You Lie, You Lose; Fraudster Denied PIP (No Fault) Benefits
Michigan’s highest court has ruled in a unanimous opinion that if you make a materially fraudulent statement at any time when making or pursuing a claim for Michigan PIP (No Fault) benefits, your claim will be denied. This holds even if the fraudulent statement occurs during the litigation process.
The reported case is Williamson v. AAA of Michigan. In this case a pedestrian was injured by a car. The injured pedestrian subsequently died after an unrelated event. Because he had no insurance, the pedestrian’s claim went to the Michigan Auto Insurance Placement Facility (MAIPF). The MAIPF referred the case to AAA of Michigan to administer. An Estate was established which continued the lawsuit for unpaid PIP benefits. During the discovery portion of the ensuing litigation the Estate submitted claims for replacement services and attendant care for dates of service which were after the pedestrian died!
MCL 500.3173a(4) concerns fraudulent insurance acts against the MAIPF and provides that a person who presents a statement to the MAIPF, or to an insurer to which the claim is assigned through the MACP, for payment or other benefit knowing that the statement contains false information concerning a fact or thing that is material to the claim commits a fraudulent insurance act under the statute. Further, the statute provides that a claim that is supported by a fraudulent insurance act is ineligible for payment of PIP benefits under the MACP. For a statement to be a fraudulent insurance act under MCL 500.3173a(4), it must be part of or in support of a claim to the MAIPF or to an insurer to which the claim is assigned by the MACP.
This new case law provides a potent weapon in the defense of fraudulent PIP insurance claims. It behooves adjusters, insurance companies and their counsel to closely scrutinize the material facts submitted by claimants throughout the claims process, even during litigation.
Read entire case at:
Williamson v. AAA of Michigan
About Alexander & Angelas, P.C.
Alexander & Angelas, P.C. represents defendants in civil liability litigation across Michigan and Northern Ohio. The firm’s practice areas include insurance defense litigation, premises liability, motor carrier (trucking) defense, corporate and commercial litigation, construction defect litigation, auto negligence, insurance coverage disputes, emergency casualty response services, alternative dispute resolution, subrogation claims, workers’ compensation, employment law, and liquor liability.
Attorneys practice in all state and federal courts in Michigan, including Wayne County (Detroit), Macomb County (Mount Clemens), Oakland County (Pontiac), Washtenaw County (Ann Arbor), and Genesee County (Flint). Legal services are also provided in Northern Ohio. Since its founding in 1992, the firm has litigated over 4,000 civil cases.
A 24/7 Emergency Hotline is available (800-219-0007) for trucking and insurance company clients. When an accident requires an immediate response to protect evidence, members of the firm quickly launch an investigation with the assistance of well-qualified accident investigators, crash re-constructionists, mechanical engineers, civil evidence photographers, and independent adjusters positioned throughout Michigan and Northern Ohio.
Alexander & Angelas, P.C. measures its performance based upon three key metrics: aging of claims, indemnity expense, and legal defense costs. The firm refuses to over-litigate cases merely to increase legal fees and strives to resolve matters within one year from initial case assignment.
