Michigan PIP Benefits: What No-Fault Insurance Covers

If you were hurt in a Michigan car accident, your own auto insurance — not the other driver’s — pays your medical bills and part of your lost wages. These payments are called Personal Injury Protection benefits, or PIP. They are the heart of Michigan’s no-fault system, and they apply no matter who caused the crash.

PIP benefits are powerful, but they come with strict rules and some of the shortest deadlines in Michigan law. This guide explains what PIP pays for, how the coverage levels work, and what to do if your insurance company delays or denies payment.

What PIP Benefits Pay For

Michigan’s no-fault statute, MCL 500.3107, lists three main categories of PIP benefits:

• Medical expenses (“allowable expenses”). The statute covers “reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation.” That language is broad. It can include hospital care, surgery, doctor visits, physical therapy, prescriptions, medical equipment, in-home attendant care, and home or vehicle modifications when your injuries require them.
• Work loss. If your injuries keep you from working, PIP pays for income you would have earned during the first three years after the accident. Because these benefits are not taxed, the law reduces the payment by 15 percent — in effect, you receive about 85 percent of your lost gross income. There is also a monthly maximum that the state adjusts every year. If you earn more than the cap, PIP alone will not replace your full paycheck.
• Replacement services. PIP pays up to $20 per day for help with ordinary tasks you can no longer do yourself — things like cleaning, yard work, snow removal, and driving the kids to school — for up to three years after the accident.

PIP also covers funeral and burial expenses, in an amount set by your policy (Michigan law requires between $1,750 and $5,000), and survivor’s loss benefits for dependents when an accident is fatal.

PIP Coverage Levels: The Choice You Made Matters

Since Michigan’s no-fault reform took effect in July 2020, drivers choose how much medical (allowable expense) coverage to carry under MCL 500.3107c. The options are:

• Unlimited coverage — no cap on allowable expenses, the traditional Michigan standard.
• $500,000 per person, per accident.
• $250,000 per person, per accident.
• $50,000 per person, per accident — available only to drivers enrolled in Medicaid whose household members also have qualifying coverage.
• Opt-out — drivers with Medicare (and qualifying household coverage) may elect to carry no PIP medical coverage at all under MCL 500.3107d.

The level you selected on your policy controls how much your insurer must pay for your care. After a serious injury, one of the first things to confirm is which level applies — and whether other coverage, such as health insurance, fills the gap above your cap.

The Deadlines That End PIP Claims

MCL 500.3145 sets the time limits, and they are unforgiving:

• One-year notice rule. You generally cannot sue for PIP benefits more than one year after the accident unless you gave the insurer written notice of the injury within that first year, or the insurer already made a payment. The notice must identify the injured person and describe the time, place, and nature of the injury.
• The “one-year-back” rule. Even with proper notice, a lawsuit can only recover benefits for losses incurred within the one year before you file. Waiting too long means losing older bills permanently — even if the claim itself is valid.
• Tolling after a claim. The clock pauses between the date you submit a specific claim for payment and the date the insurer formally denies it, as long as you pursue the claim with reasonable diligence.

The practical lesson: report your injury to your own insurer in writing as soon as possible, and do not sit on unpaid bills. The calendar — not the seriousness of your injury — decides whether benefits can still be recovered.

When Insurers Delay or Deny

PIP disputes usually are not about whether the accident happened. They are about whether treatment is “reasonably necessary,” whether charges are “reasonable,” and how long benefits should continue. Common friction points include:

• Cut-offs after an insurance medical examination concludes you have “recovered,” even while your own doctors disagree.
• Denials of attendant care or replacement services because forms were incomplete or hours were not documented.
• Disputed wage-loss calculations, especially for self-employed people and those with variable income.
• Slow-walked payments that quietly push older losses past the one-year-back window.

Keep everything in writing: claim forms, treatment records, mileage logs, care calendars, and every letter from the adjuster. Written proof of when you submitted each claim is what makes the tolling rule work in your favor.

PIP Is Only Half of a Michigan Injury Case

PIP pays economic benefits, but it does not compensate you for pain and suffering. If your injuries meet Michigan’s serious-impairment threshold, you may also have a third-party claim against the at-fault driver for non-economic damages and excess wage loss. The two claims run on different rules and different deadlines, which is why it helps to have both evaluated together.

How Baldori Law Helps

Our Michigan no-fault attorneys deal with PIP carriers so you can focus on recovery: confirming your coverage level, getting written notice on file, documenting attendant care and replacement services properly, pushing back on unjustified cut-offs, and filing suit before the one-year-back rule erases benefits. If your crash involved a negligent driver, we evaluate the injury claim alongside the PIP claim.

If your PIP benefits have been delayed, cut off, or denied — or you simply want to understand what your policy owes you — contact Baldori Law for a free case review. Time limits apply, so it is better to ask early.