What does Michigan no-fault pay for work loss, attendant care and replacement services?
I am Mitchell Bisson, a Grand Rapids personal injury lawyer. I have litigated for over 15 years. This page explains what Michigan no-fault personal protection insurance (PIP) pays for besides the medical bills themselves: work loss, replacement services, attendant care, survivor’s loss and funeral costs, and the rules that reduce or cap each one. Most of the rules come from MCL 500.3107 and the sections around it. I start these claims with the wage records, the care records and every benefit statement from other sources, because the numbers have to be built from them. I do not promise outcomes.
The short answer. PIP pays allowable expenses, which are reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery or rehabilitation, along with work loss and replacement services. MCL 500.3107(1). Work loss covers income from work the injured person would have performed in the first 3 years after the accident. It is reduced by 15% unless the claimant proves a lower tax advantage, it is subject to a monthly maximum, and it ends at death. MCL 500.3107(1)(b). Replacement services are limited to $20 per day for the first 3 years. MCL 500.3107(1)(c). Benefits accrue as the expense or loss is incurred, and benefits provided under state or federal law are subtracted. MCL 500.3110(4); MCL 500.3109(1). Nothing here predicts how your claim will end.
A person hurt in a crash often needs all of these benefits at once. The paycheck stops, someone has to handle the household chores, and a family member starts providing care at home. Each benefit has its own proof, its own cap and its own kind of dispute, so the sections below take them one at a time.
The benefits and their limits
The table lists each benefit, what it covers and where the statute caps it. For a policy issued or renewed after July 1, 2020, the coverage level in MCL 500.3107c also limits allowable expenses, and the fee schedule in MCL 500.3157 limits what providers can be paid.
| Benefit | What the statute covers | Limits | Authority |
|---|---|---|---|
| Allowable expenses | Reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery or rehabilitation | Hospital room charges above a reasonable and customary charge for semiprivate accommodations are excluded unless the injured person needs special or intensive care | MCL 500.3107(1)(a) |
| Funeral and burial | Part of allowable expenses | Limited to the amount in the policy, which must be at least $1,750 and no more than $5,000 | MCL 500.3107(1)(a)(ii) |
| Work loss | Loss of income from work the injured person would have performed during the first 3 years after the accident | Reduced 15% unless a lower tax advantage is proved; monthly maximum adjusted annually; no loss after death | MCL 500.3107(1)(b); MCL 500.3107a |
| Replacement services | Expenses reasonably incurred in obtaining ordinary and necessary services in place of those the injured person would have performed, not for income but for the benefit of himself or herself or a dependent | $20 per day, for services that would have been performed during the first 3 years after the accident | MCL 500.3107(1)(c) |
| Survivor’s loss | Dependents’ loss of tangible economic support, plus up to $20 per day for ordinary and necessary services the deceased would have performed for them | Base of $1,475 per 30 days for accidents on or after October 1, 1978, adjusted annually for later accidents and applied to all survivors together; not payable beyond the first 3 years | MCL 500.3108(1), (2) |
| Waiver of work loss | A person 60 or older who would not be eligible for work loss may waive it and receive a reduced premium | The waiver applies only to the person who signed it | MCL 500.3107(2)(a) |
| Medical use of marihuana | An insurer is not required to provide coverage for it or for related expenses | Not covered | MCL 500.3107(2)(b) |
Work loss
Work loss is the loss of income from work the injured person would have performed during the first 3 years after the date of the accident if he or she had not been injured. MCL 500.3107(1)(b). The key words are “would have performed.” The benefit replaces income you would actually have earned, so I build the claim from pay records, tax returns, schedules and employer statements about the job you were doing and the hours you worked.
The benefit is reduced by 15%, because PIP benefits for loss of income are not taxable income, unless the claimant presents to the insurer, in support of the claim, reasonable proof of a lower value of the income tax advantage. In that case the lower value applies. MCL 500.3107(1)(b). The statute also sets a monthly maximum. For October 1, 2012 through September 30, 2013, the work loss benefit for a single 30-day period and the income earned for work in the same period together could not exceed $5,189, applied pro rata to any lesser period. Beginning October 1, 2013, the maximum is adjusted each year for changes in the cost of living, and a change applies only to accidents that happen after the date of the change. The cap that applies to you therefore depends on your accident date, and I look up the figure for that date instead of assuming one.
