Michigan No Fault

HOPE TBI Co-OP and Exchange

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Come visit us at the HOPE TBI Co-op and Exchange. Currently serving The United States and US Territories.

Please do NOT list items for sale here! We are a Co-Op/Exchange Group Only (no monies exchanged)!!!

Remember to Bookmark this Group: https://www.facebook.com/groups/HOPETBICoOpExchange/

This group is to list durable medical equipment, supplies, technology, machinery, prosthetics, etc. that you are ‘gifting” for FREE to someone in need.

You may also post a request if you are needing something as well. Please only request item(s) if unable to acquire by any other means. No acquiring items just to sell them.

THIS GROUP IS NOT OPEN TO VENDORS.

[Disclaimer: This group does not support or endorse the exchange of medications or supplements in any form. Please see your medical providers for those needs. This Group or its Owners/Moderators are not responsible for any transactions, equipment, or product exchanges with another member]

    Gifted Items/Needed items can be, but are not limited to: vehicles, hospital beds, wheelchairs, braces, ventilator equipment, oxygen concentrators, traction equipment, personal care aids, books, Posey Lifts, adaptive equipment, Manuals/information, Bathing Supplies, mobility aids, etc – and other items useful to a person with a disability or injury. The sharing opportunities are endless.

We realize that Insurance does not always cover all the needs a person has after experiencing a devastating and catastrophic medical emergency. We also realize not everyone has insurance. We understand being financially strapped, destitute, or handicapped after a life changing medical event.

Being a member of this Group does not imply nor guarantee that you will have your needs met or provided, but merely an additional opportunity to network with those who may be able to help directly or indirectly.

This Group will also allow you the opportunity to share your fundraising pages or place to post your public funding request page links (like Go Fund Me Page, PostHope page, Pay It Forward Page, YouCaring page, Give Forward, Donors Choose, etc). Be prepared to be vetted for authenticity.

It is strongly advised that if you meet anyone offline, that you do so in a public and safe location.

Our 2 Newest HOPEsters – Debbie and Kris

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#MoreThanMyBrainInjury

We want to introduce a Survivor story and a Caregiver story.  The battle for survival and quality of life continues with these two powerful stories.  

 

Debbie Webb – “The year was 1990, I was practicing barrel racing and the horse I was riding slipped onto her side.  Upon impact with the ground, I was immediately unconscious.”  Check out her story here: 

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Kris Ruckle-Mahon – “My role went from being a parent to a caregiver on April 11, 2007, something I was not financially prepared for. I was fortunate though, to have a great work and family support system to help us through it.”  Check out her story here:

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Legal Monstrosity

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Hello Folks. I’m back on my blog. YAY!!! While I visit often, I have lots to share with you all, and have much medical information, numerous discoveries, and lots of additions to add to this site over the next several weeks. Now however, I am in a position to express my own personal views candidly and without fear of reprisal about something I have been wanting to for quite some time.

It has been a while since I have posted in my blog here. I wanted to explain that in addition to focusing on my rehabilitation goals, I was also embroiled in a fight for my life with the insurance company representing me in my Michigan NO FAULT claim.

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I had sued them for numerous items of service they were not paying on time/stopped paying under the laws that are supposed to, in theory, mandate and compel them to act in a judicious and timely fashion by the letter of those laws.

I, like so many other NO FAULT recipients, suffered additional and repeated traumas at the hands and manipulation of the Insurance Company(ies) that are supposed to be handling the various aspects of our NO FAULT claims. Instead, bills that they are supposed to pay in full, within 30 days of the bill being submitted to them (according to law); attendant care established through a prescription of a licensed physician ( for home health care, nursing care etc) provided by an agency or family member; medical mileage/travel supposed to be reimbursed after it has been incurred; replacement services (household services), wage loss, and other benefits afforded by Michigan law – they ignore &/or pay at their whim…not based on the actual laws. These laws are great on paper, for the constituents, yet there is no accountability for the Insurance companies to be mandated to actually follow the law on paper.

Did you know that the law States that the insurance companies can be charged “Interest” on any bill that is not paid within the 30 day time frame that it is submitted to the insurance company.

Again, this sounds good on paper, right? WRONG! Apparently the manipulation of that law is wholly accepted throughout the whole NO FAULT process as there are currently not any laws in place detailing when or how those interest payments must be paid AND making them non-negotiable items, or compelling them to actually be something the insurance company(ies) wish to avoid, because they would be required to pay that interest. It does not eliminate them from being negotiated away. They can only be charged this “interest” if you acquire an attorney, sue them, AND actually go through a trial where they can still negotiate out of that responsibility. The majority of cases go through a settlement procedure (like mine) and apparently that eliminates all possibility of them every having to pay interest on anything, that by law, they owe the interest on. This abhorrent process is just one of the many things that needs to be reformed in our NO FAULT system. Bottom line….if you don’t pay your bills within 30 days of receipt of that bill, you WILL incur interest for each day that is delayed. That interest should NOT be allowed to be negotiated away in Settlements, Trials, or other modalities regarding the NO FAULT process. This is a willful and purposeful choice they make, knowing there are no consequences. Holding them accountable, will, in theory, allow the NO FAULT system to do what it is supposed to do, take the burden off the individual who was actually in the wreck, so they can focus on their recovery. This would also take the burden off of the Courts being tied up in months or years of the back and forth legal ping pong that these Insurance Companies can afford to play. Reform should be attempting to compel the Insurance Company(ies) to do their jobs …..with our money.

