Medical payments coverage, also known as med pay, is coverage that may be available to help pay or reimburse you for medical bills or funeral expenses if you or a loved one has been injured or killed in an automobile accident. Under Med Pay, the insurance company agrees to pay “reasonable” expenses incurred for “necessary” medical bills and funeral expenses because of the bodily injury or death caused in the auto accident. In some situations, the adjuster handling your claim for the insurance company determines what is “reasonable” and “necessary”, not you or your Doctor. Most clients believe that their insurance premiums will go up if they use their medpay. This is not true. Generally, medical payments coverage provides protection for the named insured or any family member while occupying, or as a pedestrian when struck by, a motor vehicle designed for use mainly on public roads or a trailer of any type. Coverage is also provided to any other person while occupying the covered vehicle or any other motor vehicle operated by the named insured or by a family member thereof if the motor vehicle is a private passenger automobile or trailer. In other words, whether you are entitled to medical payments coverage from one or more policies will depend on the coverage available for the vehicle you were occupying, your own automobile policy, and any household relative’s policy. In other words, you may be able to “stack” the coverages of multiple med pay policies in some circumstances.
Medical payments coverage generally ranges from $500.00 to $10,000.00, but can be greater in some circumstances. We have even handled cases where there is up to $25,000.00 in medpay available. However, we usually find that the coverage tends to be $1000, $2,000 or $5,000. The actual limit of liability for each person covered under your med pay policy will be shown on the Declarations Page of your policy or renewal form. In addition, your policy most likely provides a standard provision that if there is a dispute regarding benefits or med pay coverage, you may demand arbitration. Obviously, this may benefit you greatly if you have been injured in an accident because your med pay money will help you get your medical bills paid prior to settlement of your case; therefore, it is important for you to discuss your case with a licensed North Carolina attorney who understands how medical payments coverage works. In addition, there are certain exclusions that could bar coverage under med pay. Most importantly, there are time limitations on med pay claims. The expenses must be incurred within three years from the date of the accident and you are required to give notice of the accident to the insurance company as soon as practical or within a reasonable period of time. What is a reasonable period of time may depend on the facts and circumstances. At Riddle & Brantley, LLP, we are happy to discuss how this coverage may apply to your case. If any medical payments coverage is available for you, we will help you get it.