Bill Text: MI SB0293 | 2011-2012 | 96th Legislature | Introduced
Bill Title: Insurance; no-fault; personal insurance protection coverage; provide for different benefit levels. Amends secs. 2111, 3101, 3104, 3107, 3114, 3115, 3163 & 3172 of 1956 PA 218 (MCL 500.2111 et seq.).
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2011-03-24 - Referred To Committee On Insurance [SB0293 Detail]
Download: Michigan-2011-SB0293-Introduced.html
SENATE BILL No. 293
March 24, 2011, Introduced by Senators HUNE and SMITH and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
by amending sections 2111, 3101, 3104, 3107, 3114, 3115, 3163, and
3172 (MCL 500.2111, 500.3101, 500.3104, 500.3107, 500.3114,
500.3115, 500.3163, and 500.3172), section 2111 as amended by 2002
PA 492, section 3101 as amended by 2008 PA 241, section 3104 as
amended by 2002 PA 662, section 3107 as amended by 1991 PA 191,
section 3114 as amended by 2002 PA 38, section 3163 as amended by
2002 PA 697, and section 3172 as amended by 1984 PA 426.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 2111. (1) Notwithstanding any provision of this act and
this chapter to the contrary, classifications and territorial base
rates used by any insurer in this state with respect to automobile
insurance or home insurance shall conform to the applicable
requirements of this section.
(2) Classifications established pursuant to this section for
automobile insurance shall be based only upon 1 or more of the
following factors, which shall be applied by an insurer on a
uniform basis throughout the state:
(a) With respect to all automobile insurance coverages:
(i) Either the age of the driver; the length of driving
experience; or the number of years licensed to operate a motor
vehicle.
(ii) Driver primacy, based upon the proportionate use of each
vehicle insured under the policy by individual drivers insured or
to be insured under the policy.
(iii) Average miles driven weekly, annually, or both.
(iv) Type of use, such as business, farm, or pleasure use.
(v) Vehicle characteristics, features, and options, such as
engine displacement, ability of vehicle and its equipment to
protect passengers from injury and other similar items, including
vehicle make and model.
(vi) Daily or weekly commuting mileage.
(vii) Number of cars insured by the insurer or number of
licensed operators in the household. However, number of licensed
operators shall not be used as an indirect measure of marital
status.
(viii) Amount of insurance.
(b) In addition to the factors prescribed in subdivision (a),
with respect to personal protection insurance coverage:
(i) Earned income.
(ii) Number of dependents of income earners insured under the
policy.
(iii) Coordination of benefits.
(iv) Use of a safety belt.
(v) Amount of insurance.
(c) In addition to the factors prescribed in subdivision (a),
with respect to collision and comprehensive coverages:
(i) The anticipated cost of vehicle repairs or replacement,
which may be measured by age, price, cost new, or value of the
insured automobile, and other factors directly relating to that
anticipated cost.
(ii) Vehicle make and model.
(iii) Vehicle design characteristics related to vehicle
damageability.
(iv) Vehicle characteristics relating to automobile theft
prevention devices.
(d) With respect to all automobile insurance coverage other
than comprehensive, successful completion by the individual driver
or drivers insured under the policy of an accident prevention
education course that meets the following criteria:
(i) The course shall include a minimum of 8 hours of classroom
instruction.
(ii) The course shall include, but not be limited to, a review
of all of the following:
(A) The effects of aging on driving behavior.
(B) The shapes, colors, and types of road signs.
(C) The effects of alcohol and medication on driving.
(D) The laws relating to the proper use of a motor vehicle.
(E) Accident prevention measures.
(F) The benefits of safety belts and child restraints.
(G) Major driving hazards.
(H) Interaction with other highway users such as
motorcyclists, bicyclists, and pedestrians.
(3) Each insurer shall establish a secondary or merit rating
plan for automobile insurance, other than comprehensive coverage. A
secondary or merit rating plan required under this subsection shall
provide for premium surcharges for any or all coverages for
automobile insurance, other than comprehensive coverage, based upon
any or all of the following, when that information becomes
available to the insurer:
(a) Substantially at-fault accidents.
(b) Convictions for, determinations of responsibility for
civil infractions for, or findings of responsibility in probate
court for civil infractions for, violations under chapter VI of the
Michigan vehicle code, 1949 PA 300, MCL 257.601 to 257.750.
However,
beginning 90 days after the effective date of this
sentence
May 28, 1996, an insured shall not be merit rated for a
civil infraction under chapter VI of the Michigan vehicle code,
1949 PA 300, MCL 257.601 to 257.750, for a period of time longer
than that which the secretary of state's office carries points for
that infraction on the insured's motor vehicle record.
(4) An insurer shall not establish or maintain rates or rating
classifications for automobile insurance based upon sex or marital
status.
(5) Notwithstanding other provisions of this chapter,
automobile insurance risks may be grouped by territory.
