PERSONAL INJURY PROTECTION (PIP) MEDICAL COVERAGE EXPLAINED


<INSERT COMPANY FORM NUMBER> Ed. 7/2/2020 Page 1 of 4 . MICHIGAN SELECTION OF PERSONAL INJURY PROTECTION (PIP) MEDICAL COVERAGE – INDIVIDUAL(S) AGENCY: APPLICANT/NAMED INSURED: INSURANCE COMPANY: POLICY/QUOTE NO.: EFFECTIVE DATE: READ THIS ENTIRE FORM CAREFULLY. THE PURPOSE OF THIS FORM . The purpose of this form is to explain the choice you ...

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  • Source: www.michigan.gov

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