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No Fault Insurance Benefits 
 


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  No-Fault Insurance (personal injury and car accidents)

INDEX

What are No Fault Benefits?
How Much Coverage is Necessary?
How do I claim benefits?
What medical expenses are covered by No Fault?
Must I use a certain health care provide?
What wage loss is covered under No Fault?
What Mileage expenses are covered under No Fault?


  1. What are "no-fault benefits"?

    "No-fault benefits" are also often referred to as "Personal Injury Protection benefits or "PIP Benefits" for short. No Fault or PIP benefits refers to insurance coverage provided by your own automobile insurance policy regardless of who was at fault in the automobile accident. In other words, simply because the other driver was at fault does not mean that your insurance will not pay you for your injuries. In fact, the opposite is true. No fault benefits may include compensation for wage loss, medical expenses, mileage and replacement vehicle. Under Minnesota law, all motor vehicle owners must have no-fault coverage as part of their automobile insurance coverage. No Fault insurances is also called first-party coverage. This means that if you are injured in a car accident, it is your insurance that pays the no fault compensation rather than the insurance of the party at fault or even the insurance of the vehicle in which you were riding. Essentially, no fault coverage applies to the insured person, not the vehicle.
    --------------------

  2. How much coverage is necessary?

    Minnesota requires automobile owners to carry a minimum no-fault policy that pays $20,000 for medical coverage for any individual and $20,000 for all other losses including any income loss, replacement services and other economic losses. The requirement for insurance is set out in Minnesota Statutes 65B.44
    -------------------------

  3. How do I claim benefits after a car accident?

    Immediately after an automobile accident, you should contact your automobile insurance agent to report the accident. If you suffered an injury, your agent will provide you with an application for "no fault" benefits which may include wage loss, medical expenses, mileage and replacement services and other economic damages.

    Under the Minnesota No-fault statute the claimant must get past at least one of several thresholds before they qualify to make a claim. The thresholds are as follows:

    • Medical expenses of $4,000 or more.
    • Some or all of the injuries are permanent.
    • A permanent scar and/or disfigurement.
    • The injury results in disability for 60 days or more.
    • Death. If the victim dies as a result of someone else's negligence, the family has a wrongful death claim.
  4. What medical expenses are covered by No Fault?

    Any medical expenses that are reasonable and necessary are covered. Often, this definition may exclude experimental treatments or holistic treatments. Minnesota Statutes 65B.44 specifically includes as necessary the following::

    • medical, surgical, x-ray, optical, dental, chiropractic, and rehabilitative services, including prosthetic devices
    • prescription drug;
    • ambulance and all other transportation expenses incurred in traveling to receive other covered medical expense benefits;
    • sign interpreting and language translation services, other than such services provided by a family member of the patient, related to the receipt of medical, surgical, x-ray, optical, dental, chiropractic, hospital, extended care, nursing, and rehabilitative services; and
    • hospital, extended care, and nursing services. (Hospital room and board benefits may be limited, except for intensive care facilities, to the regular daily semiprivate room rates customarily charged by the institution in which the recipient of benefits is confined.)
    • Benefits also include necessary remedial treatment and services recognized and permitted under the laws of this state for an injured person who relies upon spiritual means through prayer alone for healing in accordance with that person's religious beliefs. * Medical expense loss includes medical expenses accrued prior to the death of a person notwithstanding the fact that benefits are paid or payable to the decedent's survivors.

  5. Do I have to use a certain health care provider when treating for my injuries?

    Your health insurance is not covering your treatment. Instead, your no fault automobile coverage is paying the costs. As a direct result, you are not restricted to the health care providers that you use under your health insurance policy. Instead, once a claim is made, your insurance adjuster will give you a claim number which can be used for your treatment at any medical care facility.

    It is important to note that a continued pattern of medical treatment is necessary to ensure No Fault coverage continues. In most cases, insurance policies will lapse if there is a gap of one-year or more between medical treatments.

    It is also true that most insurance companies view Chiropractic medicine with some skepticism. As a result, insurance companies are far more likely to pay your medical claims resulting from your injury if you have treated with a medical doctor as well. It is equally important to follow your doctor's recommendations for care and therapy.

  6. What wage loss is covered by "No Fault"?

    You are entitled to up to $20,000 in lost income replacement from your own insurance company pursuant to Minnesota Statutes 65B.44. The actual payment amount is calculated based on a percentage of your gross income. Specifically, No-fault benefits will provide compensation in the amount of 85% of your gross income up to a maximum amount of $250 per week. If you reach the threshold cap, you may still seek full repayment for wage loss from the driver that was at fault in your accident

    Even self-employed people may receive wage loss compensation. This wage loss is calculated by determining the cost which must be incurred to hire a substitute employee or employees to perform the work the injured party and which are necessary to maintain the income of the business.

    Before any wage loss claim will be paid by your insurer, you must provide:

    • A doctor's disability slip (permission to miss work) must be presented to your No-fault insurance adjuster in order for you to receive wage loss benefits, AND
    • Proof of wage loss from your employer on a form available from your insurance adjuster.

     

  7. Mileage claims under No Fault?

If you are injured, No Fault benefits will also repay you for any "reasonable" mileage expenses incurred for transportation to and from your medical provider.

Contact us at 612.240.8005.

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