ATTENTION: This is a Minnesota, USA site. Questions and answers pertain only to Minnesota law and have no application to matters outside the state of Minnesota. This web site is designed for general information only and in no way should be construed as formal legal advice. Emails and answers to questions do not establish the formation of a lawyer/client relationship. Every legal situation can be different. Persons accessing this site are encouraged to seek independent counsel for advice.
This law firm offers free consultations on Minnesota No-Fault law; we are Minnesota No-Fault Insurance lawyers. Please do not hesitate to contact us with specific questions. An attorney would be happy to discuss your matter without fee or obligation. Please also check out our blog for video explanation of several no-fault topics.
Note: In Minnesota, automobile insurance operates under the 1975 Minnesota No-Fault Automobile Insurance Act. It is codified at Minnesota Statutes Chapter 65B. The entire chapter is available online.
People often express a certain aversion to, or even hostility towards the Minnesota No-Fault system. This may be due to the confusion its name imparts. Rest assured that if another driver negligently causes an accident, they will be held responsible for the damages to your vehicle and for serious personal injuries you sustain.
Under the Minnesota No-Fault Act, an injured person’s own automobile insurance company generally pays for their own insured's medical bills, wage loss and other benefits. These benefits are paid quickly and according to guidelines set forth by the Minnesota Legislature. Before the Minnesota No-Fault Act, the innocent victim of an accident was responsible for paying her own medical bills and absorbing wage loss until fault for the accident could be established through settlement or litigation. This meant waiting months or years for reimbursement and compensation.
The No-Fault Act not only protects the innocent victims of automobile accidents, it also provides important benefits to those who are at fault for the accident. When you think about your friends or family members who may have caused an accident due to their inattention, inexperience or just bad luck, you can appreciate the safety net that is in place. The No-Fault Act ensures they too can get good medical treatment and maintain a base income while they are unable to work.
The Minnesota No-Fault Act provides an important basic level of protection for Minnesota motorists. The Act ensures a minimum level of continued wages and ensures that injured Minnesotans get the medical treatment they need after an automobile accident. For serious accidents that result in death, there are survivor benefits available to help those left behind with funeral expenses and loss of earnings.
The Minnesota No-Fault Act was developed for a number of reasons articulated by the legislature at Minnesota Statute §65B.42:
It was established to relieve the severe economic distress of accident victims by ensuring prompt payment of wage loss, medical and other economic benefits after an injury regardless of fault. This also encourages appropriate medical treatment by making prompt payment for any reasonable and necessary medical services. The Act seeks to reduce automobile-related litigation by restricting the right to sue only to seriously injured victims. In addition, because insurance companies pay for their own customers' injuries, the Act reduces the need to determine fault.
Answers to many common No-Fault questions can be found by clicking one the topics listed below, or by exploring the statutes by clicking here. If you cannot find a satisfactory answer to your particular question, please email or call attorney Matthew Brenengen. He will respond promptly, of course without fee or obligation. Topics will be added based on your questions, so check back frequently.
Medical Benefits
Wage Loss Benefits
Replacement Services
Vocational Rehabilitative Services
Funeral Expenses
Persons Surprisingly Entitled to No-Fault Benefits
Negligent or Careless Drivers
Resident Relatives
Uninsured Drivers
Uninsured Passengers and Pedestrians
Slip and Fall Injuries
Injuries without Contact with a Motor Vehicle
Car Thieves
Persons Generally not Entitled to No-Fault Benefits
Motorcycle Drivers and Passengers
Owners of Uninsured Automobiles
Resident Relatives of Uninsured Drivers
Loading and Unloading Injuries
Even People who Caused Accidents May Need Help with No-Fault
Most Injuries Involving an Automobile are Covered
Under the Minnesota No-Fault Act, most people injured in connection with a Minnesota motor vehicle accident, regardless of fault, are covered. This includes the driver, all passengers, pedestrians, bicyclists, etc. The Act also covers people hurt working in and around the car or even trailers. We have successfully litigated two cases in recent years that established needed no-fault medical benefits for people who were seriously injured when they slipped and fell while getting into their cars. The breadth and scope of the Act is large, so it is important that any injury related to the "maintenance or use of a motor vehicle" be investigated thoroughly by a lawyer that practices Minnesota No-Fault law to see if there is coverage under the Act. In most cases, No-Fault coverage can be found.