(6) This section shall not be construed as limiting insurers
or rating organizations from establishing and maintaining
statistical reporting territories. This section shall not be
construed to prohibit an insurer from establishing or maintaining,
for automobile insurance, a premium discount plan for senior
citizens in this state who are 65 years of age or older, if the
plan is uniformly applied by the insurer throughout this state. If
an insurer has not established and maintained a premium discount
plan for senior citizens, the insurer shall offer reduced premium
rates to senior citizens in this state who are 65 years of age or
older and who drive less than 3,000 miles per year, regardless of
statistical data.
(7) Classifications established pursuant to this section for
home insurance other than inland marine insurance provided by
policy floaters or endorsements shall be based only upon 1 or more
of the following factors:
(a) Amount and types of coverage.
(b) Security and safety devices, including locks, smoke
detectors, and similar, related devices.
(c) Repairable structural defects reasonably related to risk.
(d) Fire protection class.
(e) Construction of structure, based on structure size,
building material components, and number of units.
(f) Loss experience of the insured, based upon prior claims
attributable to factors under the control of the insured that have
been paid by an insurer. An insured's failure, after written notice
from the insurer, to correct a physical condition that presents a
risk of repeated loss shall be considered a factor under the
control of the insured for purposes of this subdivision.
(g) Use of smoking materials within the structure.
(h) Distance of the structure from a fire hydrant.
(i) Availability of law enforcement or crime prevention
services.
(8) Notwithstanding other provisions of this chapter, home
insurance risks may be grouped by territory.
(9) An insurer may utilize factors in addition to those
specified in this section, if the commissioner finds, after a
hearing held pursuant to the administrative procedures act of 1969,
1969 PA 306, MCL 24.201 to 24.328, that the factors would encourage
innovation, would encourage insureds to minimize the risks of loss
from hazards insured against, and would be consistent with the
purposes of this chapter.
Sec. 3101. (1) The owner or registrant of a motor vehicle
required to be registered in this state shall maintain security for
payment
of benefits under personal protection insurance , in an
amount not less than that required under section 3107(1)(a)(i) and
property
protection insurance , and
residual liability insurance in
an amount not less than that required under section 3009. Security
shall only be required to be in effect during the period the motor
vehicle is driven or moved upon a highway. Notwithstanding any
other provision in this act, an insurer that has issued an
automobile insurance policy on a motor vehicle that is not driven
or moved upon a highway may allow the insured owner or registrant
of the motor vehicle to delete a portion of the coverages under the
policy and maintain the comprehensive coverage portion of the
policy in effect.
(2) As used in this chapter:
(a) "Automobile insurance" means that term as defined in
section 2102.
(b) "Highway" means that term as defined in section 20 of the
Michigan vehicle code, 1949 PA 300, MCL 257.20.
(c) "Motorcycle" means a vehicle having a saddle or seat for
the use of the rider, designed to travel on not more than 3 wheels
in contact with the ground, which is equipped with a motor that
exceeds 50 cubic centimeters piston displacement. The wheels on any
attachment to the vehicle shall not be considered as wheels in
contact with the ground. Motorcycle does not include a moped, as
defined in section 32b of the Michigan vehicle code, 1949 PA 300,
MCL 257.32b. Motorcycle does not include an ORV.
(d) "Motorcycle accident" means a loss involving the
ownership, operation, maintenance, or use of a motorcycle as a
motorcycle, but not involving the ownership, operation,
maintenance, or use of a motor vehicle as a motor vehicle.
(e) "Motor vehicle" means a vehicle, including a trailer,
operated or designed for operation upon a public highway by power
other than muscular power which has more than 2 wheels. Motor
vehicle does not include a motorcycle or a moped, as defined in
section 32b of the Michigan vehicle code, 1949 PA 300, MCL 257.32b.
Motor vehicle does not include a farm tractor or other implement of
husbandry which is not subject to the registration requirements of
the Michigan vehicle code pursuant to section 216 of the Michigan
vehicle code, 1949 PA 300, MCL 257.216. Motor vehicle does not
include an ORV.
(f) "Motor vehicle accident" means a loss involving the
ownership, operation, maintenance, or use of a motor vehicle as a
motor vehicle regardless of whether the accident also involves the
ownership, operation, maintenance, or use of a motorcycle as a
motorcycle.
(g) "ORV" means a motor-driven recreation vehicle designed for
off-road use and capable of cross-country travel without benefit of
road or trail, on or immediately over land, snow, ice, marsh,
swampland, or other natural terrain. ORV includes, but is not
limited to, a multitrack or multiwheel drive vehicle, a motorcycle
or related 2-wheel, 3-wheel, or 4-wheel vehicle, an amphibious
machine, a ground effect air cushion vehicle, an ATV as defined in
section 81101 of the natural resources and environmental protection
act, 1994 PA 451, MCL 324.81101, or other means of transportation
deriving motive power from a source other than muscle or wind. ORV
does not include a vehicle described in this subdivision that is
registered for use upon a public highway and has the security
described
in this section 3101 or section 3103
in effect.
(h) "Owner" means any of the following:
(i) A person renting a motor vehicle or having the use thereof,
under a lease or otherwise, for a period that is greater than 30
days.