If you were temporarily unemployed at the time of the accident or during the period of disability, work loss is based on earned income for the last month you were employed full time before the accident. MCL 500.3107a. In Popma v Auto Club Ins Ass’n, 446 Mich 460, 463, 471-472 (1994), the Michigan Supreme Court held that a person who is employed, even part time, is not unemployed, so the work loss was calculated under section 3107(1)(b) and limited to what he would have earned without the accident. The Court also said that a part-time worker is not barred from proving he would have taken a higher-paying full-time job had he not been injured, and that in all cases claimants are left to their proofs.
Work loss ends when the injured person dies, and it is not payable beyond the 3-year window. The tort statute preserves a claim against the person at fault for work loss in excess of “the daily, monthly, and 3-year limitations contained in” sections 3107 to 3110. MCL 500.3135(3)(c). That claim depends on fault, and the person liable gets an exemption reducing liability by the taxes that would have been payable on the income. The 3-year and monthly limits are why a long disability can leave a gap that PIP does not fill.
Replacement services
Replacement services pay for the ordinary and necessary services an injured person would have performed during the first 3 years after the accident, such as household chores, “not for income but for the benefit of himself or herself or of his or her dependent.” The benefit is limited to expenses “not exceeding $20.00 per day, reasonably incurred.” MCL 500.3107(1)(c). At $20 a day the most a full year can produce is $7,300, so this is a small benefit that is easy to lose by not keeping records.
The statute’s word is “incurred.” Benefits accrue “not when the injury occurs but as the allowable expense, work loss or survivors’ loss is incurred.” MCL 500.3110(4). In Proudfoot v State Farm Mut Ins Co, 469 Mich 476, 483-484 (2003), the Michigan Supreme Court defined “incur” as to become liable for, especially because of one’s own actions, and held that a ruling that an expense is necessary does not oblige the insurer to pay it until it is actually incurred. That case involved home modifications, not household services. I use it for the accrual rule and not as a ruling on any particular arrangement for chores. The practical point is a log that records who did what, on which days, and what you owe or paid for it.
Attendant care, family care and home changes
Attendant care is an allowable expense when it is reasonably necessary for the injured person’s care, recovery or rehabilitation and the charge is reasonable. MCL 500.3107(1)(a). Disputes can turn on how many hours are needed, what a caregiver can be paid and who provides the care.
The family care limit. For attendant care rendered in the injured person’s home, an insurer is only required to pay up to the hourly limitation in section 315 of the worker’s disability compensation act when the care is provided, directly or through another person, by a relative of the injured person, a person domiciled in the injured person’s household, or a person with whom the injured person had a business or social relationship before the injury. MCL 500.3157(10). Section 315 states that attendant or nursing care “shall not be ordered in excess of 56 hours per week” if the care is provided by the employee’s spouse, brother, sister, child, parent, or any combination of them. MCL 418.315. An insurer may contract to pay for more hours. MCL 500.3157(11). The two lists of caregivers do not match, so I read the text against each caregiver and each period of care instead of assuming that 56 hours is a flat ceiling for everyone.
Which injuries it reaches. The fee provisions in subsections (2) to (13) apply to treatment or rehabilitative occupational training rendered after July 1, 2021. MCL 500.3157(14). In Andary v USAA Cas Ins Co, 512 Mich 207 (2023), the Michigan Supreme Court held that the scope of PIP benefits vests at the time of injury and that the amended subsections (7) and (10) do not apply to an insured who was injured while covered by a policy issued before June 11, 2019. The Court of Appeals extended that reasoning to other amended fee provisions in Fremont Ins Co v Lighthouse Outpatient Ctr, No. 370500 (Mich Ct App Apr 11, 2025), a published decision with a partial concurrence, and I check for further review before I rely on it. The injury date, the policy date and the date of the care all go into the analysis.