The NO FAULT system through and through is a progressive, positive and integral part of our infrastructure in this State, absolutely worth saving and investing time and money in. It is a system to be envied by all other States and a model worth replicating. However, it is a system that needs transparency across the board, and accountability across the board as well though. After all, fraud and spuriousness is often propagated by the Insurance Company and their agent(s) themselves.

NO FAULT does require reform and clearer lines of accountability for all involved, but specifically the Insurance Providers themselves (obviously I feel this cannot be expressed enough). The very leviathan presence of these companies who with impudent disregard for the Courts, Judges, constituents, and laws voted on and enacted by the constituents (voting citizens) – often find themselves escaping their financial responsibilities, shirking the due diligence required of them, and using subterfuge and prevarication, knowing there is nothing to hold them accountable. Nothing at all. In my opinion, this is the grossest form of medical negligence, injustice, and sheer despicability.

That all being said, I have come to the end of this particular chapter of this grueling process through a Settlement process that was to say the least….less than desirable. Since physicianthe wreck I have literally fought for each breath, each step, each grip, each movement, each thought; each valuable, talented, progressive, and proficient providers; each benefit afforded to me by law, each opportunity to improve and have a decent quality of life. While not easy, while not always positive…absolutely necessary to survive.

I have endured countless days, weeks, months…and now years of acute/chronic pain, loss of body integrity, loss of social confidence, ongoing medical crises, and a complete change in my life, the way I live and relate to others and even relate to myself.

I have been made aware, through my personal experiences, of the dark side of the medical establishment that includes some incompetent white_coat_man_small_compressed_400x4008763830801952850647.jpgcolluding providers “in white coats and black hats (figuratively speaking)”, inaccurate medical documentation, missed/delayed labs, missed/delayed surgeries, missed injuries, delayed treatment,missed radiology exams, and the desperately fallible humanness of those we should be able to trust implicitly with our lives.

Despite all of this though….I have learned to advocate for myself on a different level. I have learned I AM a voice for those who are not able to be one for themselves. I have learned that we as a medical society are only just starting to learn about the miraculous processes that make us who we are.

I have learned who my true friends are or aren’t. I have learned that there is always a reason to HOPE and to never give up. I have learned that FAITH and LOVE really does prevail over darkness and injustice.

I have learned that every bit of essence that this blessing of a life has given me by the miraculous opportunity I have been given to survive is something to be protected and coveted. I have learned that sometimes being an honest, honorable, and sincere individual is sometimes just not enough. I have learned that discrimination comes in forms we don’t even talk about as a society. I have learned that I can endure more pain than I would have ever thought possible. I have learned that my life matters and I can find value in the person I am now. I am still learning how I can make a difference in this world and be a catalyst for positive changes and not compromise the core of who I am.

Finding the path to recovery is not just a journey….it is a pilgrimage. I will survive, despite continually traversing all of this Legal Monstrosity.

Michigan NO FAULT – Personal Injury Protection

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michigan-no-fault-lawADVOCACY:

I feel it is imperative that I voice my strong and unequivocal support for the NO FAULT system and voice that I speak about this system from personal experience….not just opinion from a desk somewhere trying to increase our financial “bottom line” (like insurance companies want to do) without knowing or understanding the ripple affect of taking this much needed program away or altering it for the patients whose lives literally depend on this system being in place.

No Medical Limits For Life (no Financial Caps on  reasonable and necessary Care for injuries related to wreck):

I just want to say that here we are almost 3 years later and we are still discovering injuries acquired from the wreck.  These would not have been found and treated if it were not for the current No Fault System and my disabilities would have been much more extensive.

I never would have been able to get out of the wheelchair, or have the majority of the use back in my right arm without the lifesaving reconstructive surgeries in MN by Dr. Peter Cole. I wouldn’t have gotten the life saving Rib Surgery here locally by an Orthopedic Surgeon to plate ribs 5,6,7,8,9,and 10.  I wouldn’t have had access to all the Specialists I have see or been referred to.

I wouldn’t have received the extensive and ongoing Physical Therapy, Occupational Therapy, Speech Therapy and Counseling needed to help me Rehabilitate.progress

I would not have been given the majority of the radiology (Xrays, CT Scan, MRI’s, etc), EMG’s, EEG, and other testing; the Dental Repairs, the Vision Therapy, the Audiology Testing and Follow-Up Care, Case Management, etc.

