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What is med-pay?

Updated: 9/11/2023
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12y ago

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Med pay coverage is called medical payments coverage in an insurance policy. This coverage will pay for reasonable expenses incurred for necessary medical and funeral services because of bodily injury caused by an accident and sustained by an insured. The insurance policy will not reimburse for experimental treatment, treatment not recognized within the medical profession within the United States. The services are only reasonable and necessary if the treatment is rendered by a licensed medical provider within his/her practices and the charges are consistent with the usual charges within the geographical area for similar services. In California, acupuncture is a covered expense by licensed acupuncturists.

This coverage applies only in limited circumstances. First you must be injured

and you must have incurred medical expenses. The insurance coverage does not pay for future medical expenses; it only reimburses for medical expenses you have due to your injuries in the accident. Secondly, you must be an insured under the policy to receive the benefits of med pay coverage. An insured under the insurance policy is

  1. the named insured on the policy (usually the one who owns the vehicle that is insured),
  2. the named insured's resident spouse,
  3. any family member to the named insured which is any person related to you by blood marriage or adoption who is a resident of your household
  4. any one using the vehicle covered under the named insured's policy.

Insurance coverage follows the vehicle. If you are in a vehicle that has med pay coverage on its policy, you will likely be a covered insured under the med pay coverage of the policy. However, you may be a covered insured for med pay coverage under more than one policy. It is best to consult attorney to be sure you know which policies may cover you under the medical payments coverage of the insurance policy.

As is the case with most insurance policies, there are listed exclusions to when the policy does not apply. Here is a list of some of the exclusions:

  1. If you are using the car as a taxi no one will be covered;
  2. If the vehicle you are using was furnished for your regular use it will not be covered;
  3. If you own the vehicle and did not buy med pay coverage on that vehicle you will not be covered;
  4. If your family member owns his own car or uses a car regularly, the family member will not be covered under your policy
  5. If the injury caused by war, rebellion, etc. there is no coverage
  6. If you are on a motorized vehicle with fewer than 4 wheels there will be coverage.

It is not required that you carry med pay coverage in some states. Therefore, the coverage is only a supplemental coverage you can purchase on your policy. Typically the charge for this coverage is small compared to the benefit you can receive if you are ever in an accident. If you are injured and an insured under the med pay policy, then you are entitled to this benefit regardless of fault. I encourage you to ask your agent about adding this coverage to your policy today.

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Q: What is med-pay?
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What is Medical Payments Coverage and how might it affect your NC personal injury case?

Many automobile insurance policies include MedPay, which can be used to pay for reasonable and necessary medical and funeral expenses due to a car accident, regardless of who is at fault. The coverage will pay up to the limits listed in the policy for each individual injured. Typical limits of MedPay coverage are $1,000 or $2,000, but most insurance companies will sell much more, depending on what you want to pay as a premium. Unlike liability coverage, which is required by law for all automobile insurance policies, MedPay is an optional coverage, so it is not included in every policy. It is typically only included if the policyholder asks for it when applying for the policy. You can add Med Pay or increase your amount of MedPay when you renew your policy. After a collision, the at-fault party may be liable for the cost of your medical bills, lost wages and pain & suffering. In North Carolina, you may be able to recover from your MedPay coverage as well. There can be complicated interactions with MedPay and other insurance coverage, including health insurance, that may require consultation with an experienced NC personal injury lawyer.


What does full coverage insurance cover?

most people refer to ''full coverage'' as having the state required liability coverages as well as coverage on your vehicle, ''collision' and ''comprehensive coverages''.......there are many many coverages that you can elect to purchase, (ie accidental death, umpd,medpay, rental, tow, and etc)


Is there accident insurance available that covers a person when the car they are riding in is uninsured?

I am assuming you are referring to bodily injuries. There are, indeed, other remedies available. 1. If you have PIP or MedPay on your own auto policy, it will pay for reasonable and necessary medical expenses up to policy limits. ONE CAVEAT: This is state dependent, and mandatory in some states. In no more than two or three states, PIP (Personal Injury Protection) is mandatory and the coverage from the owner of the vehicle is ALWAYS primary. New York is an example. 2. Private or group health insurance will cover any injuries sustained. They will pay without question because it is a contractual coverage and the policy says they will cover specified expenses. They WILL, however, then 'subrogate' (recover paid amounts from) any available carrier that insures the patient for that loss. The sequence would be as follows: They would turn to the patient's carrier first (for PIP or Medpay) because that is a contractual coverage and they MUST reimburse if the coverage is in place. (They may do some negotiations of their own, but it will not affect the policyholder.) If that is not in place, or is not enough coverage to pay all the bills, they will go directly to the unisured motorist in whose vehicle you were riding.


What to do when your car got an accident?