Home changes and vehicles. In Admire v Auto-Owners Ins Co, 494 Mich 10 (2013), the Court held that an insurer owed the modifications needed to make a van wheelchair accessible but not the van’s base price, which is an ordinary transportation expense. In Proudfoot v State Farm Mut Ins Co, 469 Mich 476, 483-484 (2003), the Court affirmed a declaration that the proposed home modifications were reasonably necessary and set the allowable amount, but held the insurer did not have to pay the future cost until it was incurred. Both cases predate the 2019 amendments, and on a policy issued or renewed after July 1, 2020 the coverage level can also cap what is payable.
Utilization review. A provider that treats an injured person for an injury covered by PIP after July 1, 2020 is considered to have agreed to submit records for utilization review. MCL 500.3157a(1). If treatment, products or services are not usually associated with the diagnosis, or last longer or occur more often than usual, the insurer may require the provider to explain the necessity in writing, and a provider that disagrees with an overutilization determination may appeal it to the department. MCL 500.3157a(4), (5). The statute defines utilization review as the insurer’s initial evaluation of the appropriateness, in level and quality, of the care based on medically accepted standards. MCL 500.3157a(6). When a claim is cut after a review, I ask for the review itself and the standards it applied.
Other benefits that reduce PIP
Benefits provided or required to be provided under the laws of any state or the federal government are subtracted from the PIP benefits otherwise payable for the injury. MCL 500.3109(1). The Michigan Supreme Court upheld that subtraction as applied to workers’ compensation benefits against an equal protection challenge in Mathis v Interstate Motor Freight Sys, 408 Mich 164 (1980). In Popma v Auto Club Ins Ass’n, 446 Mich 460, 473-478 (1994), the Court held that the whole amount of Social Security disability benefits is subtracted, including the part paid directly to the claimant’s lawyer as a fee, and explained that the setoff exists to prevent duplicate recovery.
The statute speaks of benefits under the laws of a state or the federal government. It does not mention private disability policies, so I read the policy language and the benefit rules separately. Because the subtraction applies to the PIP benefit “otherwise payable,” I ask for every benefit statement and compare it with the PIP payment log line by line. A wrong subtraction is easy to miss when the figures arrive months apart.
The Catastrophic Claims Association
The Catastrophic Claims Association is a nonprofit association that every insurer writing the required coverage must join. MCL 500.3104(1). For policies issued or renewed before July 2, 2020, and for later policies with the unlimited coverage level, it reimburses its member insurers for 100% of the ultimate loss above a threshold. MCL 500.3104(2). The threshold was $580,000 for policies issued or renewed from July 1, 2019 to June 30, 2021, and the statute raises it every two years by the lesser of 6% or the Consumer Price Index. MCL 500.3104(2)(o). After July 1, 2020 the association has no liability for a policy that carries a $50,000, $250,000 or $500,000 limit. MCL 500.3104(27). The association reimburses insurers, so you still claim from your no-fault insurer. Members must report to the association each claim that may reasonably be expected to involve it, and if the association considers a member’s claims practices inadequate, it may undertake the adjustment of those claims or contract with someone else to do it. MCL 500.3104(7)(b), (g).
When PIP is not enough
A person who has used up a PIP limit, or who is past the daily, monthly or 3-year limits, may have a claim against the at-fault driver for the excess. MCL 500.3135(3)(c). The statute also allows damages “without limit for allowable expenses” when the injured person elected not to maintain PIP coverage under section 3107d or an exclusion under section 3109a(2) applies. The Supreme Court decided how that claim works for a Medicare beneficiary in Canty v Mason, No. 167772 (Mich July 27, 2026).
In Canty, the plaintiff had waived PIP coverage because he had Medicare Parts A and B, and he sued the driver for allowable medical expenses. The Court held that the common-law duty to mitigate damages applies to that claim, so the plaintiff had to make reasonable efforts to reduce his economic harm, which here meant seeking Medicare payment for treatment from Medicare-participating providers. The defendant raises failure to mitigate as an affirmative defense and bears the burden of proving it. The Court also held that the reimbursement limits in section 3157 do not apply to that tort claim, and the damages must still be reasonable charges for reasonably necessary care. Justice Welch concurred and Justice Zahra concurred in part and dissented in part, so the opinion has separate writings that I read before applying it. If you waived PIP because of Medicare, that decision affects how I document your treatment and billing from the start.
