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The Michigan No Fault Insurance form is a crucial document for vehicle owners in the state, serving as proof of insurance compliance. This form is issued by authorized Michigan insurers and certifies that the vehicle in question is covered under a policy that adheres to the requirements set forth in Act 294, P.A. 1972, as amended. It includes essential information such as the policy number, effective and expiration dates, vehicle make and model, and the vehicle identification number (VIN). The form must be kept in the vehicle at all times, as failure to present it upon request from a police officer can result in a civil infraction. Additionally, it is necessary to present this certificate when applying for license plates, either by mail or in person at a Secretary of State branch office. The form also contains warnings regarding the consequences of operating a vehicle without proper insurance and the implications of providing false information. A clear understanding of these requirements is vital for all registered vehicle owners in Michigan to avoid legal repercussions.

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VEHICLE COPY - FRONT SIDE

STATE OF MICHIGAN CERTIFICATE OF NO-FAULT INSURANCE

COMPANY

 

 

 

COMMERCIAL

 

PERSONAL

POLICY NUMBER

 

EFFECTIVE DATE

EXPIRATION DATE

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

AGENCY/COMPANY ISSUING CARD

INSURED

An authorized Michigan insurer, certifies that it has issued a policy complying with Act 294, P.A. 1972, as amended for the described motor vehicle.

WARNING: KEEP THIS CERTIFICATE IN YOUR VEHICLE AT ALL TIMES. If you fail to produce it upon a police officer's request, you will be respon- sible for a civil infraction.

STATE OF MICHIGAN CERTIFICATE OF NO-FAULT INSURANCE

COMPANY

 

 

 

COMMERCIAL

 

PERSONAL

POLICY NUMBER

 

EFFECTIVE DATE

EXPIRATION DATE

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

AGENCY/COMPANY ISSUING CARD

INSURED

An authorized Michigan insurer, certifies that it has issued a policy complying with Act 294, P.A. 1972, as amended for the described motor vehicle.

WARNING: KEEP THIS CERTIFICATE IN YOUR VEHICLE AT ALL TIMES. If you fail to produce it upon a police officer's request, you will be respon- sible for a civil infraction.

SECRETARY OF STATE'S COPY - FRONT SIDE

STATE OF MICHIGAN CERTIFICATE OF NO-FAULT INSURANCE

COMPANY

 

 

 

COMMERCIAL

 

PERSONAL

POLICY NUMBER

 

EFFECTIVE DATE

EXPIRATION DATE

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

AGENCY/COMPANY ISSUING CARD

INSURED

An authorized Michigan insurer, certifies that it has issued a policy complying with Act 294, P.A. 1972, as amended for the described motor vehicle.

SECRETARY OF STATE'S COPY

STATE OF MICHIGAN CERTIFICATE OF NO-FAULT INSURANCE

COMPANY

 

 

 

COMMERCIAL

 

PERSONAL

POLICY NUMBER

 

EFFECTIVE DATE

EXPIRATION DATE

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

AGENCY/COMPANY ISSUING CARD

INSURED

An authorized Michigan insurer, certifies that it has issued a policy complying with Act 294, P.A. 1972, as amended for the described motor vehicle.

SECRETARY OF STATE'S COPY

SECRETARY OF STATE'S COPY - REVERSE SIDE

VEHICLE COPY - REVERSE SIDE

Michigan Law (MCLA 500.3101) requires that the owner or registrant of a motor vehicle regis- tered in this state must have insurance or other approved security for the payment of no-fault benefits on the vehicle at all times. An owner or registrant who drives or permits a vehicle to be driven upon a public highway without the proper insurance or other security is guilty of a misdemeanor.

An owner or registrant convicted of such a misdemeanor shall be fined not less than $200.00 nor more than $500.00, or imprisoned for not more than 1 year, or both.