STOP. Never drive away from the scene of an accident, even a minor one.PROTECT THE SCENE. You can prevent further accidents by setting up flares, or keeping your flashers on. If it is dark and your lights don't work, you should have a flashlight to keep you safe while you wait in your disabled car or by the side of the road.CALL THE POLICE. Even if there are no serious injuries, it is a good idea to call the police. You may need a police report to file a claim with your insurance company, even if it is just to make a claim for damage to your vehicle. The vehicles involved in the accident should remain where they are, unless they interfere with traffic.MAKE AN ACCURATE RECORD. When the police arrive, make sure you tell the investigating officer(s) exactly what happened, to the best of your ability. If you do not know certain facts, tell that to the officer. Do not speculate, guess or misstate any of the facts. If you are asked if you are injured and you are not sure, say you are not sure, rather than no. Often, the pain and injuries from motor vehicle accidents become apparent hours after the actual collision. You should also make sure statements made by other persons involved in the accident are accurate as well.TAKE PICTURES. If you happen to have a camera in your vehicle, or a cell phone equipped with a camera, you should take pictures of the vehicles if there is visible damage. If you have visible injuries, you should photograph them as well. However, you should in no way interfere with the on-going police investigation. If you cannot take pictures at the scene of the accident, take them as soon as possible after the accident.EXCHANGE INFORMATION. Typically, the investigating police officer obtains this information. However, if the police do not respond to the accident, you should obtain the name, address and telephone number of all persons involved in the accident, drivers and passengers alike. You should also obtain information about insurance by asking to see the insurance card for all vehicles involved in the accident. If there are witnesses, you should get information from them as well so that you or your attorney can contact them in the future. If police respond to the accident, the investigating officer usually will provide all drivers with a police report number. You can use that number later to obtain the police report. If the accident occurs on a state highway, you must request the report from the state police.REPORT THE ACCIDENT. Notify your insurance company as soon as possible. Many policies require immediate reporting and full cooperation. Find out if you have medical benefits as part of your insurance coverage. You pay extra for that type of coverage - known as "medpay" - so you should use it. In fact, if you have medpay coverage, you are required to submit your accident-related medical bills to your insurance company. Medpay coverage is primary for accident-related medical bills. Once medpay benefits are exhausted, private health insurance becomes your primary insurer. Medpay benefits are available to all the occupants of the vehicle. Your insurance rates should not increase as a result of submitting claims for medpay coverage.SEEK MEDICAL ATTENTION. Often, injuries caused by motor vehicle accidents are not immediately apparent. Most of our clients report feeling the most pain a day or two following an automobile accident. Unless you are absolutely certain you were not injured, you should seek medical attention at your local emergency room or by seeing your family physician. Even in accidents involving minor impact, you can sustain a serious and permanent injury to your spinal cord. If you lost consciousness or were dazed for even a short period of time following the collision, you may have suffered a concussion or closed head injury. This can cause cognitive and behavioral changes if left untreated.KEEP A FILE. Keep all your accident-related documents and information together. This information should include a claim number, the claim's adjuster who is handling the claim, names and phone numbers of all contacts, receipts for a rental car and other expenses incurred as a result of the accident.PROTECT YOUR RIGHTS. Perhaps the most important thing you should do after an accident is to consult your attorney. Your attorney can protect your rights and make sure valuable evidence is not destroyed. Often, insurance companies want to take statements immediately after an accident. It is important that you have received legal advice before providing such a statement. Your attorney can advise you on issues ranging from how to make sure you are fully compensated for your vehicle to how to make sure you are getting the best medical treatment available. Personal injury attorneys work on a contingency fee basis, which means there is no legal fee unless the attorney recovers compensation for your injuries.


How does homeowners insurance medical payment coverage work?

the actual MEDICAL PAYMENTS coverage works like this (in MO, and most states that i am aware of)..........someone is hurt on your property thru NO negligence of your own.....(ie i just trip and fall for no reason, I'm a clutz-have even seen it pay for poison ivy contracted on a property).....medpay will pay for medical bills (up to the limit which is low, usually 2k-5k)......only..........no pain and suffering, loss of wage etc........must be incurred bills..........it will not cover the insured or any residents of the house hold............there are many exclusions here.........now your liability coverage (which is much higher, usually a min. of 100k)........covers pain and suffering and medical bills, loss of wage etc..........for injured persons when you ARE negligent in some manner, ie... your wife wasn't watching what she was doing and dropped a hot pan on my foot........your dog bit me.........your step crumbled when i stepped on it.......hope that helps


If a pedestrian is found at fault in an accident involving a car and pedestrian which insurance would pay the medical bills - the auto insurance or the pedestrian's health insurance?

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Can you claim bodily injury from your insurance for a car accident in which you were found at fault?

If you had medical coverage, you can.You cannot claim bodily injury against your own policy for yourself because you cannot be liable to yourself. Bodily injury coverage falls under the liability portion of your policy, for injury to others caused by you or the driver of your vehicle. You must carry PIP or MEDPAY for your own injuries.In the UK - the law is based on fault. Namely the driver at fault pays for the injury and vehicle damage to the innocent road user. Motor insurance is compulsory as this pays the liability of the driver at fault. So you cannot claim for bodily injury from your own insurance as you would be claiming against yourself - but if your motor policy was comprehensive you can claim from your own insurer for vehicle damage - subject to an excess. See the related link entitled "car driver injury claims" for a full explanation as to when a car driver can claim and when a car driver is considered liable.