If a lawyer tells you that you are not entitled to No-Fault benefits, it is a good idea to get a second opinion. Feel free to leave us an email if you would like one of our lawyers to contact you. We will answer your questions without fee or obligation.
Which Insurance Policy to Look to for Coverage
The Minnesota Statutes set out the priorities of coverage at Minn. Stat. §65B.47, Subd. 4 (a litany of confusing exceptions is laid out in subdivisions 1-3). Generally, people injured in motor vehicle accidents would look to their own insurance company for coverage, regardless of whether they were a driver, passenger or a pedestrian at the time of the accident.
The vast majority of automobile accidents that we see, involve one Minnesota insured driver in her own car crashing into another Minnesota insured driver on a public road. These are the unfortunate incidents you see every week. In these "typical" cases, each person’s own insurance provides its driver No-Fault benefits. No-Fault coverage also extends to the insured driver’s children and spouse or other resident relatives, whether or not the insured driver is involved in the accident with the family member or not.
If the injured person is a passenger in someone else's vehicle at the time of the injury (i.e. a taxi cab), that person still looks to her own insurance policy, not to the policy covering the vehicle she was in. Her own policy includes not only a policy issued to her personally, but any policy maintained by any resident relative. Therefore, if the injured person does not have her own policy, but a brother (or mother, or sister, or cousin, etc.) that lives in the same house with her has a policy, that is where to look for no-fault benefits. Only if there is no other policy would the injured person be covered by the policy covering the taxi or other non-owned vehicle she was in at the time of the crash. Never would one look to the insurance policy of the other vehicle involved in the accident for no-fault coverage, unless the injury involved a pedestrian.
Remember, even if the pedestrian or bicyclist was at fault, they are still entitled to No-Fault coverage. If none of the vehicles involved in the accident are insured, there is a safety net called the Minnesota Assigned Claims Plan which provides coverage for otherwise injured and uninsured victims. The Minnesota Assigned Claims Plan will generally not provide coverage, however, for people driving owned, uninsured vehicles at the time of the injury.
What Benefits are Available
The minimum No-Fault coverage required in Minnesota is set forth at Minn. Stat. §65B.44. It provides a minimum requirement of $20,000 for medical and medical related expenses and $20,000 for economic loss or wage loss benefits. This coverage can be easily and economically be increased by stacking two or more policies, provided there are two or more vehicles within the household. If there is only one vehicle, ask your insurance agent about increasing your limits of coverage - the problem is that even with increased limits, without stacking, it is likely your wage loss will be limited to $250 per week.
No-Fault insurance covers a wide range of medical benefits including "surgical, X-ray, optical, dental, chiropractic, and rehabilitative services, including prosthetic devices, prescription drugs, necessary ambulance and all other reasonable transportation expenses incurred in traveling to receive covered medical benefits, hospital, extended care and nursing services." Minn. Stat. §65B.44 Subd. 2. This generally includes all medical bills including reasonable and necessary chiropractic care and physical therapy. It also includes reimbursement for prescription medications and travel expenses incurred in pursuit of medical treatment. Usually travel expenses are paid at a rate of around $.33 per mile.
Economic loss benefits include 85% of actual lost wages (even if compensated by sick leave or vacation pay) up to a maximum of $250 per week. The details are in Minn. Stat. §65B.44 Subd. 3. This maximum will increase as policies are stacked or if the policyholder has elected to increase the coverage limits.
No-Fault insurance covers "Replacement Services" (Minn. Stat. §65B.44 Subd. 5). A replacement service expense would be incurred when an injured person has to hire someone to perform tasks she would normally perform herself, i.e. shoveling, laundry, mowing, even auto repair and remodeling in some cases. Important! In order to receive compensation for replacement services, the injured person must have a disability slip from her doctor specifically forbidding the person to perform the activity herself.