(ii) A person who holds the legal title to a vehicle, other
than a person engaged in the business of leasing motor vehicles who
is the lessor of a motor vehicle pursuant to a lease providing for
the use of the motor vehicle by the lessee for a period that is
greater than 30 days.
(iii) A person who has the immediate right of possession of a
motor vehicle under an installment sale contract.
(i) "Registrant" does not include a person engaged in the
business of leasing motor vehicles who is the lessor of a motor
vehicle pursuant to a lease providing for the use of the motor
vehicle by the lessee for a period that is greater than 30 days.
(3) Security may be provided under a policy issued by an
insurer duly authorized to transact business in this state which
affords insurance for the payment of benefits described in
subsection (1). A policy of insurance represented or sold as
providing security is considered to provide insurance for the
payment of the benefits.
(4) Security required by subsection (1) may be provided by any
other method approved by the secretary of state as affording
security equivalent to that afforded by a policy of insurance, if
proof of the security is filed and continuously maintained with the
secretary of state throughout the period the motor vehicle is
driven or moved upon a highway. The person filing the security has
all the obligations and rights of an insurer under this chapter.
When the context permits, "insurer" as used in this chapter,
includes any person filing the security as provided in this
section.
Sec. 3104. (1) An unincorporated, nonprofit association to be
known as the catastrophic claims association, hereinafter referred
to as the association, is created. Each insurer engaged in writing
insurance coverages that provide the security required by section
3101(1) within this state, as a condition of its authority to
transact insurance in this state, shall be a member of the
association and shall be bound by the plan of operation of the
association. Each insurer engaged in writing insurance coverages
that provide the security required by section 3103(1) within this
state, as a condition of its authority to transact insurance in
this state, shall be considered a member of the association, but
only for purposes of premiums under subsection (7)(d). Except as
expressly provided in this section, the association is not subject
to any laws of this state with respect to insurers, but in all
other respects the association is subject to the laws of this state
to the extent that the association would be if it were an insurer
organized and subsisting under chapter 50.
(2) The association shall provide and each member shall accept
indemnification for 100% of the amount of ultimate loss sustained
under personal protection insurance coverages in excess of the
following amounts in each loss occurrence:
(a) For a motor vehicle accident policy issued or renewed
before July 1, 2002, $250,000.00.
(b) For a motor vehicle accident policy issued or renewed
during the period July 1, 2002 to June 30, 2003, $300,000.00.
(c) For a motor vehicle accident policy issued or renewed
during the period July 1, 2003 to June 30, 2004, $325,000.00.
(d) For a motor vehicle accident policy issued or renewed
during the period July 1, 2004 to June 30, 2005, $350,000.00.
(e) For a motor vehicle accident policy issued or renewed
during the period July 1, 2005 to June 30, 2006, $375,000.00.
(f) For a motor vehicle accident policy issued or renewed
during the period July 1, 2006 to June 30, 2007, $400,000.00.
(g) For a motor vehicle accident policy issued or renewed
during the period July 1, 2007 to June 30, 2008, $420,000.00.
(h) For a motor vehicle accident policy issued or renewed
during the period July 1, 2008 to June 30, 2009, $440,000.00.
(i) For a motor vehicle accident policy issued or renewed
during the period July 1, 2009 to June 30, 2010, $460,000.00.
(j) For a motor vehicle accident policy issued or renewed
during the period July 1, 2010 to June 30, 2011, $480,000.00.
(k) For a motor vehicle accident policy issued or renewed
during the period July 1, 2011 to June 30, 2013, $500,000.00.
Beginning July 1, 2013, this $500,000.00 amount shall be increased
biennially on July 1 of each odd-numbered year, for policies issued
or renewed before July 1 of the following odd-numbered year, by the
lesser of 6% or the consumer price index, and rounded to the
nearest $5,000.00. This biennial adjustment shall be calculated by
the association by January 1 of the year of its July 1 effective
date.
(3) An insurer may withdraw from the association only upon
ceasing to write insurance that provides the security required by
section 3101(1) in this state.
(4) An insurer whose membership in the association has been
terminated by withdrawal shall continue to be bound by the plan of
operation, and upon withdrawal, all unpaid premiums that have been
charged to the withdrawing member are payable as of the effective
date of the withdrawal.
(5) An unsatisfied net liability to the association of an
insolvent member shall be assumed by and apportioned among the
remaining members of the association as provided in the plan of
operation. The association has all rights allowed by law on behalf
of the remaining members against the estate or funds of the
insolvent member for sums due the association.
(6) If a member has been merged or consolidated into another
insurer or another insurer has reinsured a member's entire business
that provides the security required by section 3101(1) in this
state, the member and successors in interest of the member remain
liable for the member's obligations.
(7) The association shall do all of the following on behalf of
the members of the association:
(a) Assume 100% of all liability as provided in subsection
(2).
(b) Establish procedures by which members shall promptly
report to the association each claim that, on the basis of the
injuries or damages sustained, may reasonably be anticipated to
involve the association if the member is ultimately held legally
liable for the injuries or damages. Solely for the purpose of
reporting claims, the member shall in all instances consider itself
legally liable for the injuries or damages. The member shall also
advise the association of subsequent developments likely to
materially affect the interest of the association in the claim.
