Michigan No-Fault lawyers explain how attendant care services help car accident victims recover from their injuries and help rebuild their lives to as close to normal as possible. What is attendant care benefit? Attendant care are personal services such as assistance with bathing, dressing, grooming, supervision, nursing care, etc. The attendant care benefit is a No-Fault PIP benefit that ensures that car accident victims have the personal care type nursing assistance they need to recover from their injuries or help them function daily. The no fault auto insurance company pays for a nurse, friend, or a family member to help the car accident injury victim with the “activities of daily living” they are unable to do alone without help because of their disabilities. What kinds of attendant care services are covered by no fault insurance? The key to attendant care services is they are personal care type service unique to the injured person’s needs. Some examples of Attendant care services can include the following: • Assistance getting in and out of bed • Assistance getting into and out of a car • Assistance with bathing • Assistance with dressing • Help with eating • Helping with taking medication • Wound Care • Helping with grooming • Helping with walking • Helping with lifting and carrying things • Safety supervision This is a nonexhaustive list of attendant care examples. Who can provide attendant care services? Attendant care services can be provided by a family member, a friend, licensed nurse, or certified home health aide from a private agency or court appointed legal guardian or conservator of the car accident victim. Is Attendant Care limited to the home or facility? Attendant care services can be provided in the home setting or facility like a nursing home. Usually, friends and family can provide attendant care at a cheaper rate to the insurance company than a commercial attendant care facility like a nursing home. Who is responsible to pay for attendant care services? The No-Fault Insurance Company found to have “priority” under the law rules will pay for the cost of your attendant care services delivered. Generally, the car insurance will be your own or the auto insurance of a household relative at the time of the accident. If none of these two exist, the proper insurance carrier can be assigned by the Michigan Assigned Claims Plan to pay your no fault benefits. What if I exceed the attendant services limit paid by No Fault Insurance? You can now sue the at fault driver for excess attendant care service expenses if your car accident attendant service expenses exceed the No-Fault PIP medical benefits coverage limit in the car insurance policy. The law now allows the injured accident victim to sue the at-fault driver whose negligence caused the car accident for his or her “excess” costs. See MCL500.3135(3)(c). What are the rates for attendant care services? Under the Michigan no fault reform law after July 1, 2021, generally the Medicare-based fee schedule will set all rates for attendant care services rendered after July 1, 2021, regardless of whether the attendant care assistance is delivered in a care facility or in the injury victim’s home or by a nurse or home health aide or by a family member of the auto accident victim. If the services are covered by Medicare, the provider will be paid between 200% and 190% of the Medicare reimbursement rate. (MCL500.3157(2)) However, if the services are not covered by Medicare, the attendant care provider will be paid between 55% and 52.5% of his or her “charge description master in effect on January 1, 2019” or “the average amount the person charged for [attendant care] on January 1, 2019.” See MCL 500.3157(7)(a). Some examples that are not covered by Medicare include: (1) Round the clock 7 days per week assistance at home; (2) attendant care help provided by a family member; and (3) personal help that involves assisting a car accident victim with bathing, dressing, and using the bathroom. In Douglas v. Allstate Insurance Company, docket#143503, the Michigan Supreme Court provided some guidance on attendant care services provided by family and friends: “[I]t is appropriate for the [court] to consider hourly rates charged by individual caregivers when selling their services (whether to their employers that commercially provide those services or directly to injured persons) . . . because it helps the fact-finder to determine what the caregivers could receive on the open market.” “[W]e hold that a [court] may base the hourly rate for a family member’s provision of attendant care services on what health care agencies compensate their employees, but [not on] what health care agencies charge their patients . . .” The Supreme Court also held that, “even though the family member who provided these services was not a licensed medical care provider, “[t]he statute does not require that these services be supplied by ‘trained medical personnel’.”
How do the No-Fault PIP medical benefits coverage limit affect my attendant care? Under the new law, Michigan No-Fault Personal Protection Insurance, will be limited by the PIP medical coverage benefits limit purchased in the car accident policy. This is one reason why its critically importantly to purchase unlimited PIP medical coverage or select an attendant care rider that would provide coverage for attendant care services “in excess of the applicable” No-Fault PIP medical benefits coverage limit selected in the policy. See MCL 500.3107c(8). Is there a limit on in home family and friends provided attendant care services? As of July 2, 2021, the in-home family or friends provided attendant care services, the no fault auto insurance company will only be obligated to pay for 56 hours per week, unless the insurance company agrees to more hours. The attendant care limits do not apply to services provided in a private facility or by a nurse or home health aide from a private business agency unrelated to the car accident victim. Specifically, the 56-hours-per-week limit on in-home, family and friends provided services to car accident victims only applies if the assistance is “provided directly, or indirectly through another person, by any of the following” people: “An individual who is related to” the car accident victim. See MCL 500.3157(10)(a). “An individual who is domiciled in the household of” of the car accident victim. See MCL 500.3157(10)(b). “An individual with whom the [car accident victim] had a business or social relationship before the injury.” See MCL 500.3157(10)(c). Noteworthy, all of this means that a car insurance company can decide to enter into a contract with a car accident victim’s family or friend’s services provider “to pay benefits for attendant care for more than” the 56-hours-per-week limitation on in-home, family-provided assistance. See MCL 500.3157(10), (11) and (14). Thus, an auto insurance company may find this “contract” option attractive where they can save by paying family or friends attendant care providers less than a private agency’s higher charges. Is there a grandfather provision for accidents before the effective date of the no fault insurance reform? The new Michigan No-Fault law effective on June 11, 2019, provides that after July 1, 2021, an auto insurance company is not obligated to pay for more than 56 hours per week of in home, family and friends provided attendant care for car accident victims. If Legislature does not change this provision, the new law will limit attendant care, unless an argument can be made that the auto insurance contract provides greater benefits. In addition, victims of car accidents injured prior to July 1, 2021, challenges to the statute applying retroactively will be made in courts on constitutional grounds and contractual grounds for the changes to not apply. The Courts will have the last word on these points. In LaFontaine Saline, Inc., vs. Chrysler Group, LLC (#146722 ((2014)), the Michigan Supreme Court discussed retroactive application. Courts will generally look for “specific language providing for retroactive application.” This language may include the use of the word “retroactive” and/or the Legislature may include language that the statute applies to pre-existing contracts. Michigan Supreme Court stated courts will determine whether “retroactive laws [take away or] impair vested rights [including existing contract rights] acquired under existing laws.” Michigan Courts evaluate whether retroactive application of new legislation will “create new obligations or duties [or a new disability] with respect to transactions or considerations already past.” Usually, Michigan Courts have recognize laws in existence at the time a contract is created are treated as part of the contract, which bodes well for the insureds. Need help with Michigan No Fault Attendant Care Benefits? Call Michigan Auto Law lawyers now If you have been injured in a Michigan car accident, call toll free anytime at (866) 447-3563 for a free consultation with one of our attorneys. Our experienced accident attorneys can help you by visiting our contact page.
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