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Minnesota No-Fault Law
This portion of the Milavetz, Gallop & Milavetz, P.A. blog will be dedicated to??Minnesota No-Fault Law.
So Who Pays No-Fault Benefits?
Posted by: euser
December 26, 2006
The priority system under which an insurance company must pay no-fault benefits is described in Minn. Stat. ? 65B.47. The general rule is provided in Subdivision 4, which provides the following:
(a) The security for payment of basic economic loss benefits applicable to injury to an
insured is the security under which the injured person is an insured.
(b) The security for payment of basic economic loss benefits applicable to injury to the driver or other occupant of an involved motor vehicle who is not an insured is the security covering that vehicle.
(c) The security for payment of basic economic loss benefits applicable to injury to a person not otherwise covered who is not the driver or other occupant of an involved motor vehicle is the security covering any involved motor vehicle. An unoccupied parked vehicle is not an involved motor vehicle unless it was parked so as to cause unreasonable risk of injury.
The statute also provides three general exceptions to the general rule:
Subsection 1 states that if a person is injured occupying a motor vehicle while that vehicle is being used "in the business of transporting persons or property," the injured person must seek no-fault benefits from the insurer of the occupied vehicle.
Subsection 2 also provides that an injured person must seek benefits from the insurer of the occupied vehicle if that vehicle was "furnished by the employer."
Finally, Subsection 3 provides that any person not occupying a motor vehicle, such as a pedestrian or a bike rider, who is injured by a vehicle "in the business of transporting persons or property" or a vehicle "furnished by the employer," the injured person must go to the insurer of the vehicle .
In all of these exceptions, if the occupied vehicle does not have coverage, the injured person may then make a no-fault claim to their own insurance company.
The Damages Threshold for "Noneconomic Detriment"
Posted by: euser
December 26, 2006
Under Minn. Stat. ? 65B.51, Subdivision 3, a person seeking damages for "noneconomic detriment" must meet one of two threshold requirements. Under the first threshold, the sum of the following must exceed $4,000:
(1) reasonable medical expense benefits paid, payable or payable but for any applicable
deductible, plus
(2) the value of free medical or surgical care or ordinary and necessary nursing services
performed by a relative of the injured person or a member of the injured person's household, plus
(3) the amount by which the value of reimbursable medical services or products exceeds the
amount of benefit paid, payable, or payable but for an applicable deductible for those services or
products if the injured person was charged less than the average reasonable amount charged in
this state for similar services or products, minus
(4) the amount of medical expense benefits paid, payable, or payable but for an applicable
deductible for diagnostic X-rays and for a procedure or treatment for rehabilitation and not for
remedial purposes or a course of rehabilitative occupational training.
If this threshold cannot be meet, the injury must result in:
(1) permanent disfigurement;
(2) permanent injury;
(3) death; or
(4) disability for 60 days or more,
in order to receive damages for noneconomic detriment
For the purposes of this subdivision, disability means the inability to engage in substantially
all of the injured person's usual and customary daily activities.
What About Uninsured or Underinsured Drivers?
Posted by: euser
December 26, 2006
First, what is an "uninsured" driver? The No-Fault Act describes an "uninsured motor vehicle" as "a motor vehicle or motorcycle for which a plan of reparation security meeting the requirements of [the No-Fault Act] is not in effect. (Minn. Stat. ?65B.43, Subd. 16) Therefore, the Act requires drivers to carry uninsured motorist coverage for the "protection of persons insured under that coverage who are legally entitled to recover damages for bodily injury from owners or operators of uninsured motor vehicles and hit-and-run motor vehicles." (Minn. Stat. ? 65B.43, Subd. 18)
Likewise, an "underinsured motor vehicle" is "a motor vehicle or motorcycle to which a bodily injury liability policy applies at the time of the accident but its limit for bodily injury liability is less than the amount needed to compensate the insured for actual damages." (Minn. Stat. ? 65B.43, Subd. 17) The Act also requires that drivers carry underinsured motorist coverage. (Minn. Stat. ? 65B.43, Subd. 19)
So how much uninsured and underinsured coverage should drivers have? Minn. Stat. ? 65B.49, Subd. 3(a)(1) explains:
No plan of reparation security may be renewed, delivered or issued for delivery, or executed in this state with respect to any motor vehicle registered or principally garaged in this state unless separate uninsured and underinsured motorist coverages are provided therein. Each coverage, at a minimum, must provide limits of $25,000 because of injury to or the death of one person in any accident and $50,000 because of injury to or the death of two or more persons in any accident. In the case of injury to, or the death of, two or more persons in any accident, the amount available to any one person must not exceed the coverage limit provided for injury to, or the death of, one person in any accident.
