Recent Michigan No Fault Insurance Court Decision
In the recent case of Johnson v. Wausau, the Court of Appeals held that an insurance company did not have to pay insurance benefits to a ten-month old girl with catastrophic brain injuries sustained in a car accident sixteen years ago. For over 16 years, the auto insurance adjuster had been telling the family that they were only entitled $20 per day for “replacement services.” What the insurance company failed to tell the family is that the family was entitled to extensive attendant care benefits for over 16 years.
Even though the insurance company was not being truthful about the availability of benefits, it was determined that the insurance company did not have to pay the full benefits because a timely claim had not been filed by the injured girl. The Court of Appeals reasoned that an insurance policyholder has the ability and responsibility to know and understand the terms of his or her auto insurance policy. Unfortunately, auto insurance policies are very difficult to interpret. Many insurance companies do not routinely provide their policyholders with a copy of the auto insurance policy. Even if a policyholder had the complete policy, the scope and nature of all of the benefits that may be available are not always available within the policy.
The best advice for individuals involved in an insurance coverage dispute, such as individuals injured in car accidents, is to seek legal counsel immediately after an accident occurs. A qualified attorney who handles auto negligence cases and also handles cases against insurance companies, will be able to quickly determine what benefits an injured individual and/or his or her family may be entitled to receive from the insurance company. The worst thing that an injured person – or his family – can do is to simply accept what an insurance adjuster says as being the “gospel truth.” The case of Johnson v. Wausau, stands for the proposition that an insurance company is not obligated to make a complete disclosure of what benefits are available to an injured person or his/her family.
Persons injured in automobile accidents have many rights – some of which are not easily understood or readily discoverable through a review of the insurance policy. These rights are sometimes found in Michigan’s complicated “no fault” law. John T. Alexander, Esq. routinely handles these types of cases. John T. Alexander, Esq., has been in private practice in Oakland County, Michigan, since 1992. His Oakland County, Michigan personal injury practice is devoted to auto negligence and serious personal injury claims. He also routinely handles severe truck accident and motorcycle accident cases. He can be contacted at johntalexanderlaw.com or by calling (248/290-5600).