The No-Fault insurer must typically pay or deny a specific claim within 30 days after the insurer receives notice of the claim for benefits (i.e. within 30 days of when it receives a medical bill). This rule is set forth at Minn. Stat. §65B.54. If an insurer denies a claim, it must provide the injured person with written notice of its denial and information on how to appeal its decision. We handle dozens of these arbitrations annually for clients. Matthew Brenengen is also appointed about 20 times each year by the American Arbitration Association and Twin Cities attorneys as an arbitrator to decide these no-fault disputes. If your benefits have been wrongfully denied or terminated, contact us for a no cost, no obligation consultation.
In the tragic situation where a person is killed in a motor vehicle accident, the No-Fault Act provides benefits for the survivors of the person's family. These benefits include funeral and burial expenses, replacement income, and replacement service expense compensation. Remember that these benefits, as well as all of the above, are available regardless of fault. If you have particular questions about your situation, please feel free to contact us.
There are many sub-issues in area of medical and wage loss No-Fault benefits that are very fact specific, and best addressed on a case-by-case basis. Please click to send an email question.
Out-of-State Residents Injured in Minnesota Accident
Many out-of-state drivers will automatically be eligible for Minnesota No-Fault benefits when they cross the border into Minnesota. Minn. Stat. §65B.50. This will be true so long as the out-of-state resident's insurance company is licensed to sell insurance in the State of Minnesota and the insured car is physically in Minnesota at the time of the accident (although it need not actually be involved in the accident). Eligibility for Minnesota No-Fault benefits is a complicated issue that depends on many factors. If you are an out-of-state resident that was injured in an automobile accident in Minnesota, we would be happy to determine whether you are entitled to No-Fault benefits.
Incidentally, insured Minnesotans are entitled to No-Fault benefits for injuries arising out of accidents that occur outside of Minnesota. Minn. Stat. §65B.46, Subd. 2. This includes the 50 states and Canada. It does not extent coverage to Mexico.
Stacking No-Fault Benefits
Everyone who earns more than $300 per week and has more than one car in the family should strongly consider (get it!) "stacking" automobile insurance policies. As the name implies, stacking multiplies the amount of available No-Fault coverage. With two cars, total benefits double to $40,000 for wage loss and $40,000 for medical expenses. With three cars, the coverage triples.
While the increased aggregate coverage is beneficial for serious accidents, even in a relatively minor accident, the increased weekly maximums can make the difference between paying bills after an accident and being forced into bankruptcy. Basic No-Fault coverage pays 85% of wage loss up to $250.00 per week. If you are making more than $300.00 per week, you will hit this maximum if you are unable to work after an accident. If your income is significantly higher than $300.00 per week, basic No-Fault coverage is not going to ensure you an adequate income replacement should you be disabled for an extended period.
By law, every time you renew your policy, your insurance agent is supposed to ask you if you want to stack your policies. If you think you might benefit from stacked No-Fault coverage, ask your agent for more details. The cost of stacking is usually quite affordable and can make a big difference after an accident.
Surprisingly Entitled to Minnesota No-Fault Insurance Benefits
As stated above, the scope of Minnesota No-Fault coverage is very large. If you are ever told you are not entitled to Minnesota No-Fault benefits, it would be a good idea to get a second opinion from a lawyer that specializes in Minnesota injury law. The following list contains just some examples of coverage that is less than obvious. This list is by no means complete.
Negligent or Careless Drivers
A driver whose own negligence, carelessness or even drunkenness causes an accident is entitled to No-Fault benefits. Exceptions: there is no coverage in situations where an insured person is hurt in an official race off public roads or was intentionally trying to hurt himself or others.
Resident Relatives
An otherwise uninsured relative, connected by marriage or blood (i.e. brother, aunt, cousin, father-in-law, etc.), who lives in the same house as any insured person may be entitled to no-fault benefits from the insured person’s insurance company.
For example: Fred’s son recently married Susan. Due to downsizing at Susan’s firm, she was laid off. The couple can no longer afford their own apartment and move in with Fred. Neither Fred’s son, nor Susan have a car or carry insurance. One morning, a friend is giving Susan a ride to the store when a drunk driver runs into the car and Susan is injured. In this case, Susan would be covered under Fred’s policy since she is one of Fred’s resident relatives.
