Medical Payments Coverage
Medical Payments (medpay) coverage is a portable health insurance policy that attaches to your auto insurance package. Medpay is purely optional coverage in North Carolina. It is very inexpensive, and I recommend that you always carry at least $5,000.00 in medpay coverage for all insured vehicles. The cost per vehicle for this coverage would only be approximately $8.00 per month. For that small premium, you have $5,000.00 in immediate coverage for all medical care arising from any car accident. This is a per-person limit and would apply for every passenger in your car. Further, medpay will pay your medical expenses even if you are riding with a friend in a car that is not insured on your policy, when struck by any vehicle while riding a bicycle, or when walking as a pedestrian and under multiple policies when medpay is available from several sources.
Don’t Worry about Your Premiums
If you use medpay to collect for medical expenses arising from an accident that is not your fault, the medical payments claims will not impact your coverage or premiums. Thus, you will not face any additional costs or premium hikes if you collect the full amount of medpay available under your policy. If the accident was your fault, the accident (and not the medical payments claim filing) would result in an increase in premiums either way, but you would not face dropped coverage or any meaningful premium increase as a result of any medpay claim.
Medpay Coverage Allows Duplicate Payments
Medical payments coverage is not subject to rights of subrogation. This means that if you are able to collect your medical expenses through a liability claim against another driver who causes your accident, you do not have to reimburse your medpay carrier for their pay out. Thus, if you have $5,000.00 in medpay and they pay that total amount for your medical bills, you can collect again for the same medical expenses through your claims against the responsible driver’s liability policy. You would not be required to reimburse your medpay carrier. Essentially, you are legally allowed to collect two times for your medical expenses in these cases. In fact, most health insurance coverage also overlaps with medical payments. If your health insurance is the type that does not have rights of subrogation and reimbursement, this would be a third source of payment and collection for medical expenses. Your attorneys will help you to apply overlapping coverages properly to ensure that you secure all insurance benefits available to you.
Available Medpay Coverage Options
Medpay coverage is typically sold in the following increments/amounts:
- $500.00 per person / per accident
- $1,000.00 per person / per accident
- $2,000.00 per person / per accident
- $5,000.00 per person / per accident
- $10,000.00 per person / per accident
- $25,000.00 per person / per accident
- $50,000.00 per person / per accident
- $100,000.00 per person / per accident
Because this coverage is very inexpensive and allows duplicate collection of medical-care costs foraccident victims, we strongly recommend that you carry the highest medpay limit that you can afford.
Avoid Attorneys’ Fees on Medpay
If you have medpay coverage and you undergo medical treatment for accident-related injuries, the insurance carrier is required to pay reasonable and necessary medical costs. The treatment must be medical in nature and indeed medically necessary. Also, the billed charges must be reasonable and customary for medical practitioners in the local medical community. Once these conditions are met, the medpay adjuster will pay medpay benefits to you or directly to your doctors.
While lawyers can charge a fee to present your medpay claims, I feel that the coverage is automatic and therefore my law firm files medpay claims for our clients free of charge. You should ask this of any attorney. If you must pay a fee, you may prefer to present your medpay claims alone and without counsel. In these cases, it is always best to use the medpay solely for unpaid medical expenses or as direct reimbursement to you for medical charges that you already paid. Proper use of medpay and careful priority of payment (e.g., pay EMS charges first, as they can garnish wages and impact personal credit faster than other medical bills) will allow you to maximize your net share of the personal injury settlement, protect your personal credit, and allow you access to more medical treatment options.