THIS FORM MUST BE PRESENTED AS EVIDENCE OF INSURANCE WITH YOUR APPLICA- TION FOR LICENSE PLATES, EITHER BY MAIL OR AT ANY SECRETARY OF STATE LICENSE PLATE BRANCH OFFICE. A PERSON WHO ISSUES OR WHO SUPPLIES FALSE INFORMA- TION TO THE SECRETARY OF STATE OR USES AN INVALID CERTIFICATE OF INSURANCE IS GUILTY OF A MISDEMEANOR PUNISHABLE BY IMPRISONMENT FOR NOT MORE THAN 1 YEAR, OR A FINE OF NOT MORE THAN $1,000.00, OR BOTH.

If this vehicle is driven by the person(s) named below, residual liability insurance does not apply and the vehicle will be considered uninsured:

WARNING - when a named excluded person operates a vehicle, all liability coverage is void - no one is insured. Owners of the vehicle and others legally responsible for the acts of the named excluded person remain fully responsible.

ACORD 50 MI (2007/12)

© 1993, 2007 ACORD CORPORATION. All rights reserved.

Michigan Law (MCLA 500.3101) requires that the owner or registrant of a motor vehicle regis- tered in this state must have insurance or other approved security for the payment of no-fault benefits on the vehicle at all times. An owner or registrant who drives or permits a vehicle to be driven upon a public highway without the proper insurance or other security is guilty of a misdemeanor.

An owner or registrant convicted of such a misdemeanor shall be fined not less than $200.00 nor more than $500.00, or imprisoned for not more than 1 year, or both.

THIS FORM MUST BE PRESENTED AS EVIDENCE OF INSURANCE WITH YOUR APPLICA- TION FOR LICENSE PLATES, EITHER BY MAIL OR AT ANY SECRETARY OF STATE LICENSE PLATE BRANCH OFFICE. A PERSON WHO ISSUES OR WHO SUPPLIES FALSE INFORMA- TION TO THE SECRETARY OF STATE OR USES AN INVALID CERTIFICATE OF INSURANCE IS GUILTY OF A MISDEMEANOR PUNISHABLE BY IMPRISONMENT FOR NOT MORE THAN 1 YEAR, OR A FINE OF NOT MORE THAN $1,000.00, OR BOTH.

If this vehicle is driven by the person(s) named below, residual liability insurance does not apply and the vehicle will be considered uninsured:

WARNING - when a named excluded person operates a vehicle, all liability coverage is void - no one is insured. Owners of the vehicle and others legally responsible for the acts of the named excluded person remain fully responsible.

ACORD 50 MI (2007/12)

© 1993, 2007 ACORD CORPORATION. All rights reserved.

Michigan Law (MCLA 500.3101) requires that the owner or registrant of a motor vehicle regis- tered in this state must have insurance or other approved security for the payment of no-fault benefits on the vehicle at all times. An owner or registrant who drives or permits a vehicle to be driven upon a public highway without the proper insurance or other security is guilty of a misdemeanor.

An owner or registrant convicted of such a misdemeanor shall be fined not less than $200.00 nor more than $500.00, or imprisoned for not more than 1 year, or both.

A PERSON WHO SUPPLIES FALSE INFORMATION TO THE SECRETARY OF STATE OR WHO ISSUES OR USES AN INVALID CERTIFICATE OF INSURANCE IS GUILTY OF A MISDEMEAN- OR PUNISHABLE BY IMPRISONMENT FOR NOT MORE THAN 1 YEAR, OR A FINE OF NOT MORE THAN $1,000.00, OR BOTH.

If this vehicle is driven by the person(s) named below, residual liability insurance does not apply and the vehicle will be considered uninsured:

WARNING - when a named excluded person operates a vehicle, all liability coverage is void - no one is insured. Owners of the vehicle and others legally responsible for the acts of the named excluded person remain fully responsible.

ACORD 50 MI (2007/12)

© 1993, 2007 ACORD CORPORATION. All rights reserved.

Michigan Law (MCLA 500.3101) requires that the owner or registrant of a motor vehicle regis- tered in this state must have insurance or other approved security for the payment of no-fault benefits on the vehicle at all times. An owner or registrant who drives or permits a vehicle to be driven upon a public highway without the proper insurance or other security is guilty of a misdemeanor.

