What is ‘Medical Payments Insurance Coverage?’

By Jedidiah McKeehan

Medical payments insurance coverage, or “Med Pay” is something that you may have never heard of, but it is an important part of most car insurance policies.

So what is med pay coverage? Med pay coverage is coverage that will pay for medical costs related to an auto accident regardless of who is at fault. How does that work exactly?

Say that you and I have an accident and I am driving the car that hits you. You contact my insurance company and they open up a claim. Even before my insurance company has made an assessment on liability (who caused the accident), if I have med pay coverage as part of my policy, they may offer it to you. Remember, med pay coverage is usually paid out regardless of who is eventually determined to be liable for causing the accident.

So, again, you and I have been involved in an accident and you have gone to the emergency room or to physical therapy as a result of the accident. My insurance company may offer to pay those medical providers directly or they may offer to write you a check for the total amount of the med pay coverage amount. The most common amount of med pay coverage is $5,000.00.

In the scenario I have laid out, my med pay coverage has been paid to you or your medical providers, and let’s say the full $5,000.00 has been paid. Let’s continue our hypothetical, and assume that I am eventually found to be at fault for the accident and my insurance company offers to pay you a settlement amount of $20,000.00. That settlement amount is almost always reduced by the amount of med pay that has been thus far paid out. So, the settlement check you will receive will be $15,000.00 instead of $20,000.00.

If you have medical insurance and the other driver causes an accident, you may decide to decline to accept med pay money from his insurance company.

Why would you do that? Well, you may get more money in to your pocket by declining the med pay money. Often, healthcare providers will negotiate what they are owed, but if they are paid directly with med pay funds, your ability to negotiate a reduced payoff with the provider has been taken away.

Jedidiah McKeehan is an attorney practicing in Knox County and surrounding counties.  He works in many areas, including criminal, personal injury, landlord-tenant, probate, and estate planning. Visit attorney-knoxville.com for more information about this legal issue and other legal issues.

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