I would not have been given Recreational Therapy and Vocational Therapy to help me return to some form of a quality of life.

Household Services (Replacement Services) and Attendant Care:

Without these things in place I would not have been able to come home to a hospital bed to be near my children and my family after NeuroRehab.  I was able to be cared for in my home where there was less chance for infection, higher rate of healing ability in a real world environment, by my family or caregiver of my choice.  I was more and more appreciative as time went on and it allowed me to be near my husband and my children and them near me.  A cap on Attendant Care would be Catastrophic for any Survivor.  There were some weeks that I needed 24 hour care 7 days a week.  Other weeks 16 hours of care then 14 then 10 then 6 then 4 hours per day seven days per week.  This continually varied based on what was going on with me.  I often used several hours a day 7 days per week after each major surgery.

Without this system in place.  I know for a fact, without a doubt, I would be dead 2.5 years ago now due to the Polytruma I sustained which included multiple orthopedic injuries and multi-system involvement.

There are a lot of  things that have been resolved.  There are some injuries I will have for life (like my back injuries, hardware in my body that may need replaced later in life, and various other injuries being cared for, etc.  I wake up every day….grateful for my life.  Grateful for the NO FAULT system here in Michigan.

I am the poster child of sorts about how the success of the NO FAULT system can work when given the care needed.  I will also add that if the insurance company did not fight this benefit so much, it would have cost less over time as I would have received recommended treatments in a more timely manner and not have had to suffer the debilitating chronic pain of unhealed fractures, nerve damage due to delayed treatment,  and exacerbation of other disabilities for the duration of time that I did.

I will also say that there needs to be an educational process in place for families and patients from the beginning on what is available and how to fill out paperwork properly etc.  This would eliminate a lot of challenges that present themselves by learning things the hard way.

I can say that I didn’t even know what NO FAULT insurance was until falling victim to this catastrophy and needing what NO FAULT provides to either live or die.

So What is Auto NO FAULT?  There are several states that have it….Michigan is the most comprehensive.

A Michigan no-fault policy provides unlimited medical  and rehabilitation benefits. It provides wage loss benefits for up to three years, and $20 per day for replacement services if you are injured in an auto accident, regardless of fault. In exchange for these benefits, Michigan motorists gave up the right to sue in auto accidents except when someone is killed
or very seriously injured. Because of this, disputes over who was at-fault in an accident will not hold up payment of medical bills. Michigan is unique in that damage to vehicles also falls under the no-fault system. This, too, saves time and money in claims payment. Michigan drivers must buy collision and/or comprehensive insurance to cover damage to
their own car.

The Michigan Catastrophic Claim Association (MCCA) was established in 1978. The MCCA
pays for claims paid by an insurer that exceed a certain amount. All insurers that sell auto insurance in Michigan must pay the MCCA an annual fee for each vehicle insured. That fee is known as the MCCA assessment, and is passed on in whole or in part to the policyholders.

The Basic No-Fault Policy Has Three Parts:

Personal Injury Protection (PIP) -If you are hurt in an auto accident, this part of your no-fault policy will pay all of your medical costs. It will also pay up to 85% of the income
you would have earned if you had not been hurt, for up to three years.

Property Protection (PPI) No-fault will pay up to $1 million for damage your car does in Michigan to other people’s property, such as buildings and fences. It will also pay for damage your car does to another person’s properly parked vehicle. It does not pay for any other damage to cars.

Residual Bodily Injury and Property Damage Liability Insurance (BI/PD)

What is an Assigned Claim?

The State of Michigan established the Michigan Assigned Claims program in 1973 to provide assistance to people injured in an accident involving a motor vehicle, when there is no automobile insurance available.

The Secretary of State managed the Assigned Claims program until December 17, 2012, when it transitioned to the Michigan Automobile Insurance Placement Facility.

The state of Michigan provides a safety net of insurance coverage for no-fault (PIP) benefits in situations where a person is involved in a car accident, but there is no insurance company available to provide no-fault benefits.

The name of the safety net is an organization called the Michigan Automobile Insurance Placement Facility (MAIPF), formerly known as the Michigan Assigned Claims Facility. The Michigan Automobile Insurance Placement Facility (MAIPF) is considered the insurance company of last resort.

The Michigan Automobile Insurance Placement Facility (MAIPF) administers the Michigan Assigned Claims Plan, which sets out the procedures for ensuring that Michigan No Fault benefits are provided to uninsured auto accident victims.

The Michigan Automobile Insurance Placement Facility (MAIPF) does not apply to a person driving an uninsured car that is owned. However, if an individual who doesn’t have auto no-fault insurance is injured in a car accident in a non-owned vehicle, and if there is no other insurance company of higher priority, then the Michigan Automobile Insurance Placement Facility (MAIPF) would provide payment of benefits.michigan-no-fault-law

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