HOUSE BILL No. 5135

 

October 7, 2003, Introduced by Rep. Mortimer and referred to the Committee on Insurance.

        

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1956 PA 218, entitled                                             

                                                                                

    "The insurance code of 1956,"                                               

                                                                                

    by amending section 3107 (MCL 500.3107), as amended by 1991                 

                                                                                

    PA 191.                                                                     

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 3107.  (1) Except as provided in subsection (2),                       

                                                                                

2   personal protection insurance benefits are payable for the                  

                                                                                

3   following:                                                                  

                                                                                

4       (a) Allowable expenses consisting of all reasonable charges                 

                                                                                

5   incurred for reasonably necessary products, services, and                   

                                                                                

6   accommodations for an injured person's care, recovery, or                   

                                                                                

7   rehabilitation.   Allowable expenses within personal protection             

                                                                                

8   insurance coverage shall not include charges for a hospital room            

                                                                                

9   in excess of a reasonable and customary charge for semiprivate              

                                                                                

10  accommodations except if the injured person requires special or             

                                                                                


                                                                                

1   intensive care, or for funeral and burial expenses in the amount            

                                                                                

2   set forth in the policy which shall not be less than $1,750.00 or           

                                                                                

3   more than $5,000.00.                                                        

                                                                                

4       (b) Work loss consisting of loss of income from work an                     

                                                                                

5   injured person would have performed during the first 3 years                

                                                                                

6   after the date of the accident if he or she had not been                    

                                                                                

7   injured.  Work loss does not include any loss after the date on             

                                                                                

8   which the injured person dies.  Because the benefits received               

                                                                                

9   from personal protection insurance for loss of income are not               

                                                                                

10  taxable income, the benefits payable for such loss of income                

                                                                                

11  shall be reduced 15% unless the claimant presents to the insurer            

                                                                                

12  in support of his or her claim reasonable proof of a lower value            

                                                                                

13  of the income tax advantage in his or her case, in which case the           

                                                                                

14  lower value shall apply.   Beginning March 30, 1973  For the                

                                                                                

15  period October 1, 2001 through September 30, 2002, the benefits             

                                                                                

16  payable for work loss sustained in a single 30-day period and the           

                                                                                

17  income earned by an injured person for work during the same                 

                                                                                

18  period together shall not exceed  $1,000.00  $4,027.00, which               

                                                                                

19  maximum shall apply pro rata to any lesser period of work loss.             

                                                                                

20  Beginning October 1,  1974  2002, the maximum shall be adjusted             

                                                                                

21  annually to reflect changes in the cost of living under rules               

                                                                                

22  prescribed by the commissioner but any change in the maximum                

                                                                                

23  shall apply only to benefits arising out of accidents occurring             

                                                                                

24  subsequent to  after the date of change in the maximum.                    

                                                                                

25      (c) Expenses not exceeding $20.00 per day, reasonably                       

                                                                                

26  incurred in obtaining ordinary and necessary services in lieu of            

                                                                                

27  those that, if he or she had not been injured, an injured person            


                                                                                

1   would have performed during the first 3 years after the date of             

                                                                                

2   the accident, not for income but for the benefit of himself or              

                                                                                

3   herself or of his or her dependent.                                         

                                                                                

4       (2) A person who is 60 years of age or older and in the event               

                                                                                

5   of an accidental bodily injury would not be eligible to receive             

                                                                                

6   work loss benefits under subsection (1)(b) may waive coverage for           

                                                                                

7   work loss benefits by signing a waiver on a form provided by the            

                                                                                

8   insurer.  An insurer shall offer a reduced premium rate to a                

                                                                                

9   person who waives coverage under this subsection for work loss              

                                                                                

10  benefits.  Waiver of coverage for work loss benefits applies only           

                                                                                

11  to work loss benefits payable to the person or persons who have             

                                                                                

12  signed the waiver form.                                                     

                                                                                

13      (3) As used in this section:                                                

                                                                                

14      (a) Allowable expenses within personal protection insurance                 

                                                                                

15  coverage shall not include charges for a hospital room in excess            

                                                                                

16  of a reasonable and customary charge for semiprivate                        

                                                                                

17  accommodations except if the injured person requires special or             

                                                                                

18  intensive care.                                                             

                                                                                

19      (b) Allowable expenses for funeral and burial expenses shall                

                                                                                

20  not include charges in excess of the amount set forth in the                

                                                                                

21  policy which shall not be less than $1,750.00 or more than                  

                                                                                

22  $5,000.00.                                                                  

                                                                                

23      (c) Allowable expenses for home health care services                        

                                                                                

24  including room and board, transportation, and case management               

                                                                                

25  shall not exceed the reasonable and customary daily rate for the            

                                                                                

26  reasonable and necessary institutional care that would be                   

                                                                                

27  required for the injured person in the community in which the               


                                                                                

1   injured person resides or, if unavailable in the injured person's           

                                                                                

2   resident locale, the geographic area closest to the injured                 

                                                                                

3   person's resident locale where such institutional care could be             

                                                                                

4   provided.  Allowable expenses for home health care service                  

                                                                                

5   provided by the injured person's spouse, brother, sister, child,            

                                                                                

6   stepchild, parent, extended family member, or member of the same            

                                                                                

7   household, whether or not employed by a home health care provider           

                                                                                

8   to perform that service, shall not exceed $10.00 per hour.  This            

                                                                                

9   hourly rate shall be adjusted on January 1, 2004 and on January 1           

                                                                                

10  biennially thereafter based on the percentage increase or                   

                                                                                

11  decrease in the consumer price index rounded to the nearest whole           

                                                                                

12  dollar.  Allowable expenses provided for under this subdivision             

                                                                                

13  are issues of law to be decided by the court.  As used in this              

                                                                                

14  subdivision:                                                                

                                                                                

15                                                                               (i) "Consumer price index" means the percentage of change in                        

                                                                                

16  the consumer price index for all urban consumers in the United              

                                                                                

17  States city average for all items for the 24 months prior to the            

                                                                                

18  January 1 effective date of the biennial adjustment as reported             

                                                                                

19  by the United States department of labor, bureau of labor                   

                                                                                

20  statistics, and as certified by the commissioner.                           

                                                                                

21      (ii) "Home health care service" means a reasonably necessary                 

                                                                                

22  service, including medical care, activities of daily living,                

                                                                                

23  executive functions, or supervision, provided by a skilled or               

                                                                                

24  unskilled caregiver to an injured person in a noninstitutional              

                                                                                

25  setting.                                                                    

                                                                                

26      (iii) "Transportation" means the cost of 1 person                            

                                                                                

27  transporting the injured person in a vehicle from 1 place to                


                                                                                

1   another.