An owner or registrant convicted of such a misdemeanor shall be fined not less than $200.00 nor more than $500.00, or imprisoned for not more than 1 year, or both.

A PERSON WHO SUPPLIES FALSE INFORMATION TO THE SECRETARY OF STATE OR WHO ISSUES OR USES AN INVALID CERTIFICATE OF INSURANCE IS GUILTY OF A MISDEMEAN- OR PUNISHABLE BY IMPRISONMENT FOR NOT MORE THAN 1 YEAR, OR A FINE OF NOT MORE THAN $1,000.00, OR BOTH.

If this vehicle is driven by the person(s) named below, residual liability insurance does not apply and the vehicle will be considered uninsured:

WARNING - when a named excluded person operates a vehicle, all liability coverage is void - no one is insured. Owners of the vehicle and others legally responsible for the acts of the named excluded person remain fully responsible.

ACORD 50 MI (2007/12)

© 1993, 2007 ACORD CORPORATION. All rights reserved.

Form Specifications

Fact Name Description
Governing Law The Michigan No-Fault Insurance form is governed by Act 294, P.A. 1972, as amended, specifically outlined in MCLA 500.3101.
Insurance Requirement Owners or registrants of motor vehicles in Michigan must maintain insurance or approved security for no-fault benefits at all times.
Consequences of Non-Compliance Driving without proper insurance can lead to a misdemeanor charge, with fines ranging from $200 to $500, or imprisonment for up to one year.
Evidence of Insurance This form must be presented as evidence of insurance when applying for license plates at any Secretary of State office or by mail.

Michigan No Fault Insurance: Usage Guidelines

Completing the Michigan No Fault Insurance form is an essential step in ensuring that your vehicle is properly insured under state law. This form serves as proof of insurance and must be presented when applying for license plates. Below are the steps to help you fill out the form accurately.

  1. Obtain the Form: Get a copy of the Michigan No Fault Insurance form from your insurance provider or download it from the Michigan Secretary of State's website.
  2. Fill in the Insurance Company Details: Write the name of the insurance company that issued your policy. Include whether it is a commercial or personal policy.
  3. Enter the Policy Number: Locate your policy number and write it in the designated space on the form.
  4. Effective and Expiration Dates: Fill in the effective date when your insurance coverage starts and the expiration date when it will end.
  5. Vehicle Information: Provide details about your vehicle. This includes the year, make, and model, as well as the Vehicle Identification Number (VIN).
  6. Agency/Company Issuing Card: Write the name of the agency or company that issued the insurance card.
  7. Insured Information: Fill in the name of the insured individual or entity. This is typically the owner of the vehicle.
  8. Review the Information: Double-check all entries for accuracy. Make sure that names, dates, and numbers are correct.
  9. Keep a Copy: Make a copy of the completed form for your records before submitting it.
  10. Submit the Form: Present the form as evidence of insurance with your application for license plates, either by mail or at a Secretary of State license plate branch office.

Your Questions, Answered

What is the Michigan No Fault Insurance form?

The Michigan No Fault Insurance form is a document that certifies a motor vehicle is insured under Michigan's No Fault Insurance law. This form is issued by authorized insurers and must be kept in the vehicle at all times. It includes important details such as the policy number, effective dates, and vehicle identification information.

Why do I need to keep the No Fault Insurance form in my vehicle?

It's crucial to keep the No Fault Insurance form in your vehicle because, if a police officer requests it and you cannot provide it, you may face a civil infraction. This could lead to fines or other penalties. Keeping the form handy ensures you can prove your insurance coverage when needed.

What happens if I drive without the No Fault Insurance form?

If you drive without the No Fault Insurance form, you could be charged with a misdemeanor. The penalties for this can include fines ranging from $200 to $500, imprisonment for up to one year, or both. It's best to avoid these consequences by keeping the form in your vehicle at all times.

What information is included on the No Fault Insurance form?

