injuries, injuries that are alleged long after the accident, prolonged medical treatment, excessive replacement services, unreasonable home modifications, and extended restrictions from work- these are just some of the scenarios where further investigation is required. The defense lawyers at MacArthur, MacArthur & Associates, P.C. have what it takes to wade through the sea of medical records and the expertise to sort out fact from fiction.

In Michigan no-fault cases, having the right medical expert is key. The tired medical expert from the national IME service won’t cut it. At MacArthur, MacArthur & Associates, P.C. we work with a team of physicians who have extensive treating practices and who teach at local medical schools. Our experts conduct thorough evaluations of plaintiffs that enable them to find the truth. That means credible medical defenses for us and savings for you.
Even when you’re dealing with legitimate no-fault claims, knowing the what benefits a claimant is entitled to can be complex. Medical coordination, wage loss benefit calculations, statutory maximums, setoffs, reductions, and reimbursements all come into play. You’re responsible for not paying too much. The defense attorneys at MacArthur, MacArthur & Associates, P.C. can steer you through these complexities to give you the assurance that the benefits paid are the benefits that are due.

Property Protection Benefits

Many times no-fault claims involve property damage. Most of these claims are straight forward but others aren’t. Scope of coverage issues, the involved in the accident requirement, arising out of and use problems, environmental contamination considerations- these are all issues that come up with regard to property protection benefits. In addition, there are various exclusions that apply to certain types of vehicles, activities, and insured property. Finally, there are priority as well as reimbursement and indemnification issues. MacArthur, MacArthur & Associates, P.C. has the expertise to guide you through these legal issues so you can determine whether you should be paying any benefits at all.

When you’re the responsible insurer and the property damage is extensive, you need to ascertain the actual versus claimed property damage. The law firm of MacArthur, MacArthur & Associates, P.C. can help. We work with property damage experts who will cut through the excesses and arrive at the actual damages so that you can have the confidence that you aren’t paying too much.

Indemnification by the Michigan Catastrophic Claims Association

You’ve got a serious injury claim. The PIP benefits are adding up and have exceed the statutorily specified catastrophic level. The Michigan Catastrophic Claims Association (MCCA) was established by the Michigan No-Fault Act to give relief to insurers in these situations. However, legal issues still arise. When the MCCA refuses to indemnity, contact the defense attorneys at MacArthur, MacArthur & Associates, P.C. We can identify the pertinent case law, give you strategic advice, and get you the indemnification that was intended under Michigan No-Fault Act.

Uninsured and Underinsured Motorist Coverage

Michigan law requires that applicants of automobile registration have auto insurance. But some people subsequently stop paying their insurance premiums and end up driving without auto insurance. When these uninsured drivers cause injuries to others, the injured individual does not have the source of recovery against the negligent tortfeasor that the legislature intended. Many insurers offer uninsured motorist policies that allow injured individuals to seek from their own insurer damages that they would otherwise be entitled to recover from the uninsured driver, such as pain and suffering. Beyond that, many auto insurers also offer underinsured motorist coverage. When an injured individual has this coverage and suffers damages beyond the tortfeasor’s policy limits, he or she may file a claim with their own insurance carrier for the difference between the actual damages and the policy limits of the tortfeasor’s policy limits.

The No-Fault Act does not require uninsured or underinsured coverage. So, the legal issues relating to these coverages arise from the contract of insurance. The uninsured or underinsured provisions within the policy have specific requirements for coverage to apply as well as various exclusions. Chances are, the courts have interpreted policy language that is similar to the provision in your contract of insurance. The defense firm of MacArthur, MacArthur & Associates, P.C. can provide you with the coverage opinion that you need to make the right decision so that you can make the decision to provide or deny coverage with assurance.
Even when a claimant is eligible for uninsured or underinsured coverage, there are issues involving the extent of the injuries suffered. Our attorneys at MacArthur, MacArthur & Associates, P.C. will conduct thorough yet efficient discovery that will provide the insight to determine the real extent of the injuries suffered so that you don’t pay more than what is necessary.

We’re the Right Choice for You

Contact us today for a for a free consultation.

Personal Injury Protection Attorney Rochester Hills

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