(c) Maintain relevant loss and expense data relative to all
liabilities of the association and require each member to furnish
statistics, in connection with liabilities of the association, at
the times and in the form and detail as may be required by the plan
of operation.
(d) In a manner provided for in the plan of operation,
calculate and charge to members of the association a total premium
sufficient to cover the expected losses and expenses of the
association that the association will likely incur during the
period for which the premium is applicable. The premium shall
include an amount to cover incurred but not reported losses for the
period and may be adjusted for any excess or deficient premiums
from previous periods. Excesses or deficiencies from previous
periods may be fully adjusted in a single period or may be adjusted
over several periods in a manner provided for in the plan of
operation. Each member shall be charged an amount equal to that
member's total written car years of insurance providing the
security required by section 3101(1) or 3103(1), or both, written
in this state during the period to which the premium applies,
multiplied by the average premium per car and adjusted to reflect
the amount of coverage selected by each member's insureds under
section 3107. The average premium per car shall be the total
premium calculated divided by the total written car years of
insurance providing the security required by section 3101(1) or
3103(1) written in this state of all members during the period to
which the premium applies. A member shall be charged a premium for
a historic vehicle that is insured with the member of 20% of the
premium charged for a car insured with the member. As used in this
subdivision:
(i) "Car" includes a motorcycle but does not include a historic
vehicle.
(ii) "Historic vehicle" means a vehicle that is a registered
historic vehicle under section 803a or 803p of the Michigan vehicle
code, 1949 PA 300, MCL 257.803a and 257.803p.
(e) Require and accept the payment of premiums from members of
the association as provided for in the plan of operation. The
association shall do either of the following:
(i) Require payment of the premium in full within 45 days after
the premium charge.
(ii) Require payment of the premiums to be made periodically to
cover the actual cash obligations of the association.
(f) Receive and distribute all sums required by the operation
of the association.
(g) Establish procedures for reviewing claims procedures and
practices of members of the association. If the claims procedures
or practices of a member are considered inadequate to properly
service the liabilities of the association, the association may
undertake or may contract with another person, including another
member, to adjust or assist in the adjustment of claims for the
member on claims that create a potential liability to the
association and may charge the cost of the adjustment to the
member.
(8) In addition to other powers granted to it by this section,
the association may do all of the following:
(a) Sue and be sued in the name of the association. A judgment
against the association shall not create any direct liability
against the individual members of the association. The association
may provide for the indemnification of its members, members of the
board of directors of the association, and officers, employees, and
other persons lawfully acting on behalf of the association.
(b) Reinsure all or any portion of its potential liability
with reinsurers licensed to transact insurance in this state or
approved by the commissioner.
(c) Provide for appropriate housing, equipment, and personnel
as may be necessary to assure the efficient operation of the
association.
(d) Pursuant to the plan of operation, adopt reasonable rules
for the administration of the association, enforce those rules, and
delegate authority, as the board considers necessary to assure the
proper administration and operation of the association consistent
with the plan of operation.
(e) Contract for goods and services, including independent
claims management, actuarial, investment, and legal services, from
others within or without this state to assure the efficient
operation of the association.
(f) Hear and determine complaints of a company or other
interested party concerning the operation of the association.
(g) Perform other acts not specifically enumerated in this
section that are necessary or proper to accomplish the purposes of
the association and that are not inconsistent with this section or
the plan of operation.
(9) A board of directors is created, hereinafter referred to
as the board, which shall be responsible for the operation of the
association consistent with the plan of operation and this section.
(10) The plan of operation shall provide for all of the
following:
(a) The establishment of necessary facilities.
(b) The management and operation of the association.
(c) Procedures to be utilized in charging premiums, including
adjustments from excess or deficient premiums from prior periods.
(d) Procedures governing the actual payment of premiums to the
association.
(e) Reimbursement of each member of the board by the
association for actual and necessary expenses incurred on
association business.
(f) The investment policy of the association.
(g) Any other matters required by or necessary to effectively
implement this section.
(11) Each board shall include members that would contribute a
total of not less than 40% of the total premium calculated pursuant
to subsection (7)(d). Each director shall be entitled to 1 vote.
The initial term of office of a director shall be 2 years.
(12) As part of the plan of operation, the board shall adopt
rules providing for the composition and term of successor boards to
the initial board, consistent with the membership composition
requirements in subsections (11) and (13). Terms of the directors
shall be staggered so that the terms of all the directors do not
expire at the same time and so that a director does not serve a
term of more than 4 years.
(13) The board shall consist of 5 directors, and the
commissioner shall be an ex officio member of the board without
vote.
(14) Each director shall be appointed by the commissioner and
shall serve until that member's successor is selected and
qualified. The chairperson of the board shall be elected by the
board. A vacancy on the board shall be filled by the commissioner
consistent with the plan of operation.
(15) After the board is appointed, the board shall meet as
often as the chairperson, the commissioner, or the plan of
operation shall require, or at the request of any 3 members of the
board. The chairperson shall retain the right to vote on all
issues. Four members of the board constitute a quorum.