The form includes the policy number, effective and expiration dates, the vehicle's year, make, and model, and the vehicle identification number (VIN). It also identifies the insurance company and the insured individual. This information is vital for verifying that you have the required coverage.

What is the significance of the warning on the form?

The warning on the form emphasizes the importance of having valid insurance. It states that if the vehicle is driven by someone named as an excluded driver, all liability coverage is void. This means that if an excluded person operates the vehicle, you may be held fully responsible for any damages or injuries that occur.

What should I do if I lose my No Fault Insurance form?

If you lose your No Fault Insurance form, contact your insurance provider immediately to request a replacement. They can issue a new certificate that reflects your current coverage. It's important to have this document readily available to avoid any legal issues.

How does the No Fault Insurance system work in Michigan?

The No Fault Insurance system in Michigan ensures that drivers are covered for medical expenses and lost wages resulting from an accident, regardless of who is at fault. This system aims to simplify the claims process and reduce the need for lawsuits. However, it also requires all registered vehicles to have proper insurance coverage at all times.

What are the consequences of providing false information on the No Fault Insurance form?

Providing false information on the No Fault Insurance form is a serious offense. It can lead to misdemeanor charges, which may result in fines of up to $1,000 or imprisonment for up to one year. Always ensure that the information you provide is accurate to avoid these severe penalties.

Common mistakes

  1. Incomplete Information: One of the most common mistakes is leaving out essential details. Ensure that all sections of the form are filled in completely, including the policy number, effective date, and vehicle identification number (VIN).

  2. Incorrect Policy Number: Double-check the policy number entered on the form. An incorrect number can lead to delays or complications in processing your insurance.

  3. Failure to Sign: Remember to sign the form. A signature is often required to validate the information provided. Without it, your application may not be accepted.

  4. Using an Expired Certificate: Ensure that the certificate of insurance is current. Using an expired document can result in penalties and may not provide the coverage you need.

  5. Ignoring the Warning: The form includes a warning about keeping the certificate in your vehicle. Ignoring this can lead to civil infractions if you cannot produce it when requested by law enforcement.

  6. Providing False Information: Be honest and accurate when filling out the form. Providing false information can lead to severe penalties, including fines and imprisonment.

Documents used along the form

The Michigan No Fault Insurance form is essential for vehicle registration and compliance with state law. However, several other documents often accompany it to ensure complete adherence to insurance requirements. Below is a list of these documents, each with a brief description.

  • Proof of Insurance Card: This card serves as immediate evidence of insurance coverage and must be kept in the vehicle at all times.
  • Application for Vehicle Registration: This form is required to register a vehicle with the Michigan Secretary of State and must include proof of insurance.
  • Policy Declarations Page: This document outlines the specific details of the insurance policy, including coverage limits and deductibles.
  • Claim Form: Used to initiate a claim for no-fault benefits following an accident, this form collects necessary details about the incident.
  • Exclusion Form: This form identifies any excluded drivers who will not be covered under the policy, impacting liability coverage.
  • Vehicle Title: The title proves ownership of the vehicle and must be presented when registering the vehicle or transferring ownership.
  • Affidavit of No Insurance: In cases where insurance is not in place, this document may be required to confirm the lack of coverage.
  • SR-22 Form: This certificate is often required for high-risk drivers to prove they have the necessary insurance coverage.
  • Renewal Notice: This document reminds policyholders of upcoming renewal dates and any changes in coverage or premiums.

Each of these documents plays a vital role in the insurance process and ensures compliance with Michigan's no-fault insurance laws. Maintaining accurate and up-to-date records is crucial for all vehicle owners in the state.

