MINNESOTA NO-FAULT AUTOMOBILE INSURANCE ACT


PURPOSE

The topic discusses your rights of an individual who has been injured in an automobile accident in the State of Minnesota.

Effective January 1, 1975, the Minnesota No-Fault Automobile Insurance Act came into existence. The basic premise behind the Minnesota No-Fault Automobile Insurance Act is that anyone owning a car in the State of Minnesota is required to carry insurance to cover their own medical expenses, wage loss and other economic losses arising out of an automobile accident. The injured person’s own insurance company will pay such person medical expenses, wage loss, and other economic losses regardless of who was at fault in causing the accident. Hence, the name “no-fault insurance.”

INJURY TO PERSON

The No-Fault Automobile Insurance Act covers only economic losses arising out of personal injury. Damage to personal property is specifically excluded from coverage under the Act. Such damage would be covered under collision, comprehensive, and liability portions of your own automobile insurance policy.

LOCATION OF ACCIDENT

If the accident causing injury occurs in this state, every person suffering loss from injury arising out of the maintenance or use of a motor vehicle or as a result of being struck as a pedestrian by a motorcycle, has a right to basic economic loss benefits i.e. medical expenses, wage loss, etc. No distinction is made between residents and non-residents.

For all persons suffering loss from Minnesota automobile accidents, benefits will be payable. If one is insured under a Minnesota No-Fault automobile insurance policy, the policy provides coverage for accidents occurring outside the State of Minnesota, in the United States, United States possessions or Canada.

MOTOR VEHICLE

In order for the Minnesota No-Fault Automobile Insurance Act to apply, a vehicle must be both subject to state registration laws, and self-propelled, or a trailer attached to such a vehicle. The Act does not include motorcycles. Injuries suffered by a person while on, mounting, or alighting from a motorcycle are specifically excluded from coverage under the Act. You should be aware; however, that no-fault insurance may be purchased as an optional coverage as opposed to a mandatory coverage for motorcycles.

MAINTENANCE OR USE OFA MOTOR VEHICLE

The Minnesota No-Fault Act does not apply to an injury unless the injury occurred in connection with the maintenance or use of a motor vehicle. Maintenance or use of a motor vehicle includes acts which are incident to the maintenance or use of such vehicle, including occupying, entering into, and alighting from such vehicle. Maintenance or use of a motor vehicle does not include conduct within the course of a business of repairing, servicing, or otherwise maintaining motor vehicles unless the conduct occurs off business

DISABILITYAND INCOME LOSS

Disability and income loss benefits shall provide compensation for 85% of the injured person’s loss of present and future gross income from inability to work proximately caused by the injury subject to a maximum of $250.00 per week. Loss of income includes the cost incurred by a self-employed person 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.

REPLACEMENT SERVICES

Replacement service loss shall reimburse expenses reasonably incurred by or on behalf of the injured person in obtaining usual and necessary substitute services in lieu of those that had the injured person not been injured the injured person would have performed not for income but for direct personal benefit or for the benefit of the injured person’s household. If the injured person normally, as a full-time responsibility, provides care and maintenance of a home with or without children and by reason of the injury is unable to perform such services, then such person is entitled to the reasonable expenses incurred in obtaining substitute care and maintenance of the home. These benefits are subject to a maximum of $200.00 per week. All replacement service loss incurred on the date of the injury and the first 7 days after the injury are excluded in calculating the replacement service loss.

REHABILITATION

In appropriate cases the insurer is obligated to pay for the costs of retraining and rehabilitation of an injured person.

FUNERAL EXPENSES

If a person is killed in a motor vehicle accident, reasonable expenses for funeral and burial of such person not to exceed $2,000.00 are payable by the insurance company.

SURVIVORS ECONOMIC LOSS

In the event of death occurring within one year of the date of the accident, caused by the accident, survivors are entitled to a maximum of $200.00 per week to cover losses incurred after the insured’s death for contributions of money or tangible things of economic value. This is not limited to wage or salary loss but also includes other tangible things of economic value.

