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MICHIGAN SELECTION OF PERSONAL INJURY PROTECTION (PIP) MEDICAL COVERAGE INDIVIDUALSAGENCY:APPLICANT/NAMED INSURED: INSURANCE COMPANY: POLICY/QUOTE NO.:EFFECTIVE DATE:READ THIS ENTIRE FORM CAREFULLY
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Gather all necessary information related to the personal injury incident.
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Complete the choice of personal injury form accurately and truthfully.
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Make sure to provide details about the nature of the injury and its impact on physical and mental well-being.
04
Include any supporting documentation or evidence with the form, such as medical records or witness testimonies.
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Submit the completed form to the appropriate party or legal entity for review and consideration.

Who needs choice of personal injury?

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Individuals who have sustained a personal injury due to an accident or incident.
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Individuals seeking compensation or legal recourse for their injuries.
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Choice of personal injury refers to the selection made by an individual who has suffered a personal injury to determine the type of compensation they are seeking.
The individual who has suffered a personal injury is required to file choice of personal injury.
Choice of personal injury can be filled out by providing details of the personal injury, desired compensation, and any supporting documentation.
The purpose of choice of personal injury is to formally declare the type of compensation sought for a personal injury.
Information such as the details of the personal injury, desired compensation, and any supporting documentation must be reported on choice of personal injury.
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