Uninsured Drivers
It is against the law to drive a car without its own policy of insurance in Minnesota. Minn. Stat. §65B.48. Uninsured drivers face stiff penalties if caught. Nonetheless, in many cases, a person injured while driving his own uninsured car, can get no-fault coverage through a policy for another owned, but insured car, or through any insured resident relative’s policy.
For example: Fred’s son recently married Susan. Due to downsizing at Susan’s firm, she was laid off. The couple can no longer afford their own apartment and move in with Fred. Unfortunately, due to their financial situation, Susan’s insurance policy lapses and her coverage is terminated. One morning, she is driving her now uninsured car to the store when she runs a red light, crashes into a truck and is injured. In this case, Susan would be covered under Fred’s policy since she is one of Fred’s resident relatives.
Uninsured Passengers or Pedestrians
When a person who has no insurance of her own is injured through the maintenance or use of an automobile, they would look to the priority section of the Minnesota No-Fault Act (Minn. Stat. §65B.49 Subd. 4) to determine which insurance company will provide coverage. If none of the vehicles involved in the accident have insurance, she would seek coverage from the Minnesota Assigned Claims Bureau. Exception: if the injured person is a competent adult that either owns or lives with a family member (or even in some cases, someone who is not a family member) who owns an uninsured motor vehicle that is not being stored, she is not entitled to benefits through the Minnesota Assigned Claims Bureau.
Slip & Fall Injuries
A person injured by falling while getting in or out of a car may be entitled to no-fault benefits. Minnesota motorists have been entitled to No-Fault coverage for injuries he sustained in slip and falls where they are pumping gas or returning to the car after closing the garage door. We have successfully gotten no-fault medical coverage in two separate cases where the client broke her arm falling on the ice as they were getting into their car.
Injuries without Contact with a Motor Vehicle
A person whose injuries result from an accident where a car was only tangentially involved may be entitled to no-fault benefits. Minnesota case law has found that a person who was hurt diving out of the way of an approaching car was covered by No-Fault benefits.
Car Thieves
A person injured while stealing a car will actually be covered under her own no-fault insurance policy or that of any resident relative. If the car thief is under 15 years of age, and no one else in her family is insured, she can look to the Minnesota Assigned Claims Bureau for coverage.
Generally Not Entitled to Benefits
IMPORTANT NOTE: the following is a list of examples where there is generally no coverage. As with most rules, there are exceptions. Please contact an attorney, who specializes in No-fault law, to determine whether you have a claim.
There are some common situations where No-Fault coverage is not available. In such situations, where an injury is caused by the negligence of another, medical bills, wage loss and general damages would have to be recovered through other insurance or a direct action against the at-fault person.
Motorcycles
Motorcyclists are required neither to purchase, nor normally entitled to Minnesota No-Fault benefits for injuries arising out of a motorcycle accident. Even if the driver or passenger on the motorcycle maintains coverage on another motor vehicle, if they are hurt while riding on a motorcycle, they usually are not entitled to no-fault benefits. Here's a tip... if you are going to ride a motorcycle, wear a helmet, ride defensively, and make sure you have health insurance!
Loading or Unloading a Vehicle
No-fault benefits may be excluded for injuries that occur while loading or unloading a truck or car, except when occupying, entering into or alighting from the vehicle. There are many exceptions, however, so it is important to discuss this issue with a qualified attorney.
Uninsured Driver’s Relatives
The Law frowns upon owners and drivers of uninsured vehicles. While there are numerous exceptions, generally, not only will the uninsured driver not be entitled to No-Fault benefits, but also any adults that live with the person can be prevented from obtaining benefits. All related adults (i.e. husband and wife) be held accountable for their partner's failure to insurer, so too will cohabiting, unmarried adults.
How Insurers Terminate No-Fault Benefits
While each person injured in a Minnesota motor vehicle accident has a minimum of $20,000 for wage loss and $20,000 for medical expenses, very often insurance companies try to terminate No-Fault benefits before the maximum is reached. Insurers usually must get a medical opinion that the insured person has either completely healed, or is receiving no further benefit from continued medical treatment. In order to obtain this medical opinion, the insurer typically schedules an Independent Medical Examination for the injured insured.
