Attendant Care Benefits and Michigan No-Fault Insurance
By: LBuckfire | Posted: 18th November 2009
Oftentimes, a person sustains serious injuries as a result of an auto accident, which renders him or her unable to do things that he or she was able to do prior to being injured. Sometimes, the injured person requires professional agencies to care for him or her at home. More often, the injured person is cared for by family and friends. This type of care is commonly referred to as "attendant care."
Attendant Care services commonly include, but are not limited to: preparing meals and feeding; assistance with personal hygiene, such as dressing and bathing; attending to wounds; assistance with medication; providing transportation to and from medical appointments; and supervision and monitoring, etc.
Section 3107(1)(a) of the Michigan No-Fault Act is the specific statutory section that entitles auto accident victims to be compensated for "attendant care" rendered by family members. Courts in Michigan have held that the word 'services' in this section of the No-Fault statute includes both skilled and unskilled attendant care as well as supervision. The courts have also held that attendant care can be provided by family members as long a physician deems the services are reasonable and necessary.
Once it is established that a person requires and is provided attendant care, the insurer is obligated to pay for the attendant care regardless of whether it is being provided by family or friends. The moral obligations of family members to care for one another are completely irrelevant to an insurer's liability for payment of attendant care provided by family and friends.
In order to submit a claim for attendant care you must provide the insurer with "reasonable proof of the fact and of the amount of loss sustained." This is usually done by submitting a claim, in the form of written documentation, to the insurer with: (1) the name of the injured claimant; (2) the name and address of the care provider; (3) the days and number of hours the care was provided; (4) the specific types of care provided; and (5) a note from a physician stating that the care is necessary, including the number of days/hours needed.
Once the claim is documented, the claimant must then demand an amount to be reimbursed by the insurer, by establishing an hourly rate and then multiplying that rate by the number of hours provided. There is no "rate schedule" of how much an insurer must pay for in-home attendant care. The only legal criterion is that the hourly rate must be "reasonable." The hourly rate that the law deems reasonable can vary greatly depending on the type of care being provided. As a general rule, family provided attendant care is commonly paid at a rate of anywhere between $10.00 - $30.00 per hour, depending on the nature and extent of the person's injuries, the level of care be provided, the skill and expertise of the care provider, geographic location etc.
Quite often, the No-Fault insurance adjuster will under pay the proper amount of the claim. This is done by either paying a low hourly amount or by refusing to pay the actual number of hours that the injury victim needs for attendant care services. In these instances, it is necessary that a lawsuit be filed against the insurance company to that the proper amount is paid for these services.
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The State of Michigan has strict deadlines for filing No-Fault Insurance claims and lawsuits against insurance companies for failing to pay your benefits. Therefore, it is essential that you contact our office immediately to discuss your case. Our office will start working on your case quickly and begin gathering the evidence to prove and win your case.This article is free for republishing
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Tags: proof, name and address, family and friends, medication, family members, claimant, wounds, supervision, insurer, personal hygiene, care provider, professional agencies