(16) An annual report of the operations of the association in
a form and detail as may be determined by the board shall be
furnished to each member.
(17) Not more than 60 days after the initial organizational
meeting of the board, the board shall submit to the commissioner
for approval a proposed plan of operation consistent with the
objectives and provisions of this section, which shall provide for
the economical, fair, and nondiscriminatory administration of the
association and for the prompt and efficient provision of
indemnity. If a plan is not submitted within this 60-day period,
then the commissioner, after consultation with the board, shall
formulate and place into effect a plan consistent with this
section.
(18) The plan of operation, unless approved sooner in writing,
shall be considered to meet the requirements of this section if it
is not disapproved by written order of the commissioner within 30
days after the date of its submission. Before disapproval of all or
any part of the proposed plan of operation, the commissioner shall
notify the board in what respect the plan of operation fails to
meet the requirements and objectives of this section. If the board
fails to submit a revised plan of operation that meets the
requirements and objectives of this section within the 30-day
period, the commissioner shall enter an order accordingly and shall
immediately formulate and place into effect a plan consistent with
the requirements and objectives of this section.
(19) The proposed plan of operation or amendments to the plan
of operation are subject to majority approval by the board,
ratified by a majority of the membership having a vote, with voting
rights being apportioned according to the premiums charged in
subsection (7)(d) and are subject to approval by the commissioner.
(20) Upon approval by the commissioner and ratification by the
members of the plan submitted, or upon the promulgation of a plan
by the commissioner, each insurer authorized to write insurance
providing the security required by section 3101(1) in this state,
as provided in this section, is bound by and shall formally
subscribe to and participate in the plan approved as a condition of
maintaining its authority to transact insurance in this state.
(21) The association is subject to all the reporting, loss
reserve, and investment requirements of the commissioner to the
same extent as would a member of the association.
(22) Premiums charged members by the association shall be
recognized in the rate-making procedures for insurance rates in the
same manner that expenses and premium taxes are recognized.
(23) The commissioner or an authorized representative of the
commissioner may visit the association at any time and examine any
and all the association's affairs.
(24) The association does not have liability for losses
occurring before July 1, 1978.
(25) As used in this section:
(a) "Consumer price index" means the percentage of change in
the consumer price index for all urban consumers in the United
States city average for all items for the 24 months prior to
October 1 of the year prior to the July 1 effective date of the
biennial adjustment under subsection (2)(k) as reported by the
United States department of labor, bureau of labor statistics, and
as certified by the commissioner.
(b) "Motor vehicle accident policy" means a policy providing
the coverages required under section 3101(1).
(c) "Ultimate loss" means the actual loss amounts that a
member is obligated to pay and that are paid or payable by the
member, and do not include claim expenses. An ultimate loss is
incurred by the association on the date that the loss occurs.
Sec.
3107. (1) Except as provided in subsection (2), personal
Personal protection insurance benefits are payable for the
following:
(a)
Allowable expenses consisting of all reasonable charges
that are as provided in subparagraphs (i), (ii), (iii), (iv), (v), and
(vi) incurred for reasonably necessary products, services, and
accommodations for an injured person's care, recovery, or
rehabilitation.
Allowable expenses within personal protection
insurance
coverage shall not include charges for a hospital room in
excess
of a reasonable and customary charge for semiprivate
accommodations
except if the injured person requires special or
intensive
care, or for funeral and burial expenses in the amount
set
forth in the policy which shall not be less than $1,750.00 or
more
than $5,000.00. Any change in
a limit selected under
subparagraph (i), (ii), (iii), (iv), (v), or (vi) applies only to
benefits arising out of accidents occurring after the date of the
change in the limit. An insurer shall require the same personal
protection coverage limits under this subdivision for all motor
vehicles insured under the same policy. An insurer shall provide
the following coverages, and an insured shall select 1 of the
following coverages which shall apply to the insured named in the
policy, the insured's spouse, and any relative of either domiciled
in the same household:
(i) Coverage for allowable expenses consisting of all
reasonable charges incurred up to a maximum of $50,000.00 for
reasonably necessary products, services, and accommodations for an
injured person's care, recovery, or rehabilitation.
(ii) Coverage for allowable expenses consisting of all
reasonable charges incurred up to a maximum of $100,000.00 for
reasonably necessary products, services, and accommodations for an
injured person's care, recovery, or rehabilitation.
(iii) Coverage for allowable expenses consisting of all
reasonable charges incurred up to a maximum of $200,000.00 for
reasonably necessary products, services, and accommodations for an
injured person's care, recovery, or rehabilitation.
(iv) Coverage for allowable expenses consisting of all
reasonable charges incurred up to a maximum of $400,000.00 for
reasonably necessary products, services, and accommodations for an
injured person's care, recovery, or rehabilitation.
(v) Coverage for allowable expenses consisting of all
reasonable charges incurred for reasonable necessary products,
services, and accommodations for an injured person's care,
recovery, or rehabilitation up to the current maximum amount of
ultimate loss sustained by the insurer for personal protection
insurance coverage under section 3104(2).