How does liability insurance work when the driver has an accident and kills a passenger due to drunk driving?

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What is the relationship between auto insurance and health insurance?

It depends on which state you are in. If you are in a no-fault state, the medical provider will typically bill the no-fault (PIP) insurance provider directly. Even in states without no-fault laws, if your injuries arose from a motor vehicle accident and you have personal injury protection or medical payment coverage, your health insurer may refuse to pay your claim until your automobile insurance coverage is exhausted and subrogation (a claim against the at-fault party or their insurer) has been explored.It is not necessarily true, despite the answer below, that no medical provider is going to bill an auto insurance carrier. I think the responder was generalizing their experience to all 50 states, which just isn't the case.This is not accurate information. Because the billing will be generated by the medical provider, they are going to bill the most likely source of reimbursement. That will be your health insurance. 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IT WILL SPECIFICALLY ASK YOU ABOUT YOUR OWN AUTOMOBILE INSURANCE AND WILL ASK IF YOU CARRY PIP OR MEDPAY ON YOUR POLICY. If you do, they will immediately send a Notice of Subrogation rights to the carrier.note that in true no-fault states, this process is quite different; the majority of states are NOT no-fault states and I am responding for those states.****If you do NOT have Medpay or PIP coverage, then the Health Insurance carrier will send a notice of subrogation rights to the carrier of the at-fault party or the at fault party themselves if they are uninsured. Your questionairre will also ask if you are represented by an attorney for your injuries. If you are, the health ins carrier will also send a Notice of Subrogation rights to your attorney.Treatment for injuries in an auto accident will be covered by the auto policy first and health insurance would start paying for amounts above the auto policy limits. Other than that, there's no relationship.You have the option of choosing whether to have your health insurance carrier pay as the primary carrier for medical treatment from an auto accident. (This would apply to injuries to you or your covered dependents, that is. Non-family member passengers would be covered under your usual auto policy limitations or the at fault driver's insurance.) If you want your own health insurance to pay as primary for your or your dependent's medical treatment due to an auto accident, you must specify this provision to your auto insurance agent (they won't ususally offer this, because they lose out on some of the premium). If you have a stable employment and good health insurance coverage history, it makes sense to choose health insurance primary because you save money, and your health insurance is usally easier to deal with when it comes to getting claims paid.Wow, this is a wide-open question.Auto insurance can be the insurance of the injured party whether at fault or not, or the insurance of the at-fault party.Here's a possible scenario.JohnDriver has an accident, for which he is clearly not liable. There is no dispute about liability between his insurance company and the other driver or the other driver's insurance company.John is injured and treats with a chiropractor. He has good health insurance and he provides the chiropractor's office with the health insurance information. But John's health insurance company notes that this was an automobile accident, when they receive his bill and treatment notes from the chiropractor.They then send John a questionnaire. They want to know the following:Who insures his vehicle; company name and policy number. >> They will then send John's insurance company a notice of subrogation, stating they intend to recover their costs under John's policy. Johns auto insurance company will indeed reimburse them IF John had first party medical coverage on his policy: PIP or Medical Payments coverage.Who was at fault and, if not John, who insures that person? >> At this point, the health insurance carrier won't really get into who is at fault/liable; they really don't care. They are simply also putting this insurance company on notice that they are going to pay for John's medical treatment, but reserve their right to 'subrogate' (recover damages/$$) from them, the carrier of the at-fault driver.So, the HEALTH insurance carrier will initially pay for medical treatment, BECAUSE they have a contract to do so. But they will subrogate in the above order, going FIRST to John's carrier, because that is not dependent on who is at fault; the coverage is there and will be available when John is injured in, on, alighting from, his vehicle NEXT, they will go to the at-fault driver's carrier. (If John himself is at fault, they obviously can't take this step, BUT, they will still put this company on notice.) Any medical costs that exceed the coverage available on John's policy will be presented to this company. If John's medical costs exceed the policy limits of the at fault driver, they will put the at fault driver on notice as well AND they will determine if John has any UM/UIM coverage on HIS policy (Uninsured Motorist/UNDERinsured Motorist). They can also recover the excess from that coverage on John's policy. They will also be conducting an investigation and determining liability, to determine who they will PURSUE. Remember, initially, they are just putting everyone on notice.Now, in the interim, John's Auto Insurancecompany will also be putting everyone on notice for the monies they are paying out under the MedPay coverage. They will attempt recovery from Driver2's Auto Carrier AND from Driver2 himself, if damages exceed Driver2's policy limits....WOW, are you sorry you asked??? :)


What is a reasonable settlement for a rotator cuff injury on the job?

I recently settled for $100,000 policy limits underlying and $62,500 UM, + $10,000 limits medpay. Surgery and other medical specials were about $50,000 One injured party 100% Liability Accident occurred in Jefferson Parish, Louisiana


What are the definitions for liability insurance medical payments insurance uninsured motorist comprehensive and collision for auto insurance?

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