Further, Minn. Stat. ? 65B.49, Subd. 3(a)(2) requires that "every owner of a motor vehicle registered or principally garaged in this state shall maintain uninsured and underinsured motorist coverages as provided in this subdivision." Finally, "no recovery shall be permitted under the uninsured and underinsured motorist coverages of this section for basic economic loss benefits paid or payable, or which would be payable but for any applicable deductible." (Minn. Stat. ? 65B.49, Subd. 3(a)(4))
What are "Basic Economic Loss Benefits"?
Posted by: euser
December 26, 2006
If an injury arises out of the "maintenance or use of a motor vehicle," the injured person is entitled to a variety of what the statute calls "basic economic loss benefits." Under Minn. Stat. ? 65B.44, basic economic benefits include up to $20,000 for medical expenses and a total of up to $20,000 for income loss, replacement services loss, funeral expense loss, and survivors? losses.
Subdivision 2 describes what is covered under the term "medical expenses." The statute provides that medical expense benefits shall reimburse all reasonable expenses for necessary:
(1) medical, surgical, x-ray, optical, dental, chiropractic, and rehabilitative services,
including prosthetic devices;
(2) prescription drugs;
(3) ambulance and all other transportation expenses incurred in traveling to receive other
covered medical expense benefits;
(4) 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
(5) hospital, extended care, and nursing services.
Furthermore, Subdivision 3 provides an explanation of disability and income loss benefits, which under the statute "provides compensation for 85 percent of the injured person?s loss of present and future gross income from inability to work proximately caused by the nonfatal injury subject to a maximum of $250 per week." For self-employed workers, loss of income includes the costs incurred "to hire substitute employees to perform tasks which are necessary to maintain the income of the injured person, which are normally performed by the injured person, and which cannot be performed because of the injury."
Subdivision 3 also discusses what is required under the term "inability to work":
"For the purposes of this section "inability to work" means disability which prevents the injured person from engaging in any substantial gainful occupation or employment on a regular basis, for wage or profit, for which the injured person is or may by training become reasonably qualified. If the injured person returns to employment and is unable by reason of the injury to work continuously, compensation for lost income shall be reduced by the income received while the injured person is actually able to work. The weekly maximums may not be prorated to arrive at a daily maximum, even if the injured person does not incur loss of income for a full week. For the purposes of this section, an injured person who is "unable by reason of the injury to work continuously" includes, but is not limited to, a person who misses time from work, including
reasonable travel time, and loses income, vacation, or sick leave benefits, to obtain medical treatment for an injury arising out of the maintenance or use of a motor vehicle."
What Happens to No-Fault Benefits When There is Also a Workers? Compensation Claim?
Posted by: euser
December 26, 2006
The basic statute describing the coordination of benefits is Minn. Stat. ? 65B.61. The statute provides that workers? compensation benefits are primary to no-fault insurance benefits, and that no-fault insurance benefits are primary to other forms of benefit payments, such as tort claims. The major purpose for this coordination is to prevent double recoveries by injured persons.
Subdivision 1 explains the general rule regarding the coordination of benefits:
Basic economic loss benefits shall be primary with respect to benefits, except for those paid or payable under a workers' compensation law, which any person receives or is entitled to receive from any other source as a result of injury arising out of the maintenance or use of a motor vehicle. Where workers' compensation benefits paid or payable are primary, the reparation obligor shall make an appropriate rebate or reduction in the premiums of the plan of reparation security. The amount of the rebate or rate reduction shall be not less than the amount of the projected reduction in benefits and claims for which the reparation obligor will be liable on that class of risks. The projected reduction or rebate in benefits and claims shall be based upon sound actuarial principles.