The Independent Medical Examination (IME)
In our experience, we find that the No-Fault insurer will pay most medical expenses incurred in the first few months after an accident. Eventually, however, the insurer will want to terminate benefits, especially in cases where the insured received soft-tissue injuries. In order for the insurer to terminate benefits, it must show that continuing treatment is no longer reasonable or necessary.
The insurance adjuster that handles a No-Fault claim typically will monitor the injured person’s status by getting copies of medical records. When the adjuster feels the injured person has received enough medical treatment, the adjuster will asks the injured person to attend an Independent Medical Examination, commonly known as an IME.
The No-Fault Act at
Minn. Stat. §65B.56 requires people claiming benefits to cooperate with their insurers. This means that the claimant must submit to an IME if requested by the insurer. The statute states that the insurer must schedule the examination with a doctor in the same city as the claimant, unless there are no doctors in that city. Benefits may be suspended (but not terminated) if the claimant refuses to attend the IME if it is scheduled at a reasonable time, location and under reasonable circumstances. While in the past the claimant could refuse to attend the IME if there were unpaid, outstanding benefits, this is no longer the case under the Hovland v. State Farm case. See also Weaver v. State Farm Ins. Co., 609 NW2d 878 (Minn.2000). For a special legal article on the ramifications of the Weaver Supreme Court decision, click here.Tips for Attending an IME
While most of the doctors who perform IME’s do so in addition to their regular practice of medicine, some doctors will do only IME’s. Insurance companies typically pay these doctors from $600 to $1200 for their reports. While the term "independent" suggests the exams are unbiased, in our experience, they are usually anything but. Regardless how incapacitated the claimant may be at the time of the IME, in almost every case, the IME doctor will find that no further medical treatment is necessary.
The situation is not as hopeless as it sounds, and anyway, the claimant has little choice but to attend. There are some suggestions we usually make to our clients that can aid in a later appeal of the doctor's findings. Because every case is different, it would not be appropriate to post any suggestions here. However, please feel free to contact us. An attorney would be happy to discuss your case and answer any questions you have regarding the IME without cost or obligation.
Challenging the Termination or Denial of Benefits
In addition to terminating benefits based on an IME, an insurer may deny benefits because it deems them "unreasonable" or "unnecessary" or not related to a motor vehicle accident. Benefits may also be terminated if the injured person goes more than a year without seeking medical treatment for accident-related injuries. Minn. Stat. §65B.55, Subd. 2.
The Insurer Does not have the Last Word
Every denial or termination by a No-Fault insurance adjuster can be appealed. Minn. Stat. §65B.525 states that all disputes under $10,000 must be settled through a dispute resolution system called Arbitration. Arbitration is a process where an Arbitrator, who is usually an attorney practicing in the area of injury law, is selected to hear the evidence and make a final, binding decision as to whether No-Fault benefits were properly denied. Any person, who has had No-Fault benefits denied may file a claim with the American Arbitration Association (AAA). Whenever an insurer denies a claim, it must provide information on how to contact AAA.
In St. Paul and Minneapolis, contact the American Arbitration Association. You can file for arbitration at the following link:
http://www.adr.org/sp.asp?id=29543
At an Arbitration, typically what happens is the lawyer for the Claimant (the injured person) presents proof of a valid claim for No-Fault benefits. The Claimant's lawyer will submit a short statement of the facts, along with a written argument as to why the insurer should pay denied benefits. She would also probably provide a letter from her doctor explaining the need for the denied medical treatment or need to stay off work. Finally, the Claimant would also provide the Arbitrator a copy of all the medical records, bills, accident reports, photos of the cars, etc. A lawyer hired by the insurance company would submit a similar book including an explaining why the Claimant is not entitled to benefits.
Both parties then meet with the Arbitrator, usually at the Arbitrator's office, where they argue their case and let the Arbitrator ask questions. The Arbitrator then considers the evidence and issues a written decision within a week or two.
