NewsKnow the Law


Know the Law – Choosing a doctor post-accident

Posted at 9:02 AM, Nov 26, 2016
and last updated 2016-11-26 09:04:20-05

No one anticipates being injured in a car accident. But when you are hurt, you need to understand what Michigan’s auto no-fault insurance law says about your medical care.

Michigan has the most comprehensive medical coverage of any no-fault state in the nation. Under Michigan’s no-fault system, a person injured in an auto accident may recover “allowable expenses” for a lifetime. Allowable expenses are “all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery or rehabilitation.” There is no cap on the amount, and the expenses may include:
• medical costs.
• in-home attendant care.
• special transportation & mileage expenses.
• home accommodations.
• rehabilitation.
• guardian/conservator fees.

However, some insurance companies might deny a claim, asserting the expense was not “medically necessary” or “medically appropriate,” or because the injured person reached the “maximum medical improvement.” Be aware that these are not the proper standards for determining when a medical expense is payable.

If you’re injured in a car accident, you also need to remember this: you have the right to choose your own doctor. In other words, the insurance company cannot require that you visit a certain medical provider.

Michigan’s No-Fault Act specifically states that injured persons can be treated by any medical provider, as long as the provider can lawfully render the services. Despite this, some insurance companies may suggest that car-accident victims choose a doctor who is part of their “Preferred Provider Network” (PPN). A PPN is a group of medical providers who accept certain discounts for their services.

What’s the concern with PPNs? Usually, the PPN doctors have insurance carrier’s financial interests in mind – not the best interests of the auto-accident victim.
The bottom line is this: do not let an insurance company tell you that you cannot select your own medical provider … because you can.