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  BURTON & SIMKIN

Medical payments insurance coverage

11/4/2016

 
​In an auto insurance policy, medical payments (med pay) coverage is available to pay for bills incurred by an occupant of the vehicle injured in a collision.  This is not money to pay for bills sustained by the driver or passengers of the other vehicle, but for yourself or your passengers.  I have found med pay coverage to be useful to clients for a number of reasons.  

First, med pay can supplement normal health insurance coverage in paying accident-related bills. Amounts that are not covered because of deductibles or co-pays can be submitted for payment to your own auto carrier under your med pay coverage.  

Second, Indiana law permits more favorable repayment terms of subrogation liens for medical bills to an auto insurance company as opposed to a employment-based health insurance carrier.  The insurance company that pays for your medical bills which they believe resulted from an injury caused by another party is likely to insist upon being reimbursed from any settlement monies you receive (under their right of subrogation).  When your auto insurance company has paid medical bills under your med pay coverage, you and your lawyer are entitled to a 1/3 reduction of the insurance company's lien to reflect the attorney fees that you will incur, as well as a pro-rata share of any costs in bringing your claim.  Because of federal law, your health insurance carrier is under no such obligation to reduce its lien.  

Let me illustrate this point from a recent case.  My client sustained very serious injuries in a collision.  He had only recently applied for health insurance and did not even have a card.  Fortunately, he had med pay coverage under his own auto policy of $100,000 (an unusually large amount).  His bills ended up totaling just over $100,000, so med pay covered virtually all of the bills  The other driver's insurance coverage limits were also $100,000.  In the course of settling the claim for these limits, I was able to persuade the client's auto carrier to reduce its lien by 2/3.  This greatly helped to increase the net amount my client received.  

I would definitely recommend speaking with your insurance company or agent about increasing your medical payments coverage.  I believe it is available in amounts up to the bodily injury limits of one's coverage (the amount available to pay for injuries to the occupants of another vehicle, when the collision is your fault).  

Med pay coverage can also be useful in other scenarios, including if non-family member is a passenger in your vehicle and is injured.  It also is available under homeowner's insurance and would be available to pay for medical bills sustained by a guest or other person injured on your property, even if the injury is no fault of yours.  

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    David Burton

    Attorney at Law

    David J. Burton
    DAVID BURTON LAW LLC
    P.O. BOX 1447
    Richmond, IN 47375
    Office Phone: (765) 966-5548
    Cell Phone: (765) 277-0041
    Fax:      (765) 405-0378
    Email: [email protected]

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David Burton Law • P.O. Box 1447 • Richmond, IN 47375
Phone: 765-966-5548 • Cell: 765-277-0041 • Fax: 765-405-0378
Email: [email protected] • Blog

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Mail: P.O. Box 1447, Richmond, IN 47375


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