Under the Michigan No-Fault Insurance laws, a person who is injured in a motor vehicle accident is entitled to receive attendant care service benefits. Attendant care benefits are benefits paid to a person or agency for attending to the injured person during his or her period of recovery. To qualify for these benefits, the injury victim must have suffered some type of injury that makes these services "necessary" and a physician's script is usually required by the insurance company before payment will be made.
Unlike some No-Fault benefits which are only payable for up to three afters after an accident, attendant care service benefits can be paid over the lifetime of the accident victim. This is often necessary for accident victims who suffer spinal cord injuries and closed head injuries (traumatic brain injuries). Additionally, these services can be provided for twenty-fours hours a day if necessary for the well-being and safety of the patient. Services often include supervision, monitoring, assistance with toileting, administering medication, and other needs.
Who Can Provide Attendant Care Services?
Attendant care benefits can be paid to a home staffing agency, a family member, or any other person providing the serives. Quite often, a family member will provide these services to the accident victim. Many times, this is better for the injured person because a familiar person living in the home is providing the services. In cases involving children, it is often a parent who provides these services.
What Are The Attendant Care Rates In Michigan?
Insurance companies often dispute the rate to be paid for attendant care services, especially when the services are performed by a family member. Rates can range from $8.00/hour to $30.00/hour depending on the level of service provided and the location that services are being provided. A staffing agency using an RN to change dressings and PICC lines would be toward the higher range and a family member essentially "babysitting" the injury victim could be toward the lower range.
What Is The Michigan Law On Determing Attendant Care Rates?
Michigan appellate courts have consistently held that the word "services" in Section 3107(1)(a) includes both skilled and unskilled attendant care and supervision. The appellate decisions have also held that these in-home services can be rendered by family members as long as the service is reasonably necessary.
The only consideration is whether the person sustained an injury in a motor vehicle accident that requires attendant care. Once that is established, the insurer is obligated to pay for the attendant care regardless of the identity of the persons rendering the care. These legal principles have been recognized in several Michigan appellate cases including Van Marter v American Fidelity, 114 Mich App 171 (1982); Visconti v DAIIE, 90 Mich App 477 (1979); Manley v DAIIE, 425 Mich 140 (1986); and Sharp v Preferred Risk Mutual Ins Co, 142 Mich App 499 (1985).
In determining what is a "reasonable charge" for family provided attendant care under Section 3107(1)(a), the Michigan appellate courts have stated that the rates charged by commercial agencies for providing in-home health care are relevant. In addition, the extent of the injured victim's disability and the amount of supervision required are also relevant considerations. See Manley v DAIIE, 127 Mich App 455 (1983) and Sharp v Preferred Risk, 142 Mich App 499 (1985).
What To Do If The Insurance Company Is Underpaying Attendant Care Rates?
Many times, the no-fault insurance company will pay attendant care service benefits, but will grossly underpay the proper amount of those benefits. For example, the insurance company will pay the rate of $8.00/hour for 12 hours a day, but should be paying $15.00/hour for 24 hours a day. In these situations, it will be necessary to file a lawsuit against the insurance company. The lawsuit will demand that the insurance company pay the proper rate in the future and pay a lump sum for all of the underpaid benefits for the last twelve months. The suit will also request payment of attorneys fees and costs.
Contact A Michigan Attendant Care Services Lawyer
If your No-Fault insurance company has refused, denied, or underpaid your attendant care service benefits, it is essential that you contact a lawyer immediately to file a lawsuit against the auto insurance company. A delay in contacting a lawyer will not only jeopardize your future rights to payments, but will also damage your ability to recoup unpaid benefits and underpaid benefits in the past.
To best protect your rights or the rights of a car accident victim who requires attendant care service benefits, call our offfice now at (800) 606-1717. We will analyze your case for free and advise you how to proceed. If we accept your case, we will represent you under our No Fee Promise, which means you pay no legal fees unless we get you a settlement.