Monday, February 23, 2015

Michigan No Fault System


The Michigan No Fault system must be investigated.  Charges have been made that insurance companies, in essence, treat their insureds as adversaries.  It wasn't supposed to be that way.

The Michigan No Fault was passed in the early 1970s.  At that time, insurance companies employed adjusters in local areas.  Adjusters were people who went to the accident scene, met with injured people and got their medical bills, wage loss, replacement service and rehabilitation bills paid.  Adjusters knew the geography and the kinds of people making the claim.  They often helped people with their claims.  They put injured people they insured in their "good hands" or act as "good neighbors."

The No Fault system was thought to be automatic.  Hurt in a motor vehicle accident?  The No Fault insurer paid.  There was an ethical question about whether an attorney could charge a contingent - a percentage - fee for helping a person with the person's No Fault claim.

Insurance companies stopped using local adjusters and began centralizing adjusting service.  Adjusters sit in a centralized office or at home and process files.  No longer do adjusters visit people.  It is a bureaucratic paper process requiring paperwork filed precisely in accordance with company requirements.  A slip up and payments are cut off.

A recent article in the Michigan Association of Justice magazine assails State Farm for using a policy that does not work to make sure State Farm's insured drivers are paid benefits they are entitled to but, instead, to make State Farm money.  The policy, if accurately described in the article, delays payments, for example, to pressure lower settlements.

Insurance companies use a couple of agencies to provide doctors, to examine injured people, and give opinions that claim there is no physical problem.  Anecdotal evidence indicates that insurance company doctors make findings against the injured person at least 90% of the time.


It is time that adjusting practices by insurance companies be vigorously investigated.  Do they treat insureds as "good neighbors" and keep them in "good hands" or do they treat insureds as adversaries?  Until the practices of No Fault companies are exposed to sunlight by investigation, people will need to seek lawyers for advice in a system originally thought to be automatic.

Richard Clark

Monday, February 9, 2015

Local Representation is Best - Here's Why!!

Very often we will receive phone calls from people that have hired attorneys that are not from the Upper Peninsula or even from Michigan.  Usually, these people have had very little contact with their attorney and often are unhappy with the current representation that they are receiving from these attorneys.  What they want is advice from us telling them to fire their attorney and assuring the caller that we will represent him or her.  Unfortunately, we can’t do that.  

According to the Michigan Rules of Professional Conduct, a lawyer shall not communicate with a person the lawyer knows to be represented in the matter by another lawyer.  (MRPC 4.2)

We represent many people with pending Social Security disability cases.  These people are waiting for a hearing and often the wait can be 12 to 18 months.  As you may see on TV, there are many law firms that advertise nationally for Social Security disability cases.  Because it is federal law, a lawyer does not have to be licensed in the state in which they represent someone for a social security disability case.  Therefore, they will advertise nationally, take just about every single case that comes in through their phone line and then once the hook is in to the client, won’t do a very good job of representing the client.  

Just recently, I had a woman call me who was waiting for a decision on her Social Security disability case.  She hired a national firm out of Texas.   When it was time for her hearing, the Texas firm did nothing for her.  She had to track down all of her medical records and submit those.  Then, no one met with her to prepare her for the hearing.  Instead, the Texas firm, hired a Marquette lawyer to go to the Social Security office and sit next to the woman during her hearing.  This lawyer had never met her and had never reviewed her file.  Then, she called us worried that her case was screwed up and wanting help.  Unfortunately, I couldn’t give her advice because she was already represented and I couldn’t tell her I would represent her should she fire her Texas attorney.  It was too late for me to jump into the case, as well, when I didn’t get a chance to look at her file, prepare the medical, and of course, meet a few times and prepare the client for the hearing.  

The short version of this is to warn people to be very careful before hiring a lawyer. While it may seem appealing to hire a big national or state wide law firm, it is often not the best avenue.  Lawyers that practice in the Upper Peninsula have a unique knowledge of the area, the people here, the judges and courtrooms and the procedures.  In addition, most local lawyers care about the people in their own community and want to do what is best for them.  Whether you want to hire Upper Michigan Law or not, please think twice before you hire a firm out of the area.  

Jessica Bray

Tuesday, February 3, 2015

Michigan Workers’ Compensation Update


Effective December 26, 2014, the new Health Care Service Rules will make it much easier for workers’ compensation insurance carriers to deny reimbursement to physicians who prescribe opioids to injured workers.

Rule 418.101008 will require the physician to submit a written report to the insurance carrier no later than 90 days after the initial opioid prescription fill, and every 90 days thereafter.  In addition, the physician will have to include a treatment plan, which includes periodic urine drug screens.

The new regulation is touted as part of the Workers’ Compensation Agency’s efforts to contain costs for job providers.  (See the Associated Press article on Michigan Radio).


Clearly, this regulation will benefit workers’ compensation insurance carriers; it is another step towards evidence-based medicine.  How it effects physicians, injured workers, and employers remains to be seen.  Can physicians provide the office time to meet with injured workers every 90 days?  Will it be feasible for physicians to meet these reporting requirements?  Will injured workers receive less than optimal treatment for their work injuries, which in turn may prevent them from being able to return to work?  Will insurance premiums be reduced for employers?

Sam Larrabee