Michigan PIP Statute: Coverage Tiers, Priority, and Notice Rules

The Michigan PIP statute, part of the state’s no-fault auto insurance law, guarantees Personal Injury Protection benefits to people hurt in motor vehicle accidents regardless of fault. It pays medical bills, a portion of lost wages, replacement services, attendant care, and funeral or survivor’s loss benefits, with medical coverage running anywhere from a full opt-out for Medicare enrollees up to unlimited lifetime benefits depending on the tier you chose when you bought or renewed your policy. The statute also sets strict deadlines: one year to give your insurer written notice of injury, and a separate one-year-back rule that can quietly erase benefits you were otherwise entitled to.

Who Can Collect PIP

PIP covers the person named on a Michigan no-fault policy, that person’s spouse, and any relative of either living in the same household.¹ Passengers in an insured vehicle and pedestrians struck by one can also qualify, though which insurer actually pays depends on the priority rules. Out-of-state residents generally are not eligible unless they were riding in a Michigan-insured vehicle.

Two situations disqualify you outright. If you were driving or riding in a vehicle you knew was stolen, PIP is unavailable. So is PIP if you were the owner or registrant of an uninsured motor vehicle involved in the crash.² That second bar catches drivers who let coverage lapse and then get hurt in their own car. Even when someone else caused the crash, being the uninsured owner of a vehicle involved in it ends the claim.

Uninsured people who don’t fall into those categories may still get benefits through the Michigan Assigned Claims Plan, which assigns an insurer to handle the claim. Medical coverage through that route is capped at $250,000 rather than the unlimited option available to insured drivers.

The Six PIP Coverage Tiers

Before the 2019 reform, every Michigan policy came with unlimited lifetime PIP medical coverage. Now you pick from six tiers when you buy or renew, and the tier sets the maximum your insurer will pay per person per accident for medical care.³

Unlimited coverage, with no cap on PIP medical benefits. This is the default if you don’t return the PIP Medical Coverage Form.
Up to $500,000, associated with roughly a 20% reduction in PIP premiums compared to unlimited.
Up to $250,000, associated with roughly a 35% premium reduction.
Up to $250,000 with exclusions, the same dollar cap but with specific household members excluded if they have their own qualifying health coverage.
Up to $50,000, available only if the named insured is enrolled in Medicaid and every other household member has separate auto insurance, Medicaid, or other health coverage for accident injuries. Associated with roughly a 45% premium reduction.
Full opt-out, available only if the named insured has both Medicare Parts A and B and every other household member has qualified health coverage or a separate auto policy with PIP medical benefits.

Skip the form and you default to unlimited, which protects you but also means you pay the highest PIP premium.⁴ The lower tiers cut premiums but expose you to catastrophic costs if a serious injury blows through the cap.

What Counts as Qualified Health Coverage

To select the $50,000 tier or opt out, household members need what the statute calls qualified health coverage. That means enrollment in Medicare Parts A and B, or a health or accident plan that does not exclude auto-accident injuries and has an annual individual deductible of $6,579 or less.⁵ The statutory base is $6,000, adjusted periodically for inflation; the $6,579 figure applies through June 30, 2027.⁶

What PIP Pays For

Medical Expenses

PIP pays for reasonable and necessary medical care tied to your accident injuries, including hospital stays, surgery, rehabilitation, prescriptions, and long-term care, up to the cap set by your tier.⁷

A separate fee schedule limits what providers can charge for treating auto-accident injuries. Most providers are capped at 190% of the Medicare rate for the same treatment, and certain providers that treat a high volume of auto-accident patients or meet other qualifying criteria can charge up to 220%.⁸ If your provider balance-bills you above what your insurer paid, the fee schedule is often the reason.

Wage Loss

If injuries keep you from working, PIP pays 85% of your gross income up to a monthly maximum that DIFS adjusts each year. For accidents between October 1, 2025 and September 30, 2026, the maximum is $7,201 per month. PIP wage loss is not taxable, and the 15% reduction roughly reflects that tax advantage, though you can submit proof that the actual tax benefit in your case is lower.⁷ Wage loss is payable for up to three years from the date of the accident. Disability and workers’ compensation payments are coordinated so you cannot collect more than the statutory maximum from combined sources.

Replacement Services

When your injuries prevent you from doing household work you would have done yourself, PIP reimburses up to $20 per day to hire someone: cleaning, cooking, yard work, childcare. Payable for up to three years after the accident.⁷ The $20 cap is a fixed statutory amount that has not been adjusted since the law was written, so it often falls short of what real help costs.