Similar forms

The Michigan No Fault Insurance form shares similarities with several other important documents related to vehicle insurance and registration. Here are seven documents that are comparable, along with how they relate to the Michigan No Fault Insurance form:

  • Certificate of Liability Insurance: This document verifies that a driver has the required liability coverage, similar to how the No Fault Insurance form confirms compliance with Michigan's insurance laws.
  • Proof of Insurance Card: Like the No Fault Insurance form, this card serves as evidence that a driver is insured and must be kept in the vehicle at all times.
  • Vehicle Registration Document: This document, issued by the state, confirms that a vehicle is registered and insured, paralleling the No Fault Insurance form's requirement for proof of insurance during registration.
  • Insurance Policy Declaration Page: This page outlines the specifics of an insurance policy, including coverage limits and effective dates, much like the details included in the No Fault Insurance form.
  • SR-22 Form: This form is required for high-risk drivers to prove they have insurance. It functions similarly to the No Fault Insurance form in demonstrating compliance with state insurance requirements.
  • State Insurance Identification Card: This card provides proof of insurance and is often required to be carried in the vehicle, akin to the No Fault Insurance form's mandate.
  • Accident Report Form: After an accident, this form is used to report details to authorities and insurance companies, similar to how the No Fault Insurance form is utilized in the context of insurance claims and compliance.

Dos and Don'ts

When filling out the Michigan No Fault Insurance form, it is important to be careful and thorough. Here are nine things to keep in mind:

  • Do keep the certificate in your vehicle at all times.
  • Do ensure that all information is accurate and complete.
  • Do provide the correct policy number and effective dates.
  • Do check the vehicle identification number (VIN) for accuracy.
  • Do sign and date the form where required.
  • Don't leave any sections blank; fill in all required fields.
  • Don't provide false information or use an invalid certificate.
  • Don't forget to present this form when applying for license plates.
  • Don't allow anyone excluded from the policy to drive the vehicle.

Following these guidelines will help ensure that your application process goes smoothly and complies with Michigan law.

Misconceptions

  • Misconception 1: The No-Fault Insurance Form is optional.
  • This form is mandatory for all registered vehicles in Michigan. You must have it to prove that you have the required insurance coverage.

  • Misconception 2: You can keep the form at home.
  • You must keep the certificate in your vehicle at all times. Failing to produce it when requested by a police officer can lead to a civil infraction.

  • Misconception 3: All vehicles are automatically covered under the same policy.
  • Each vehicle requires its own policy. The No-Fault Insurance Form specifically covers the vehicle described on it.

  • Misconception 4: The form is only needed for new registrations.
  • You need to present this form whenever you apply for license plates, whether it's for a new vehicle or a renewal.

  • Misconception 5: You can drive without insurance if you have the form.
  • The form does not replace the need for valid insurance. Driving without proper coverage is a misdemeanor.

  • Misconception 6: It’s okay to drive if someone excluded from the policy is behind the wheel.
  • If a named excluded person operates the vehicle, all liability coverage is void. The vehicle will be considered uninsured.

  • Misconception 7: Fines for not having insurance are minimal.
  • If caught driving without insurance, you may face fines ranging from $200 to $500, and possible imprisonment for up to one year.

  • Misconception 8: You can provide false information on the form without consequences.
  • Providing false information or using an invalid certificate is a misdemeanor. Penalties can include fines up to $1,000 and imprisonment.

  • Misconception 9: The No-Fault Insurance Form guarantees coverage for all types of damages.
  • This form specifically covers no-fault benefits, but it does not cover all liabilities. Understanding your coverage is essential.

Key takeaways

Filling out and using the Michigan No Fault Insurance form is a critical process for vehicle owners. Understanding its requirements can help ensure compliance with state laws and avoid penalties.

  • Keep the Certificate Accessible: It is essential to keep the No Fault Insurance certificate in your vehicle at all times. Failure to produce it upon request by a police officer may result in a civil infraction.
  • Submit with License Plate Application: This form must be presented as evidence of insurance when applying for license plates. You can submit it either by mail or in person at a Secretary of State license plate branch office.
  • Avoid False Information: Providing false information or using an invalid certificate is a serious offense. Such actions can lead to a misdemeanor charge, with penalties including fines and possible imprisonment.
  • Understand Exclusions: If a named excluded person operates the vehicle, all liability coverage becomes void. Owners remain fully responsible for any actions taken by the excluded individual.