Filing a PIP Claim: Step by Step

After a car accident in Michigan, your Personal Injury Protection (PIP) benefits are your primary source of compensation for medical bills, lost wages, and other expenses, regardless of who was at fault. However, accessing these benefits requires following specific procedures and meeting strict deadlines. Missing a single step can result in delayed payments or outright denial of your claim. This guide walks you through the entire PIP claim process from start to finish.

Step 1: Determine Which Insurer to File With (Priority Rules)

Michigan law establishes a specific order of priority for determining which insurance company is responsible for paying your PIP benefits. Filing with the wrong insurer can delay your claim by months. Under MCL 500.3114 and 500.3115, the priority order is:

1. Your own auto insurer if you were driving your own vehicle, or a vehicle owned by a resident relative, or if you were a pedestrian or cyclist.
2. The insurer of the vehicle you were occupying if you were a passenger in someone else's car (the vehicle owner's policy is primary).
3. The insurer of the vehicle that struck you if you were a pedestrian, cyclist, or motorcyclist and do not have your own auto policy.
4. The Michigan Assigned Claims Plan (MACP) if no other insurance applies or if the involved vehicles were all uninsured.

These priority rules can be complex in multi-vehicle accidents or situations involving company vehicles. For background on how the no-fault system works, see our Michigan no-fault basics guide.

Step 2: Notify the Insurer Promptly

Contact the appropriate insurance company as soon as possible after the accident. While Michigan law does not impose a specific number of days to report the accident for PIP purposes, most policies require "prompt" or "timely" notice as a condition of coverage. Delays in reporting can give the insurer grounds to investigate or potentially deny your claim.

When you contact the insurer, provide:

• Date, time, and location of the accident
• Your policy number
• A brief description of what happened
• Names of other involved parties (if known)
• Information about your injuries

Step 3: Submit the Application for Benefits

The insurer will send you an Application for Benefits form, sometimes called a "written notice of injury." This is the formal document that initiates your PIP claim. Under MCL 500.3145(1), benefits are overdue if not paid within 30 days after the insurer receives reasonable proof of the fact and amount of the loss.

The application typically asks for:

• Detailed information about the accident
• Description of your injuries
• Your employment information (for wage loss claims)
• Your health insurance information (for coordination purposes)
• Authorization to obtain your medical records
• Information about other insurance policies that might apply

Complete this form thoroughly and accurately. Inconsistencies or omissions can trigger delays or investigations.

Step 4: Submit Supporting Documentation

Along with or shortly after your application, you will need to provide documentation supporting each type of benefit you are claiming:

For Medical Benefits

• Medical records from all treating providers
• Itemized medical bills
• Prescriptions and pharmacy receipts
• Referrals or treatment plans from your physicians
• Proof of health insurance (if you have coordinated coverage)

For Wage Loss Benefits

• Employer verification of your wages and work schedule
• Pay stubs from the period before the accident (typically 3-6 months)
• Tax returns if self-employed
• Doctor's note confirming disability and work restrictions
• Documentation of any partial return to work

For Replacement Services

• List of household tasks you can no longer perform
• Doctor's certification of your physical limitations
• Receipts or records of who performed these services and when

Step 5: Understand Critical Deadlines

Michigan's PIP system has several important deadlines that can affect your right to benefits:

The One-Year-Back Rule

Under MCL 500.3145(1), a PIP claimant cannot recover benefits for any portion of a loss incurred more than one year before the date the action (lawsuit) is filed. This is one of the most misunderstood rules in Michigan no-fault law. Here is what it means in practice:

• You do not have to file a lawsuit within one year of the accident.
• However, if the insurer denies or stops paying benefits and you must sue, you can only recover benefits that accrued within the one year before you filed the lawsuit.
• Any benefits older than one year from the lawsuit filing date are lost forever.
• This rule makes it critical to act quickly if your insurer stops paying. The longer you wait, the more benefits you forfeit.

For example, if your insurer denies a medical bill on January 1, 2025, and you do not file suit until March 1, 2027, you can only recover benefits that accrued after March 1, 2026. Everything between January 2025 and February 2026 is permanently lost.

Other Important Deadlines

• 30-day payment deadline: Once the insurer has reasonable proof of loss, benefits become overdue after 30 days. Overdue benefits accrue penalty interest at 12% per year.
• Wage loss claim timing: Wage loss benefits have a three-year duration limit from the date of the accident. You cannot receive wage loss benefits beyond three years, regardless of ongoing disability.
• Statute of limitations for PIP lawsuits: You generally have one year from the date a benefit was denied or became overdue to preserve that specific benefit through legal action. See our guide on Michigan statutes of limitations for additional detail.

Step 6: Respond to Insurer Requests

After filing your claim, the insurer will likely:

• Request additional records: They may ask for prior medical history, employment records, or other documentation.
• Schedule an Independent Medical Examination (IME): Under MCL 500.3151, the insurer has the right to have you examined by a doctor of their choosing. You must attend, or your benefits may be suspended.
• Conduct surveillance: Insurers sometimes hire investigators to observe claimants in public to check for inconsistencies with reported limitations.
• Request an Examination Under Oath (EUO): The insurer may require you to answer questions under oath about your claim. Failure to attend can result in benefit suspension.

Cooperate with reasonable requests, but be aware that the insurer is also looking for reasons to reduce or deny your benefits. Having an attorney guide you through these interactions can protect your rights.

Step 7: Track Payments and Follow Up

Once benefits begin flowing, maintain careful records:

• Log every payment received with the date and amount
• Match payments to specific bills or wage loss periods
• Note any bills that remain unpaid after 30 days
• Keep copies of all correspondence with the insurer
• Document phone calls (date, time, who you spoke with, what was said)

If payments stop or bills go unpaid, do not wait. Contact the insurer immediately to determine the reason. If the issue is not resolved, consult an attorney before the one-year-back rule erodes your recoverable benefits.

Filing with the Michigan Assigned Claims Plan

If you do not have auto insurance and were injured as a pedestrian, cyclist, or passenger in an uninsured vehicle, you may need to file through the Michigan Assigned Claims Plan (MACP). The process is different:

• You must file an application with the MACP within the applicable time limits.
• The MACP assigns your claim to a specific insurance company.
• That assigned insurer then processes your claim as if you were their policyholder.
• Benefits available through the MACP may be more limited than those under a standard policy.

When to Get Legal Help

While straightforward PIP claims for minor injuries can sometimes be handled without an attorney, you should strongly consider legal representation if:

• Your claim is denied or benefits are terminated
• The insurer requests an IME or EUO
• You have serious injuries requiring ongoing or expensive treatment
• There are disputes about priority (which insurer should pay)
• You also have a potential third-party claim against the at-fault driver
• The one-year-back rule is approaching for any unpaid benefits

For guidance on what to do immediately after a crash, review our article on what to do after a car accident. If your PIP claim has been denied, read our guide on PIP claim denials and appeals for your next steps.