Michigan State Supreme Court Upholds No-Fault Auto Insurance Ruling

The decision, a 5-2 opinion, asserts that insurance providers are bound to honor existing policies for those injured prior to 2019

Fairfax, Va. In a major win for the brain injury community, the Michigan Supreme Court upheld a lower court ruling on July 31, stating that individuals who were injured in car accidents and began receiving care prior to the 2019 no-fault auto insurance change need to have their benefits restored.

The 5-2 opinion in Andary v. USAA et al, which will impact approximately 18,000 Michiganders receiving benefits through the catastrophic care fund, states that insurance providers are bound to honor their contractual benefits from the policies that existed under the law when their clients were injured.

“We are pleased with the Michigan Supreme Court’s decision to restore coverage to those who relied on the care and treatment they already paid for,” said Rick Willis, President and CEO of the Brain Injury Association of America (BIAA). “We are grateful for the tireless advocacy of our affiliate partners at the Brain Injury Association of Michigan, as well as the support of the brain injury community and its allies there.”

While the Andary decision is a victory for brain injury survivors, it does not affect those injured after June 11, 2019, nor does it protect anyone who may be injured in the future, leaving them with limited access to needed and medically prescribed care, BIAMI president and CEO Nichole Shotwell said in a statement.

“This is a significant victory for the rights of crash survivors with brain injuries,” said Dr. Owen Perlman, BIAA board member and medical director at NeuroRestorative and Resilire Neuro. “The changes in the 2019 law placed arbitrary and devastating limitations on access to treatment and attendant care and interfered with the prescribed plan of care. This included a 45 percent pay cut to providers and limitations on family-provided attendant care to 56 hours per week even if 24/7 care was prescribed.”

As a result of the change to no-fault benefits, many home care and rehab agencies closed and staffing costs remain at a premium due to the pandemic and slow recovery because of a shortage of qualified staff.

“We will now focus on protecting the rights of survivors injured after June 2019 and attempt to restore full coverage for attendant care hours and obtain reasonable reimbursement for professional services,” Dr. Perlman said.

BIAA joins with BIAMI in calling on the Michigan Legislature to enact a reasonable and fair fee schedule that enables rehabilitation providers to remain in business and provide the quality, compassionate care that survivors deserve.