Attendant Care

For serious injuries requiring in-home help with daily activities, PIP covers attendant care, but the source of the care matters. If a relative, a household member, or someone you had a prior social or business relationship with provides the care, the insurer is required to pay for only up to 56 hours per week.⁹ No such hourly cap applies to care from professional agencies or unrelated hired caregivers, though the fee schedule under MCL 500.3157 still limits what those providers can charge.⁸

Funeral and Survivor’s Loss

When an accident results in death, PIP pays funeral and burial costs. The policy must provide at least $1,750 and no more than $5,000 within that statutory range.⁷ Survivor’s loss benefits pay dependents for the tangible economic support the deceased would have provided plus up to $20 per day for services the dependents now need to hire out. Survivor’s loss is capped at a monthly maximum DIFS adjusts annually and is payable for up to three years from the date of the accident.¹⁰

Which Insurer Pays First

Priority rules decide which company is on the hook, and getting it wrong stalls payments for months. The framework works roughly like this:

For the named insured, spouse, or household relatives, your own no-fault policy pays first. If both spouses have their own policies, the injured person’s insurer pays up to that policy’s coverage level and cannot seek reimbursement from the other spouse’s insurer.
For passengers in a commercial vehicle, the commercial vehicle’s insurer generally pays, with exceptions for school buses, common-carrier buses, government transit, nonprofit buses, and rideshare vehicles.
For employees hurt in employer-owned vehicles, the insurer covering the employer’s vehicle pays.
For pedestrians and bicyclists, benefits typically come from the injured person’s own policy, a spouse’s policy, or a household relative’s policy. Other priority rules apply if no such policy exists.

These rules sit in MCL 500.3114 and 500.3115.¹ When multiple insurers dispute who pays, the insurer you submitted your claim to is still required to process it and can seek reimbursement later from whichever company ultimately bears responsibility.

Coordinating PIP With Health or Disability Coverage

Michigan law lets you coordinate PIP with other health or disability insurance. If you elect coordination, your health plan becomes the primary payer for accident-related medical bills and PIP picks up what the health plan does not cover. Premiums drop because the auto insurer’s exposure drops.¹¹

Coordination can also apply to wage loss, with disability paying first and PIP filling the gap up to the statutory maximum. The savings are real, and so is the risk: high deductibles, narrow networks, or treatment limits in your health plan become your problem before PIP steps in. That is where many people are surprised after an accident.

The One-Year Notice and the One-Year-Back Rule

Michigan sets two deadlines that catch injured people off guard, particularly those still recovering. Written notice of injury must reach your insurer within one year of the accident. It doesn’t have to be elaborate: your name, address, the injured person’s name, and a plain description of when, where, and how the injury happened.¹²

If timely notice was given or the insurer has already made at least one PIP payment, you can sue for benefits at any time within one year after the most recent allowable expense, wage loss, or survivor’s loss was incurred. The trap is the one-year-back rule: you cannot recover benefits for any loss incurred more than one year before you filed the lawsuit. Wait too long to sue and months of otherwise valid benefits vanish.¹²

One protection exists. The limitation period is tolled from the date you submit a specific claim for payment until the date the insurer formally denies it. Tolling does not apply if you fail to pursue the claim with reasonable diligence, so sending paperwork and going silent for months will not preserve your rights.

Where PIP Claims Get Fought

Fee Schedule Reductions

Insurers frequently deny or reduce payments by arguing that a provider’s charges exceed the fee schedule. Providers and claimants sometimes challenge those reductions, particularly for treatments with no direct Medicare equivalent, where calculating the cap is not straightforward.⁸

Independent Medical Examinations

Under MCL 500.3151, an insurer can require you to undergo a mental or physical exam by a physician of its choosing if your condition is relevant to your claim.¹³ These exams are rarely friendly, since the insurer picks and pays the examiner. Refuse to attend and the insurer can suspend your PIP benefits until you comply. The suspension is temporary and benefits should resume once you attend, but the payment gap creates real financial pressure, which is exactly why insurers use the tool.

Priority and Coordination Disputes

When an insurer argues another company should pay first, benefits can stall while the companies fight. Courts resolve these disputes under the priority rules in MCL 500.3114 and the coordination rules in MCL 500.3109a.¹¹ If two insurers are pointing at each other, filing a formal claim with each starts the tolling clock on both and builds a record you’ll need if you have to sue.

Reasonableness of Ongoing Treatment

Even when charges fall within the fee schedule, an insurer can dispute whether a treatment is reasonably necessary. Long-term rehabilitation, pain management, and attendant care are the common targets. The insurer’s examiner may conclude that ongoing care is no longer needed while your treating physician disagrees. If your insurer cuts off treatment payments after an IME, the matter is not settled. You retain the right to challenge the denial in court.

1
Michigan Legislature. MCL – Section 500.3114
2
Michigan Legislature. MCL – Section 500.3113
3
State of Michigan. Choosing PIP Medical Coverage
4
State of Michigan. Auto Insurance Reform FAQ
5
Michigan Department of Insurance and Financial Services. Bulletin 2026-08-INS – Qualified Health Coverage Deductible
6
Michigan Legislature. MCL – Section 500.3107d
7
Michigan Legislature. MCL – Section 500.3107
8
Michigan Legislature. MCL – Section 500.3157
9
Michigan Department of Insurance and Financial Services. Bulletin 2019-22-INS – Attendant Care Hourly Limitations
10
Michigan Legislature. MCL – Section 500.3108
11
Michigan Legislature. MCL – Section 500.3109a
12
Michigan Legislature. MCL – Section 500.3145
13
Michigan Legislature. MCL – Section 500.3151