Subdivision 2 provides that no-fault benefits may be offset depending upon the amount of disability benefits received under a workers? compensation claim:
If benefits are paid or payable under a workers' compensation law because of the injury,
no disability income loss benefits are payable unless the weekly workers' compensation disability benefits are less than the weekly disability benefit as set out in section 65B.44, subdivision 3, in which case the reparation obligor shall pay to the injured person the amount that the weekly disability and income loss benefits payable under section 65B.44, subdivision 3, exceeds the weekly workers? compensation disability benefits.
Similarly, Subdivision 2a provides that survivors? economic loss benefits, as set out in section 65B.44, subdivision 6, are payable only if the no-fault benefits are greater than the workers? compensation benefits.
What is an Independent Medical Examination?
Posted by: euser
December 26, 2006
An independent medical examination, or an IME, is a medical examination typically required by insurance companies in order to evaluate the extent of the injuries claimed by an insured after a motor vehicle accident. These examinations are allowed by Minn. Stat. ? 65B.56, Subd. 1:
Any person with respect to whose injury benefits are claimed under a plan of reparation security shall, upon request of the reparation obligor from whom recovery is sought, submit to a physical examination by a physician or physicians selected by the obligor as may reasonably be required.
The costs of any examinations requested by the obligor shall be borne entirely by the requesting obligor. Such examinations shall be conducted within the city, town, or statutory city of residence of the injured person. If there is no qualified physician to conduct the examination within the city, town, or statutory city of residence of the injured person, then such examination shall be conducted at another place of the closest proximity to the injured person?s residence. Obligors are authorized to include reasonable provisions for mental and physical examination of those injured persons.
If requested by the person examined, a party causing an examination to be made shall deliver to the examinee a copy of every written report concerning the examination rendered by an examining physician to that person, at least one of which reports must set out in detail the findings and conclusions of such examining physician.
An injured person shall also do all things reasonably necessary to enable the obligor to obtain medical reports and other needed information to assist in determining the nature and extent of the injured person?s injuries and loss, and the medical treatment received. If the claimant refuses to cooperate in responding to requests for examination and information as authorized by this section, evidence of such noncooperation shall be admissible in any suit or arbitration filed for damages for such personal injuries or for the benefits provided by sections 65B.41 to 65B.71.
The provisions of this section apply before and after the commencement of suit.
Why Have a No-Fault Automobile Insurance System?
Posted by: euser
December 26, 2006
Despite what insurance companies and some state legislators may say about the costs incurred by using a no-fault insurance, this system remains the most effective and equitable means of resolving disputes arising out of automobile collision. A quick look at the scope of the Minnesota No-Fault Act gives us five reasons why we should keep this system.
65B.42 PURPOSE.
The detrimental impact of automobile accidents on uncompensated injured persons, upon the
orderly and efficient administration of justice in this state, and in various other ways requires that
sections 65B.41 to 65.71 /bin/getpub.php?type=s&num=65B.41&year=2006/bin/getpub.php?type=s&num=65B.71&year=2006adopted to effect the following purposes:
(1) to relieve the severe economic distress of uncompensated victims of automobile accidents
within this state by requiring automobile insurers to offer and automobile owners to maintain
automobile insurance policies or other pledges of indemnity which will provide prompt payment
of specified basic economic loss benefits to victims of automobile accidents without regard
to whose fault caused the accident;
(2) to prevent the overcompensation of those automobile accident victims suffering minor
injuries by restricting the right to recover general damages to cases of serious injury;
(3) to encourage appropriate medical and rehabilitation treatment of the automobile accident
victim by assuring prompt payment for such treatment;
(4) to speed the administration of justice, to ease the burden of litigation on the courts of this
state, and to create a system of small claims arbitration to decrease the expense of and to simplify
litigation, and to create a system of mandatory intercompany arbitration to assure a prompt and
proper allocation of the costs of insurance benefits between motor vehicle insurers;
(5) to correct imbalances and abuses in the operation of the automobile accident tort liability
system, to provide offsets to avoid duplicate recovery, to require medical examination and
disclosure, and to govern the effect of advance payments prior to final settlement of liability.
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