Keeping Freedom of Choice
Most consumers don’t know this but, under Michigan law, there are two basic types of no-fault automobile insurance coverage for medical benefits. Coordinated coverage is the first type and offsets the no-fault policy’s medical benefit coverage with other available health insurance. With coordinated insurance, your automobile insurance policy only covers what your health insurance does not. Under these circumstances, you must first seek treatment for your accident related injuries through your health insurance before attempting to hold the no-fault insurer liable for medical care expenses. As a result, you remain subject to the limitations and conditions of your health care plan. For example, if your health insurance is through a health maintenance organization (HMO) you must still treat within your network and rely on your primary care physician for referrals to specialists. You can only seek coverage through your automobile insurance if the necessary treatment is not available through your heath insurance.
Uncoordinated coverage, on the other hand, gives individuals a choice to seek coverage through either their health or automobile insurance. Unlike a coordinated no-fault policy, you are not bound by the terms of your health insurance when you sustain injuries in an automobile accident. You can seek the best care available, so long as the treatment is a reasonably necessary result of the accident, regardless of whether or not the provider accepts your health insurance. Under these circumstances, your automobile insurance must cover these benefits.
Uncoordinated coverage is far superior to coordinated coverage. You retain freedom of choice over the care you receive for accident injuries and cannot be subjected to other restrictions contained in your health insurance plan, such as maximum benefit limits and reimbursement provisions requiring you to pay back the health insurer from pain and suffering damages collected from an at fault driver. An uncoordinated policy also guarantees that you will not be left without benefits while two insurance companies fight amongst themselves over who will provide coverage for your injuries.
Unfortunately, insurance companies and their agents seldom offer the consumer a choice of coordinated or uncoordinated medical care benefits. Instead they simply ask if you are covered by health insurance and automatically sign you up for a coordinated policy if you answer yes. Therefore, it is important to specifically request an uncoordinated policy when purchasing an automobile insurance policy. Although they come at a slightly higher premium, the superiority of uncoordinated benefits outweigh this cost in the unfortunate event you are injured in an automobile accident.
If you or a loved one has been injured in an automobile accident and don’t know where to turn for wage loss or medical benefits, contact Ravid & Associates, P.C. Our highly skilled and experienced attorneys know how to navigate the complex area of insurance coverage so that you receive all of the benefits you are owed. Consultation is free and you won’t be charged a dime unless we recover money on your behalf.