Detailed Answer

Short answer: If an insurer denies benefits for injuries after a minor Michigan auto accident, you should (1) carefully read the denial and your policy, (2) gather and organize medical and accident evidence, (3) follow the insurer’s internal appeal process quickly, (4) consider filing a complaint with the Michigan Department of Insurance and Financial Services (DIFS), and (5) if needed, pursue a civil action to recover benefits. Below are practical, step-by-step explanations of what each of those steps means under Michigan law and how to proceed.

1. Understand the legal framework (what Michigan law covers)

Michigan is a no-fault auto-insurance state. That means your personal injury protection (PIP) portion of your own auto policy generally covers reasonable medical expenses, wage loss, and replacement services after an auto accident regardless of who was at fault. See Michigan law summarizing PIP benefits: MCL § 500.3107.

Insurers commonly deny PIP or other injury-related claims for reasons such as: lack of causal connection to the crash, disputed medical necessity, treatment that the insurer deems unreasonable, missed notice or claim-filing deadlines, or alleged policy exclusions. A denial letter should state the insurer’s reason(s).

2. Read the denial letter and your policy immediately

Carefully review the insurer’s denial. Note the exact reason(s) given and any cited policy language. Check your policy for the insurer’s internal appeal procedure, required notices, and any deadlines. Insurance companies often have short windows (for example, 30–60 days) to request review or provide additional information, so act quickly.

3. Gather and organize evidence

To challenge a denial you will need clear documentation. Typical helpful items:

• Accident report or police report and photos of the scene/vehicles;
• Names and contact info for witnesses;
• All medical records, provider notes, diagnostic tests (X-rays, MRIs), and itemized bills tied to your treatment;
• Provider statements linking diagnoses and treatment to the crash (causation); a short written statement from your treating clinician can be persuasive;
• Records of lost wages (pay stubs, employer note) or receipts for replacement services (e.g., household help);
• All correspondence with the insurer (emails, denial letter, dated phone notes).

4. Use the insurer’s internal appeal or reconsideration process

Most policies require you to request a review of the denial with the insurer first. In that appeal you should:

1. Send a concise written appeal identifying the denial reason and attaching the supporting documents listed above.
2. Ask the insurer to explain any technical reason for denial (e.g., “not causally related,” “untimely,” or “not reasonable and necessary”) and request any internal report or file notes relevant to the decision.
3. If the insurer denies based on medical necessity, ask for a complete explanation of the medical criteria used and request a peer review or independent medical review if available under your policy or insurer procedures.

Keep copies of everything and send written materials by a method that provides proof of delivery.

5. File a complaint with Michigan’s regulator if the insurer won’t cooperate

If an insurer ignores your appeal or you believe the denial violates your policy or Michigan law, you can file a consumer complaint with the Michigan Department of Insurance and Financial Services (DIFS). DIFS can investigate unfair claim-handling practices and may ask the insurer to explain or reconsider its decision. See DIFS consumer resources for auto-insurance issues: Michigan DIFS – Auto Insurance.

6. When to consider hiring an attorney and filing a civil lawsuit

If internal appeals and regulatory complaints do not resolve the issue, you may be able to file a civil action to recover denied benefits. In Michigan, claimants have the option of suing in court to enforce PIP and other contractual benefits. Before filing suit, confirm relevant statutes of limitations and litigation deadlines; missing these deadlines can forfeit rights to recover. An attorney experienced in Michigan no-fault and insurance litigation can:

• Evaluate whether the denial was legally justified;
• Advise whether you have a viable claim for breach of contract or bad-faith denial;
• Handle filings in Michigan circuit court and explain potential recovery (benefits, interest, possibly costs/fees depending on the claim and governing law).

7. Practical timeline and expectations for a minor-accident denial

Realistically, an internal appeal and regulator inquiry can take weeks to a few months. If you must file and litigate, expect a longer timeframe. Keep getting needed treatment and keeping detailed medical records. Continuing treatment and up-to-date provider notes strengthen causation arguments for soft-tissue injuries that sometimes follow minor collisions.

8. Example (hypothetical facts to illustrate)

Imagine you had a low-speed rear-end collision, later developed neck pain, saw a primary-care doctor and chiropractor, and received treatment and bills. The insurer denies PIP medical benefits saying the records do not show that your injury was caused by the crash. Reasonable next steps:

1. Request the insurer’s specific reasons in writing and the appeal procedure.
2. Ask your treating providers for a short causation letter that ties your diagnosis and treatments to the crash and explains why the treatments were reasonable and necessary.
3. Submit those materials in a documented appeal to the insurer, and copy your state regulator if the insurer’s process is slow or unresponsive.
4. If the insurer still refuses, consult an attorney to evaluate a civil claim for PIP benefits or other remedies.

Key Michigan law reference

Primary statutory guidance about what PIP covers is found at MCL § 500.3107. For compliance questions and to file a complaint, see the Michigan Department of Insurance and Financial Services: https://www.michigan.gov/difs/consumers/insurance/auto-insurance. For court procedures and self-help materials, the Michigan Courts website offers resources on filing civil actions: Michigan Courts – Self Help.

Disclaimer

This article explains general steps under Michigan law and is for informational purposes only. It is not legal advice and does not create an attorney-client relationship. For advice about your specific situation, consult a licensed Michigan attorney who handles auto-insurance and no-fault claims.

Helpful Hints

• Act quickly: begin the appeal and gather records as soon as you receive a denial.
• Keep meticulous records of all medical care, bills, communications, and dates of treatment related to the accident.
• Ask providers for short written statements tying their treatment to the crash (causation) and explaining why treatment was reasonable and necessary.
• Send appeals and important correspondence by a trackable method and keep copies.
• Use DIFS as a resource — they can help if the insurer screens out legitimate claims or mishandles your file.
• Before signing anything or accepting a settlement, consider talking with an attorney—especially if the insurer offers a low lump-sum payment in exchange for signing away your rights.
• When contacting an attorney, bring your policy declarations page, denial letter, medical records, and any accident reports; that makes an initial evaluation faster and cheaper.