(vi) Coverage for allowable expenses consisting of all
reasonable charges incurred for reasonably necessary products,
services, and accommodations for an injured person's care,
recovery, or rehabilitation.
(b)
Work Except as provided in
subsection (2), work loss
consisting of loss of income from work an injured person would have
performed during the first 3 years after the date of the accident
if he or she had not been injured. Work loss does not include any
loss after the date on which the injured person dies. Because the
benefits received from personal protection insurance for loss of
income are not taxable income, the benefits payable for such loss
of income shall be reduced 15% unless the claimant presents to the
insurer in support of his or her claim reasonable proof of a lower
value of the income tax advantage in his or her case, in which case
the
lower value shall apply. Beginning March 30, 1973 For the
period beginning October 1, 2010 through September 30, 2011, the
benefits payable for work loss sustained in a single 30-day period
and the income earned by an injured person for work during the same
period
together shall not exceed $1,000.00 $4,929.00, which maximum
shall apply pro rata to any lesser period of work loss. Beginning
October
1, 1974 2011, the maximum shall be adjusted annually to
reflect changes in the cost of living under rules prescribed by the
commissioner but any change in the maximum shall apply only to
benefits arising out of accidents occurring subsequent to the date
of change in the maximum.
(c) Expenses not exceeding $20.00 per day, reasonably incurred
in obtaining ordinary and necessary services in lieu of those that,
if he or she had not been injured, an injured person would have
performed during the first 3 years after the date of the accident,
not for income but for the benefit of himself or herself or of his
or her dependent.
(2) A person who is 60 years of age or older and in the event
of an accidental bodily injury would not be eligible to receive
work loss benefits under subsection (1)(b) may waive coverage for
work loss benefits by signing a waiver on a form provided by the
insurer. An insurer shall offer a reduced premium rate to a person
who waives coverage under this subsection for work loss benefits.
Waiver of coverage for work loss benefits applies only to work loss
benefits payable to the person or persons who have signed the
waiver form.
(3) The following apply to subsection (1)(a):
(a) If an insured fails to select 1 of the coverages in
subsection (1)(a), an insurer shall provide coverage in the amount
set forth in subsection (1)(a)(vi).
(b) Coverage limits under subsection (1)(a) are provided on a
per individual per loss occurrence basis. Coverage under subsection
(1)(a) applies only to benefits payable to the insured named in the
policy, the insured's spouse, and any relative of either domiciled
in the same household.
(c) A person who is not an insured named in a policy, not the
insured's spouse, and not a relative of either domiciled in the
same household is entitled only to coverage in the limit set forth
in subsection (1)(a)(i). Personal protection insurance benefits
payable under this subdivision are not payable to the extent that
the benefits covering the same loss are available from other
sources, regardless of the nature and number of benefit sources
available and regardless of the nature or form of the benefits.
(d) Regardless of the number of motor vehicles insured or
insurers providing security in accordance with this chapter, or the
provisions of any other law providing for direct benefits without
regard to fault for motor or any other vehicle accidents, a person
shall not recover duplicate benefits for the same expenses or
losses incurred under subsection (1)(a).
(e) Personal protection insurance benefits are limited to the
limit set forth in section 3163 for accidents occurring in this
state if the injured person is an out-of-state resident and the
injured person's benefits are payable under a policy delivered
outside of this state only if eligible under section 3163.
(f) Personal protection insurance benefits are not payable to
an out-of-state resident injured in an accident occurring outside
of this state to the extent that benefits covering the same loss
are available from other sources, regardless of the nature and
number of benefit sources available and regardless of the nature or
form of the benefits. If personal protection insurance benefits are
payable to an out-of-state resident under this subdivision, the
benefits are limited to the limit set forth in subsection (1)(a)(i)
per individual per loss occurrence.
(g) Allowable expenses within personal protection insurance
coverage shall not include charges for a hospital room in excess of
a reasonable and customary charge for semiprivate accommodations
except if the injured person requires special or intensive care or
for funeral and burial expenses in excess of the amount set forth
in the policy, which shall not be less than $1,750.00 or more than
$5,000.00.
Sec. 3114. (1) Except as provided in subsections (2), (3), and
(5), a personal protection insurance policy described in section
3101(1) applies to accidental bodily injury to the person named in
the policy, the person's spouse, and a relative of either domiciled
in the same household, if the injury arises from a motor vehicle
accident. A personal injury insurance policy described in section
3103(2) applies to accidental bodily injury to the person named in
the policy, the person's spouse, and a relative of either domiciled
in the same household, if the injury arises from a motorcycle
accident. When personal protection insurance benefits described in
section 3107(1), or personal injury benefits described in section
3103(2), are payable to or for the benefit of an injured person
under his or her own policy and would also be payable under the
policy of his or her spouse, relative, or relative's spouse, the
injured person's insurer shall pay all of the benefits and is not
entitled to recoupment from the other insurer. In no event shall
the limit of liability for 2 or more motor vehicles under 1 policy
or for 2 or more policies be added together, combined, or stacked
to determine the limit of insurance coverage available for each
injured person covered under the policy.
