Medical Payments Coverage, or Med-Pay, is an essential but optional car insurance in California that can help you cover medical bills and funeral expenses after an accident. This coverage pays out regardless of who is to blame for an accident.
If your insurance company pays you out under your Med-Pay coverage, you may have to reimburse them. However, you may not have to reimburse a Med-Pay payment if your accident settlement money is insufficient.
What Is Med-Pay and How Does It Work?
Med-Pay is coverage you can choose to add to your existing auto insurance policy. Where health insurance may take a long time to pay out, Med-Pay usually pays out quickly and directly.
Med-Pay covers hospital bills and doctor visits. It can also cover ambulance fees and other medical costs incurred by an accident. You do not need to prove the other driver’s fault to access your Med-Pay benefits.
In addition to the above expenses, Med-Pay can also cover surgery costs, diagnostic tests, and physical therapy sessions.
The point of Med-Pay is to avoid out-of-pocket expenses while you wait for the outcome of your personal injury case. This means you can use it to cover deductibles and co-pays. Just keep in mind that these policies are usually limited to $25,000.
How Does Med-Pay Work?
Med-Pay is ready to cover your expenses and those of your passengers when an accident happens. After an accident, you must get medical treatment for your injuries.
After you get medical treatment, you must file a Med-Pay claim with your insurer. Med-Pay will then cover the medical expenses up to your policy’s limit. Your insurer will pay the doctor or hospital directly or reimburse you for your expenses.
The Benefits of Med-Pay
Medical bills escalate quickly after an accident. There are diagnostic tests to be done and potential surgery. There is also the cost of medication, rehabilitation, and future doctor’s appointments.
You do not have to worry about these increasing expenses when you have Med-Pay. This insurance coverage pays out fast, so you can focus on getting well.
Med-Pay works in tandem with your health insurance. If your health insurance policy demands a co-pay or deductible, Med-Pay will cover it. The best part is that Med-Pay offers similar protection for your passengers.
Med-Pay itself does not usually include co-pays or deductibles. This means you can get the full coverage amount when you need it. The claims process is far more straightforward than conventional health insurance claims.
Do I Have to Reimburse Med-Pay?
It is important to remember that you may have to reimburse your insurer if you were paid out a Med-Pay claim. This process is called subrogation. California has strict laws that can sometimes limit or eliminate reimbursement obligations.
For instance, your insurer cannot demand a Med-Pay reimbursement if you are not fully compensated for your damages after an accident. Your personal injury settlement does not cover all your medical expenses, lost income, and non-economic damages like mental suffering.
California’s ‘made whole’ doctrine protects accident victims who have not been financially whole for all losses. This rule states insurers cannot recover Med-Pay benefits under specific circumstances.
So, unless your contract agreement states otherwise, the ‘made whole’ doctrine must apply to your case in California.
It is important to remember that insurance contracts will use language in their legal paperwork to try and overrule this doctrine. You may find something like “the insurer is entitled to recover funds from an insured person who recovered funds from another party.’
This means the insurer wants to claim back any money it pays you from your Med-Pay benefit.
This is another reason you want to get a lawyer involved in your case. Your lawyer can check the insurance contract for conflicting language and use that to ensure that the whole doctrine applies in your case.
How Med-Pay Affects Your Personal Injury Settlement
If you are injured in an accident, knowing how Med-Pay interacts with your settlement is crucial. Yes, you get payment for medical bills, which means you can allocate your settlement towards your other damages.
But, your insurer will go the extra mile to prove you have been fully compensated so they can claim back the Med-Pay portion they paid you. Moreover, the at-fault driver’s legal team may also attempt to reduce your personal injury settlement by arguing that Med-Pay has already covered some of your damages.
How to Protect Your Rights
Navigating Med-Pay claims is not always as easy as it may seem. This is why you must review your insurance policy from back to front. Check the language used in the Med-Pay section for waivers of subrogation.
If you are in an accident, you must record everything related to it. Ensure you are keeping bills, receipts, and proof of lost wages. If there is proof of any other damages, you should keep this, too.
Again, you must hire a lawyer to help you through this process. A lawyer will immediately spot problematic language in your insurance policy. They can also help you file the necessary claims while maximizing your personal injury settlement.
If there is an issue with your insurer demanding reimbursement, your lawyer can request proof that their claim complies with California’s made whole doctrine.
Common Myths About Med-Pay
There are several myths to be aware of when it comes to Med-Pay. For instance, some people believe they do not qualify for Med-Pay. The truth is that while Med-Pay is optional in California, anyone can apply for it.
Some also believe that filing a Med-Pay claim will raise their insurance premiums. It is illegal if your insurer raises your premium even though you are not at fault for the accident.
Med-Pay Is a Lifeline
Med-Pay provides immediate financial relief for medical expenses. This makes it a critical lifeline if you have been involved in an accident that was not your fault.
It is always best to hire a lawyer whether you claim Med-Pay or not. A lawyer can ensure you get the compensation you need and that your rights remain protected throughout the legal process.