SURVIVORS REPLACEMENT SERVICE BENEFITS

Beyond compensation for direct wage loss incurred by the death of an individual, services rendered for the house-hold are also compensable under the No-Fault Act. These benefits are also subject to a maximum of $200.00 per week. Inability to work is defined by the No-Fault Act as: a disability which prevents the injured person from engaging in any substantial gainful occupation or employment on a regular basis. A partially disabled person, who is unable to work full-time or return to the same type of work he or she performed prior to the injury, has an inability to work within the meaning of statue. If the injured person returns to employment and is unable by reason of the injury to work continuously, compensation for loss of income shall be reduced by the income received while the injured person is actually able to work. Income Loss Benefits are payable for loss of time from work while receiving reasonable and necessary chiropractic or medical treatment.

PAYMENT OF BENEFITS

Benefits must be paid within 30 days of presentation to the insurer. A rejection of a claim must be made promptly and in writing by the insurance company. Overdue payments bear simple interest at the rate of 15% per annum.

LAPSE IN TREATMENTAND IN DISABILITY

An insurer is allowed to include a clause in its policy that provides that where a lapse occurs in the period of disability or in the medical treatment of a person for over a year, they may terminate their responsibility for future payments. Thus, it is very important for the insured to see to it that there is not a treatment gap in excess of one year. Thus, it would appear yearly checkups are a must in order to keep the insurance carrier responsible for future benefits.

MEDICAL EXAMINATIONS

The Minnesota No-Fault Act requires an injured person to submit a medical examination at the insurance carrier’s request. The examination must 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 such town of residence of the injured person, then such examination must take place at the closest proximity to the injured person’s residence. The statue only requires attendance at a physical examination by a physician of the insurance carrier’s choice. Thus, the statue does not appear to give the insurance carrier the right to multiple examinations. The insured is entitled to medical mileage for attending the examination and a copy of the report of the adverse examining physician.

TERMINATION OF BENEFITS

In many cases, the insurance carrier, based on the examination by the adverse examining physician, will terminate ongoing responsibility for payment of chiropractic or medical expenses and wage loss. Once this termination takes place, the insured has a right to file a claim for mandatory arbitration with the American Arbitration Association if the amount of the claim is $10,000.00 or less at the time of the filing of the arbitration. From a mechanical stand point, the arbitration claim is initiated by filing a petition with the American Arbitration Association and a $50.00 filing fee. The American Arbitration Association will then provide the parties with a list of four lawyers who will act as arbitrators on a particular case. Each party is entitled to strike one of the layers from the list leaving one of the remaining lawyers to act as arbitrator. The arbitration hearing is in essence a mini-trial at which time an arbitrator will make a decision whether or not the termination of benefits by the insurer was justified and if not the amount of benefits the injured person is entitled to. In the event the claim of the insured is over $10,000.00, an insurance company may properly refuse to arbitrate and therefore the insured is required to bring a direct action in district court against the insurance company for the benefits claimed.

EXCLUSIONS FROM COVERAGE UNDER THE NO-FAULT ACT

The Minnesota No-Fault Act excludes certain circumstances and injuries from coverage under the Act. They are as follows:

1. Intentional injury.

2. Persons injured in the course of an official racing contest.

3. Vehicle owners who are uninsured.

THE RIGHT TO BRING A CLAIM AGAINST THE PARTY WHO CAUSED YOUR INJURIES

When one is involved in a motor vehicle accident, they sustain losses other than economic losses covered under the Minnesota No-Fault Act. These include, pain,

suffering, disability, and loss of life style occasioned by the injuries. Since January 1, 1975, an injured person cannot bring a claim against the party who caused such persons

injuries for such pain and suffering, disability and change of life style, unless they meet one of four requirements. The four requirements are as follows:

1. Medical/Chiropractic expenses in excess of $4,000.00.

2. Permanent injury.

3. Permanent disfigurement.

4. Disability for more than 60 days.

In the event a person reaches one of these thresholds, then they do have the right to bring a claim against the party who caused their injuries in the motor vehicle accident. If the insured does not reach one of these thresholds, then they are limited to receiving the basic economic loss benefits which we have just gone through under the Minnesota No-Fault Act. In regard to the permanent injury threshold, a permanent injury is one from which it is reasonably certain a person will not fully recover. The injury may improve or worsen, but it will continue to some degree throughout the person’s life. From a