MEDICAL PAYMENTS PROVISION
Every insurance policy allows the person(s) it insures to pay a premium for the purchase of what is referred to as “medical payments benefits.” A medical payments provision of an auto liability policy provides that in the event of an accident where an insured, or a passenger in the insureds vehicle, is injured, he or she can file a claim with his or her own insurance company for all medical bills they have incurred within a certain period of time. Typically, this is one or two years, depending on the policy.
This coverage, when available, covers the driver, all insureds, and all passengers who can legally sit in the car. Also, this coverage protects all named insureds if they are in someone else’s car or on a bus or involved in any accident that is related to a vehicle, such as auto versus pedestrian or auto versus bicycle with the insured being the pedestrian or the bicycle rider.
Medical payments coverage comes in two types. The first is “excess with reimbursement” and the second is “non-excess without reimbursement.” The first basically means that if you have health insurance and you want to make a claim under your medical payment policy you must first have any health care provider, doctor or hospital, bill your health insurance and then submit the explanation of benefits form that you receive from your health insurance carrier to your auto liability insurance carrier when presenting the medical payments claim. The car Insurance will then pay whatever is not paid or covered by the health insurance. In the event you recover compensation from the party who wrongfully caused your injuries, you will then have to reimburse your car insurance carrier the money paid under the medical payment provisions of their policy.
With regard to “non-excess and non-reimbursable medical payment provisions” in car insurance policies, no billing need take place to your health insurance prior to submitting the claim to your car insurance carrier and no reimbursement is required in the event “medical payments benefits” are paid to the injured/insured.
Conclusion:
Typically, medical payments coverage is relatively inexpensive as compared to other coverages available in an auto liability insurance policy. We have seen premiums for this coverage range between $45.00 and $65.00 for a six months period. The excess with reimbursement is typically $5.00 to $10.00 less expensive but NOT recommended. Coverages available from the various insurance companies in the California market range from $1,000.00 medical payments coverage to $25,000.00 medical payments coverage, with the average insurance carrier having a limit of $5,000.00 medical payments coverage available.
We recommend, to the extent an individual can afford the cost of this coverage, that each insurance policy have coverage for medical payments which are NOT excess and NOT reimbursable. Where your insurance company only offers medical payment coverage with reimbursement we still recommend that you get said coverage. Medical payments can give you access to immediate medical attention without concern for health insurance authorization or issues such as co-pay and deductible. Another important factor to consider is that medical payments coverage covers an insured whether or not he or she is in or out of a motor vehicle. Therefore, an insured with medical payments protection can be a pedestrian, struck by a car in a hit and run accident, and still have medical payments benefits available to him or her for immediate medical care.
If you have any questions regarding Medical payments provision in your insurance policy or what you should have included in your insurance policy, please do not hesitate to contact TOREM & ASSOCIATES.
DO NOT BE TRICKED BY YOUR INSURANCE COMPANY OR INSURANCE AGENT TO EXCLUDE THIS COVERAGE FROM YOUR POLICY BECAUSE THEY CLAIM YOU DO NOT NEED IT. EVERYONE WHO HAS AN AUTO INSURANCE POLICY NEEDS THIS COVERAGE TO PROTECT THEMSELVES.
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