(2) A person suffering accidental bodily injury while an
operator or a passenger of a motor vehicle operated in the business
of transporting passengers shall receive the personal protection
insurance benefits to which the person is entitled from the insurer
of the motor vehicle. This subsection does not apply to a passenger
in the following, unless that passenger is not entitled to personal
protection insurance benefits under any other policy:
(a) A school bus, as defined by the department of education,
providing transportation not prohibited by law.
(b) A bus operated by a common carrier of passengers certified
by the department of transportation.
(c) A bus operating under a government sponsored
transportation program.
(d) A bus operated by or providing service to a nonprofit
organization.
(e) A taxicab insured as prescribed in section 3101 or 3102.
(f) A bus operated by a canoe or other watercraft, bicycle, or
horse livery used only to transport passengers to or from a
destination point.
(3) An employee, his or her spouse, or a relative of either
domiciled in the same household, who suffers accidental bodily
injury while an occupant of a motor vehicle owned or registered by
the employer, shall receive personal protection insurance benefits
to
which the employee is entitled from in the following order of
priority:
(a) From the insurer of the furnished vehicle.
(b) From his or her own policy, from his or her spouse's
policy, or from the policy of a relative of either the person or
his or her spouse domiciled in the same household.
(4) Except as provided in subsections (1) to (3), a person
suffering accidental bodily injury arising from a motor vehicle
accident while an occupant of a motor vehicle shall claim personal
protection insurance benefits from insurers in the following order
of priority:
(a) The insurer of the owner or registrant of the vehicle
occupied.
(b) The insurer of the operator of the vehicle occupied.
(5) A person suffering accidental bodily injury arising from a
motor vehicle accident which shows evidence of the involvement of a
motor vehicle while an operator or passenger of a motorcycle shall
claim personal protection insurance benefits from insurers in the
following order of priority:
(a) The insurer of the owner or registrant of the motor
vehicle involved in the accident.
(b) The insurer of the operator of the motor vehicle involved
in the accident.
(c) The motor vehicle insurer of the operator of the
motorcycle involved in the accident.
(d) The motor vehicle insurer of the owner or registrant of
the motorcycle involved in the accident.
(6) If 2 or more insurers are in the same order of priority to
provide
personal protection insurance benefits, under subsection
(5),
an insurer paying benefits due is
entitled to partial
recoupment from the other insurers in the same order of priority,
together with a reasonable amount of partial recoupment of the
expense of processing the claim, in order to accomplish equitable
distribution of the loss among all of the insurers.
Sec.
3115. (1) Except as provided in subsection (1) of section
3114
3114(1), a person suffering accidental bodily injury while
not
an occupant of a motor vehicle shall claim personal protection
insurance benefits from insurers in the following order of
priority:
(a) Insurers of owners or registrants of motor vehicles
involved in the accident.
(b) Insurers of operators of motor vehicles involved in the
accident.
(2) When 2 or more insurers are in the same order of priority
to provide personal protection insurance benefits an insurer paying
benefits due is entitled to partial recoupment from the other
insurers in the same order of priority, together with a reasonable
amount of partial recoupment of the expense of processing the
claim, in order to accomplish equitable distribution of the loss
among such insurers.
(3) A limit upon the amount of personal protection insurance
benefits available because of accidental bodily injury to 1 person
arising from 1 motor vehicle accident shall be determined without
regard to the number of policies applicable to the accident.
(4) In no event shall the limit of liability for 2 or more
motor vehicles under 1 policy or for 2 or more policies be added
together, combined, or stacked to determine the limit of insurance
coverage available for each injured person covered under the
policy.
Sec. 3163. (1) An insurer authorized to transact automobile
liability insurance and personal and property protection insurance
in this state shall file and maintain a written certification that
any accidental bodily injury or property damage occurring in this
state arising from the ownership, operation, maintenance, or use of
a motor vehicle as a motor vehicle by an out-of-state resident who
is insured under its automobile liability insurance policies, is
subject to the personal and property protection insurance system
under this act.
(2) A nonadmitted insurer may voluntarily file the
certification described in subsection (1).
(3) Except as otherwise provided in subsection (4), if a
certification filed under subsection (1) or (2) applies to
accidental bodily injury or property damage, the insurer and its
insureds with respect to that injury or damage have the rights and
immunities under this act for personal and property protection
insureds, and claimants have the rights and benefits of personal
and property protection insurance claimants, including the right to
receive benefits from the electing insurer as if it were an insurer
of personal and property protection insurance applicable to the
accidental bodily injury or property damage.
(4) If an insurer of an out-of-state resident is required to
provide benefits under subsections (1) to (3) to that out-of-state
resident for accidental bodily injury for an accident in which the
out-of-state resident was not an occupant of a motor vehicle
registered in this state, the insurer is only liable for the amount
of
ultimate loss sustained up to $500,000.00 $50,000.00. Benefits
under this subsection are not recoverable to the extent that
benefits covering the same loss are available from other sources,
regardless of the nature or number of benefit sources available and
regardless of the nature or form of the benefits.