Arguments insurers make
- “The care is not reasonably necessary.” The statute requires charges for reasonably necessary products, services and accommodations. I answer with the treating records, the care plans and the reasons for the hours, and I look at whether a utilization review was done and what standard it used.
- “Family care is capped at 56 hours.” The cap depends on who provides the care, where, when it was rendered and which version of the statute governs. I check each of those, and I check whether the insurer agreed to pay more.
- “The expense was not incurred.” Under the incurred rule, an expense is owed when you become liable for it. I keep the contracts, invoices and logs that show when that happened.
- “You could have returned to work.” In Canty, the Supreme Court noted that it had previously held the mitigation-of-damages doctrine applies to a claim for work-loss benefits under the no-fault act, citing Marquis v Hartford Accident & Indemnity (After Remand), 444 Mich 638, 651-652 (1994). I gather the medical restrictions, job search records and employer statements that show what work was available.
- “Other benefits cover this loss.” I confirm that the other benefit comes from state or federal law, and I match it to the same loss and the same period before accepting a subtraction.
How I handle a work loss, attendant care or replacement services claim
- Pin the dates. I confirm the accident date, the policy period and the date of each service, because the version of the statute and the monthly maximum depend on them.
- Build the income claim. I collect pay records, tax returns, schedules and employer statements, and I gather the disability slips and restrictions from your doctors.
- Document the care. I ask for a prescription or care plan, a log of who provides care and for how many hours, and any agreement to pay a family caregiver.
- Track the household services. I set up a daily record for replacement services so the $20 per day limit is claimed in full for each day it applies.
- Collect every other benefit. I get statements from workers’ compensation, Social Security and any other government program so the subtraction can be checked.
- Send a written claim. I submit the proof of each loss in writing, calendar the insurer’s response dates and keep the timing of each expense in view.
- File when needed. If the insurer will not pay what is owed, I file suit before the one-year deadlines run, and I plan for the claim against the at-fault driver for losses PIP does not cover.
Ways a benefits dispute may end
A benefits dispute can end with the insurer paying the disputed hours or wages with interest, with an agreed monthly payment for ongoing care, with a ruling on how a statute applies to your dates, or with a settlement of the claim. Some disputes are decided on motion, and some go to trial. I explain the options as the facts develop, and you decide. I do not promise outcomes.
What I need from you
Bring your pay stubs, tax returns and W-2s for the years before the crash, your employer’s contact information, and any disability notes from your doctors. Bring the insurer’s letters and payment records, the explanations of benefits and every benefit statement from workers’ compensation, Social Security or any other program. If someone helps you at home, bring a log of who, when and how many hours, along with any estimates for ramps, rails or a vehicle. Tell me who depends on you, what chores you used to do, and whether you waived any coverage when you bought your policy.
Where your Kent County injury case will be heard
I represent clients in Grand Rapids, Kentwood, Grandville, Wyoming and across Kent County. Under MCL 600.8301(1), the district court has exclusive jurisdiction in civil actions when the amount in controversy does not exceed $25,000. Michigan law sets the Kent County district courts by municipality. The 61st District Court serves the city of Grand Rapids, the 59th serves the cities of Grandville and Walker, the 62A serves the city of Wyoming and the 62B serves the city of Kentwood. MCL 600.8128a; MCL 600.8130(1)-(3). The 63rd District Court serves the rest of Kent County, which includes the cities of Rockford, Lowell, Cedar Springs and East Grand Rapids and the surrounding townships. MCL 600.8130(4). A claim above the district court’s $25,000 limit is filed in the Kent County Circuit Court, which is the 17th Judicial Circuit. MCL 600.518; MCL 600.601(1).