Matthew Brenengen is a AAA certified arbitrator, and has chosen more than 125 times by the AAA and local attorneys to arbitrate these No-Fault disputes. If you have any questions regarding the process, please feel free to contact us with any questions you may have.
Interest Penalty for Wrongly Denied Benefits
If the Arbitrator determines that the insurer wrongfully denied benefits, the Arbitrator must also award the Claimant a 15% interest penalty. This is set forth in the statutes at Minn. Stat. §65B.54, Subd. 2. The interest penalty is calculated from 30 days after the time the insurer received notice of each element of the claim (i.e. each medical bill or month of wage loss).
The following is a simple example using one denied medical bill that was submitted to the insurer on March 15, 2006:
Amount of Bill: $1000
Date Rec'd by Insurer: March 15, 2006
Date Overdue (Rec'd+30): April 14, 2006
Date of Arbitration: September 1, 2006
Days Overdue (at time of Arbitration): 171
Total Interest (#daysX0.00041): $70.27
This calculation must be done for every element the claimant is seeking in the arbitration. (If you were wondering where 0.00041 came from in the above equation, it is 15% divided by 365, or the daily rate of interest). The interest penalty goes to the Claimant not the medical provider.
Arbitrators Can Not "Restore" Benefits
Arbitrators are only permitted to award compensation for wrongfully denied claims. The Arbitrator is not permitted to order an Insurer to pay any claim submitted after the arbitration. Before rushing to AAA as soon as a claim is denied, Claimants should consider how much additional treatment or wage loss is expected. This is an issue that should be discussed with a treating doctor. It may be best to wait until treatment and wage loss has ended before bringing an Arbitration. This way all benefits can be sought in a single arbitration. On the other hand, since there is no guarantee the Arbitrator will award all claimed benefits, waiting may result in more uncompensated losses. For more information, contact an attorney that practices in the area of personal injury law.
Consider the costs associated with an Arbitration before demanding one. To initiate an Arbitration, the Claimant must pay a $50.00 filing fee. The Claimant then may also be assessed with the Arbitrator's fee of $150.00. There are also photocopies and the doctor's report may be costly. While the Arbitrator will sometimes order the insurance company to pay all the Claimant's costs, there is no guarantee. It is possible, as well, if the Arbitrator feels that the Claimant's case is frivolous, that the insurer's costs may be awarded against the Claimant.
Does your Attorney Handle the No-Fault Claim?
It is surprising to find that some personal injury attorneys leave administration of the important and complicated No-Fault case up to the client. Other attorneys will charge a fee, in addition to whatever is recovered from the at-fault party, for handling the No-Fault claim. While dealing with the No-Fault issues can be very time consuming, we believe the No-Fault claim is so important and complicated that it requires a lawyer with years of experience to facilitate effectively.
After an accident, the wage loss and medical benefits that No-Fault provides are essential to helping the injured person recover, both financially and physically. In cases where there is no dispute over payment of no-fault claims, we charge no-fee for facilitating the claims. In cases where a dispute arises and the claim has the be arbitrated, our fee is generally taken as a percentage of the total recovered. No fee is charged unless there is a recovery.
Even People Who Caused Accidents May Need Help with No-Fault
While the contingency (percentage) fee arrangement allows people with little disposable income that have been hurt by the negligence of others to get help from competent and experienced attorneys, for those responsible for causing the accident, it can be almost impossible to get help from an attorney. Because we understand that everybody can have questions about No-Fault law, we are willing to respond to everyone's questions, whether or not they caused the accident. In many cases, even if litigation is required to get the insurance company to pay wrongfully denied claims, the legal work can be done with no out-of-pocket expense to the client.
If you need legal help, but are having trouble finding an attorney that will talk to you, please feel free to contact us. We will do what we can to assist in your claim, answer your questions and direct you to resources that may provide additional assistance at low or no cost.
ATTENTION: This is a Minnesota, USA site. Questions and answers pertain only to Minnesota law and have no application to matters outside the state of Minnesota. This web site is designed for general information only and in no way should be construed as formal legal advice. Emails and answers to questions do not establish the formation of a lawyer/client relationship. Every legal situation can be different. Persons accessing this site are encouraged to seek independent counsel for advice.