Sec. 3172. (1) A person entitled to claim because of
accidental bodily injury arising out of the ownership, operation,
maintenance, or use of a motor vehicle as a motor vehicle in this
state may obtain personal protection insurance benefits through an
assigned
claims plan if in any of
the following situations:
(a) If no personal protection insurance is applicable to the
injury. ,
(b) If no personal protection insurance applicable to the
injury
can be identified. ,
(c) If the personal protection insurance applicable to the
injury cannot be ascertained because of a dispute between 2 or more
automobile insurers concerning their obligation to provide coverage
or
the equitable distribution of the loss.
, or
(d) If the only identifiable personal protection insurance
applicable to the injury is, because of financial inability of 1 or
more insurers to fulfill their obligations, inadequate to provide
benefits
up to the maximum prescribed. In such case
(2) In any of the situations under subsection (1), unpaid
benefits due or coming due are subject to being collected under the
assigned claims plan, and the insurer to which the claim is
assigned, or the assigned claims facility if the claim is assigned
to it, is entitled to reimbursement from the defaulting insurers to
the extent of their financial responsibility.
(3) (2)
Except as otherwise provided in
this subsection,
personal protection insurance benefits, including benefits arising
from accidents occurring before the effective date of this
subsection, payable through an assigned claims plan shall be
reduced to the extent that benefits covering the same loss are
available from other sources, regardless of the nature or number of
benefit sources available and regardless of the nature or form of
the benefits, to a person claiming personal protection insurance
benefits
through the assigned claims plan. This subsection shall
only
apply only applies when the personal protection insurance
benefits are payable through the assigned claims plan because no
personal protection insurance is applicable to the injury, no
personal protection insurance applicable to the injury can be
identified, or the only identifiable personal protection insurance
applicable to the injury is, because of financial inability of 1 or
more insurers to fulfill their obligations, inadequate to provide
benefits up to the maximum prescribed. As used in this subsection
"sources" and "benefit sources" do not include the program for
medical assistance for the medically indigent under the social
welfare
act, Act No. 280 of the Public Acts of 1939, being sections
400.1
to 400.121 of the Michigan Compiled Laws, or insurance under
the
health insurance for the aged act, title XVIII of the social
security
amendments of 1965 1939 PA
280, MCL 400.1 to 400.119b, or
the federal medicare program established under title XVIII of the
social security act, 42 USC 1395 to 1395kkk-1.
(4) (3)
If the obligation to provide
personal protection
insurance benefits cannot be ascertained because of a dispute
between 2 or more automobile insurers concerning their obligation
to provide coverage or the equitable distribution of the loss, and
if a method of voluntary payment of benefits cannot be agreed upon
among or between the disputing insurers, all of the following shall
apply:
(a) The insurers who are parties to the dispute shall, or the
claimant may, immediately notify the assigned claims facility of
their inability to determine their statutory obligations.
(b) The claim shall be assigned by the assigned claims
facility to an insurer which shall immediately provide personal
protection insurance benefits to the claimant or claimants entitled
to benefits in the lowest amount applicable among the policies in
dispute.
(c) An action shall be immediately commenced on behalf of the
assigned claims facility by the insurer to whom the claim is
assigned in circuit court for the purpose of declaring the rights
and duties of any interested party.
(d) The insurer to whom the claim is assigned shall join as
parties defendant each insurer disputing either the obligation to
provide personal protection insurance benefits or the equitable
distribution of the loss among the insurers.
(e) The circuit court shall declare the rights and duties of
any interested party whether or not other relief is sought or could
be granted.
(f) After hearing the action, the circuit court shall
determine the insurer or insurers, if any, obligated to provide the
applicable personal protection insurance benefits and the equitable
distribution, if any, among the insurers obligated therefor, and
shall order reimbursement to the assigned claims facility from the
insurer or insurers to the extent of the responsibility as
determined
by the court. The reimbursement ordered under this
subdivision
shall include all benefits and costs paid or incurred
by
the assigned claims facility and all benefits and costs paid or
incurred
by insurers determined not to be obligated to provide
applicable
personal protection insurance benefits, including
reasonable
attorney fees and interest at the rate prescribed in
section
3175 as of December 31 of the year preceding the
determination
of the circuit court.
(5) If no personal protection insurance is applicable to the
injury or no personal protection insurance applicable to the injury
can be identified, personal protection insurance benefits shall be
paid only to the limit provided for in section 3107(1)(a)(i). If the
only identifiable personal protection insurance applicable to the
injury is, because of financial inability of 1 or more insurers to
fulfill their obligations, inadequate to provide benefits up to the
maximum prescribed, personal protection insurance benefits shall be
paid to the limit selected by the insured under section 3107(1)(a)
or as provided in section 3107(3)(a).
(6) Any reimbursement ordered under this section and any
recovery obtained in circumstances where personal protection
insurance benefits have been or may be paid through the assigned
claims facility shall include all benefits and costs paid or
incurred by insurers determined not to be obligated to provide the
applicable personal protection insurance benefits, including
reasonable attorney fees and interest at the rate prescribed in
section 3175 as of December 31 of the year preceding the
reimbursement order or recovery determination.
Enacting section 1. This amendatory act takes effect January
1, 2012.