Why people hire me for a no-fault benefits claim
You work directly with me, the lawyer handling your case. I read the wage and care records myself, I explain which benefit each loss belongs to, and I tell you where a position is strong and where it is thin. I do not promise outcomes. I work from the documents, the statute and the decisions, and we decide together how to proceed.
My fee depends on the type of case, how complicated it is and whether it is likely to go to trial. We talk about the fee at the consultation, before you decide whether to hire me.
Questions I hear about no-fault benefits
I receive workers’ compensation or Social Security disability. Will my no-fault insurer reduce my PIP benefits?
Often, yes. MCL 500.3109(1) subtracts benefits provided or required to be provided under state or federal law from the PIP benefits otherwise payable for the injury. The Michigan Supreme Court has applied that to workers’ compensation (Mathis) and to Social Security disability benefits, including the share paid to a lawyer (Popma). It is not automatic for every government benefit: the other benefit has to serve the same purpose as PIP and arise from the same accident (Jarosz).
Will no-fault pay for a wheelchair van, a ramp, or other changes to my home after a serious injury?
It can pay for the part your injury makes necessary. MCL 500.3107(1)(a) covers reasonable charges for reasonably necessary products, services and accommodations for your care, recovery or rehabilitation. In Admire, the Michigan Supreme Court held the insurer owed the wheelchair modifications to a van but not the van’s base price, an ordinary transportation expense. Home modifications use the same statute, but the cost is owed only once you have incurred it.
What is the Michigan Catastrophic Claims Association, and does it change who pays my no-fault benefits?
No. The MCCA is a nonprofit association of auto insurers that reimburses its members for very large PIP losses, so you still claim from your no-fault insurer. Under MCL 500.3104(2), it reimburses 100 percent of a member’s ultimate loss above a per-accident threshold, which was $580,000 for policies issued or renewed from July 1, 2019 to June 30, 2021 and is adjusted every two years. For policies issued or renewed after July 1, 2020, it covers only unlimited PIP medical coverage.
How do no-fault work loss benefits work, and how long do they last?
PIP work loss covers income you would have earned from work you would have performed during the first three years after the accident if you had not been injured. The benefit is reduced by 15% unless you prove a lower tax advantage, is subject to a monthly maximum that is adjusted annually, and ends if you die. It is not unlimited wage replacement.
What are replacement services under Michigan no-fault and how much do they pay?
Replacement services pay for ordinary and necessary services you would have done for yourself or your dependents if you had not been injured, such as household tasks. MCL 500.3107(1)(c) limits the benefit to $20 per day, for expenses reasonably incurred, for the first three years after the accident.
What survivor’s loss benefits are available after a fatal car crash in Michigan?
MCL 500.3108 provides PIP survivor’s loss benefits to dependents for contributions of tangible economic support they would have received from the deceased, plus up to $20 a day for services the deceased would have performed. The benefit is capped in any single 30-day period, with a base figure of $1,475 for accidents on or after October 1, 1978 that is adjusted yearly for later accidents, and it is not payable beyond the first three years after the accident.
How much does Michigan no-fault pay toward funeral expenses?
PIP allowable expenses include funeral and burial expenses, but only up to the amount set in the policy, which cannot be less than $1,750 or more than $5,000 under MCL 500.3107(1)(a)(ii). Costs above the policy amount are not part of PIP, though they can be part of a wrongful death claim against someone at fault.
Related Michigan pages
- Grand Rapids personal injury lawyer
- No-fault PIP
- PIP coverage levels and the medical fee schedule
- Who pays no-fault benefits and assigned claims
- No-fault claim denials
- Breach of contract
- Michigan legal FAQs
I represent people injured in Michigan crashes whose no-fault work loss, attendant care or replacement services claims are in dispute. Contact me 24/7 by phone or email. Your Rights, My Fight! Call for a free initial consultation.
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Law Offices of Mitchell S. Bisson, 2828 Kraft Ave SE, Suite 295, Grand Rapids, MI 49512, serving Kent County and West Michigan.
This page provides general information about Michigan law and is not legal advice. Reading it does not create an attorney-client relationship. Laws change and every case turns on its own facts. Consult a licensed attorney about your specific situation.