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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?
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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.
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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
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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.
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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.
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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.
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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.
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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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