Current through Public Act 76 of the 2022 Legislative Session
Section 500.3107 - Expenses and work loss for which personal protection benefits payable(1) Subject to the exceptions and limitations in this chapter, and subject to chapter 31A, personal protection insurance benefits are payable for the following: (a) Allowable expenses consisting of reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person's care, recovery, or rehabilitation. Allowable expenses do not include either of the following: (i) Charges for a hospital room in excess of a reasonable and customary charge for semiprivate accommodations, unless the injured person requires special or intensive care.(ii) Funeral and burial expenses in excess of the amount set forth in the policy, which must not be less than $1, 750.00 or more than $5, 000.00.(b) 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 the loss of income must 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 must be applied. For the period beginning October 1, 2012 through September 30, 2013, 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 must not exceed $5, 189.00, which maximum must be applied pro rata to any lesser period of work loss. Beginning October 1, 2013, the maximum must be adjusted annually to reflect changes in the cost of living under rules prescribed by the director, but any change in the maximum must be applied only to benefits arising out of accidents occurring after the date of change in the maximum.(c) Expenses not exceeding $ 20.00per 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) Both of the following apply to personal protection insurance benefits payable under subsection (1):(a) 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 subdivision 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.(b) An insurer is not required to provide coverage for the medical use of marihuana or for expenses related to the medical use of marihuana.Amended by 2019, Act 21,s 24, eff. 6/11/2019.Amended by 2012, Act 542,s 1, eff. 1/2/2013.Add. 1972, Act 294, Eff. Mar. 30, 1973 ;--Am. 1988, Act 312, Eff. Mar. 30, 1989 ;--Am. 1991, Act 191, Eff. Jan. 1, 1992 .