The most common reasons for a denial
- An insurer medical exam. The insurer sends you to a doctor it pays, who reports that your injuries have resolved or were never caused by the crash.
- Treatment is not reasonably necessary or costs more than the fee schedule allows.
- Priority disputes. The insurer says another policy should pay. Meanwhile, nobody pays.
- Fraud or rescission. The insurer claims a misstatement on the application or in the claim and tries to void the policy.
- Late notice. The insurer says it was not told within a year.
What the law gives you when they are wrong
PIP benefits are overdue if they are not paid within 30 days after the insurer receives reasonable proof of the loss. From then, MCL 500.3142 adds 12% interest a year. If the insurer’s refusal or delay was unreasonable, MCL 500.3148 lets the court order it to pay your attorney fees on top of the benefits.
What to do right now
- Keep treating if your doctor says you need care. A gap in treatment is the insurer’s best evidence.
- Ask your doctor to respond in writing to the insurer exam report.
- Keep submitting bills, wage forms and household help logs, even after the denial.
- Do not give a recorded statement or sign a release without talking to a lawyer.
- Check the deadline. A lawsuit can only recover expenses from the year before it is filed, with a pause while the claim was pending.
Denials start a clock. Under MCL 500.3145, the one-year period is paused from when you submit a specific claim until the insurer formally denies it. Once that denial arrives, the clock resumes where it left off.
Questions people ask us
Do I have to go to the insurer’s medical exam?
Usually yes, if the policy requires it and the request is reasonable. Refusing can give the insurer a reason to suspend benefits. You can bring someone with you and you should write down how long the exam actually lasted.
The insurer says I lied on my application. Can it cancel my policy?
Insurers sometimes try to rescind a policy for misstatements on the application. Rescission is not automatic, and courts weigh the equities, especially for innocent third parties. Do not sign anything the insurer sends until a lawyer reads it.
How long does a no-fault lawsuit take?
Many settle within a year. Cases that go to trial in Oakland County Circuit Court often take 18 months or more. Benefits that are paid late still earn 12% interest.