Attendant care services is a benefit for auto accident victims under the Michigan no-fault insurance laws. A person with serious injuries after a car accident often requires assistance at home during the period of recovery. This can be necessary after suffering serious orthopedic injuries or other internal injuries. Accident victims with traumatic brain injuries may require around the clock care, supervision, and monitoring for their own safety and welfare. If prescribed by a physician, the auto insurance company must pay for these services as long as they are needed.
Who Can Provide Attendant Care Services to an Accident Victim?
Services can be provided by family members or an outside staffing agency. This often depends on the nature and type of care needed. There is no educational or occupational requirement to be an attendant care service provider, but many times the victim will require medical type care, like a catheter or IV. Family members can be trained to provide many of these services.
What are the Types of Attendant Care Services?
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. Supervision is often required for closed head injury and traumatic brain injury victims and can be up to twenty-four hours a day for the lifetime of the patient. For many victims, a main purpose is also daily monitoring and reporting observations and conditions to the treating physicians to assist in overseeing the medical care.
What is the Michigan Law on Attendant Care Benefits?
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.
Who Can Get Paid for Providing Attendant Care Services Paid?
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. The accident victim can select any person to provide these services.
Many times, the task is too difficult for family member and a staffing agency can be used to provide attendant care services. The agency gets paid directly from the insurance company. Sometimes, a combination of both family provided attendant care and agency provided services is used for the victim. This gives the family a "break" each day to take care of personal business.
How do I File an Claim for Attendant Care Services?
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 (See Attending Physician's Report).
What are the Rates for Attendant Care Benefits?
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. However, sometimes No-Fault insurers improperly advise claimants that attendant care is limited to $20.00 per day. This is wrong and is an attempt by the insurer to limit attendant care to the rate at which replacement service expenses are compensable.
The only legal criteria 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, and geographic location, among other factors.
What Can I do if the Insurance Company Refuses to Pay for Attendant Care?
If your attendant care services are denied or terminated by the adjuster after an insurance medical exam (IME), then your only recourse is to file a lawsuit against the insurance company. These lawsuits seek payment of back benefits, underpaid benefits, and future benefits. They also demand attorney's fees and judgment interest from the insurance company.
Call Our Michigan Attendant Care Benefit Lawyers
If you or someone you were caring for was injured in an accident and the insurance company is denying payment for attendant care services or if the adjuster is underpaying the amount of those benefits, you should contact our experience Michigan attendant care service benefit lawyers today at (800) 606-1717. We will file a lawsuit to compel payment of those benefits for you. We charge no legal fees unless you receive a settlement and we pay all costs and expenses for the case.
We charge no legal fees unless you receive a settlement. There is nothing to lost, so make the call today!