Medical Payments Car Insurance Coverage

Learn how to get covered for medical bills after an accident -- regardless of who was at fault.

A specific type of car insurance coverage will pay for medical bills arising out of an accident (if the driver or any passengers in the covered vehicle are injured) fairly soon after the crash, regardless of who was at fault. This is commonly referred to as "medical payments" or MedPay coverage, and this article explains how it works.

Who is Covered Under Medical Payments Coverage?

The following people are usually covered by medical payments provisions:

  • you or any relative who lives with you, when driving or riding in your insured vehicle or in anyone else’s
  • anyone else who is driving with your ­permission or riding in your insured ­vehicle, and
  • anyone riding in someone else’s vehicle while you or a covered relative is driving.

When Medical Payments Coverage Won't Apply

Medical payments provisions usually do not cover accidents occurring:

  • on a motorcycle or other two-wheeled vehicle, unless that vehicle is specifically listed in the policy
  • while anyone was a passenger in a car owned or used by you or a relative if that car was not listed in your insurance policy
  • in a vehicle other than a regular passenger car if used in business
  • during the course of the injured person’s employment, if those injuries are also ­covered by workers’ compensation laws, or
  • while you were driving another person’s car, unless you have already claimed and collected the maximum of that car owner’s medical payments coverage.

Reimbursement Clauses in Medical Payments Coverage

Under the terms of medical payments coverage in some policies, the insurance company has a right to recover the amount it paid you in ­medical payments if you also collect damages from a third source—such as the liability insurance company for the other driver. If your policy has such a ­reimbursement clause and you eventually receive a settlement from another source, you will have to repay out of your settlement the amounts you received under your medical payments coverage.

Example: Shortly after an accident, you collect $1,000 in medical payments coverage from your own insurance company to pay for immediate hospital bills. Several months later, you collect $7,500 in damages from the driver of the other car involved in the accident. Because the medical payments coverage in your policy requires reimbursement, you are now required to repay your own insurance company the $1,000 medical payments it made to you, reducing the amount you have in pocket to $6,500.

If you have health insurance that does not ­require repayment, you can avoid this whole ­issue simply by using your health insurance to pay your medical bills rather than your medical payments coverage.

Understand Overlapping Medical Coverages for Auto Accidents

If you have been in a motor vehicle accident, two sources may be immediately available to pay your medical bills long before you settle your claim against the other driver: the medical payments coverage of your own auto insurance policy, and your own health insurance, including Medicare and Medicaid. It is a good idea to understand how these insurance policies interact before reaching out for any of the coverages.

Either type of coverage might require you to repay any amounts it pays if you also collect damages from another person’s liability insurance. Whether health insurance or medical payments coverage of an auto policy requires you to repay depends entirely on the terms of the policy or contract. Before using either type of coverage, read your policies to see if repayment is required. If one does and the other doesn’t, you may save hundreds and even thousands of dollars by using the nonrepayment coverage.

Getting More Information and Legal Help

For more information on insurance coverage after a car accident, and every tip you’ll need to navigate your case, get How to Win Your Personal Injury Claim by Joseph L. Matthews (Nolo). And you may want to consider talking with a personal injury attorney to make sure that all your legal bases are covered and your rights are protected.

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