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Medical Payments Insurance


By: Bill Kuziara

Do you have medical payments coverage on your insurance policy? If you have recently been in an accident you probably know the answer. If you haven’t, it’s worth your time to check. Medical payments or med-pay is the “wild card” in your insurance coverage. It is the most versatile and cost-effective coverage you can purchase.

For example, you are injured in an accident. Two children; one yours, the other the neighbor’s child, were also slightly injured. Who pays the initial ambulance, hospital and x-ray bills? If you have med-pay, your own insurance company will pay 100% of the value of reasonable services regardless of who was at fault. The payments must be made immediately without delay or litigation. The benefit of having med-pay is that it relieves you of any economic pressure to settle your case against the wrongful party prematurely.

What happens if I don’t have med-pay on my policy? The short answer is you are more likely to settle quickly. The wrongdoer’s insurance company is unlikely to pay your hospital bills etc., as it will “encourage you to continue with treatment.” The wrongdoer’s insurance company likes to have the economic pressure on you because it makes you settle sooner and generally for less money.

Your attorney can help in these matters by arranging liens with your health care providers (doctors, therapists, chiropractors, x-ray, labs, etc.) However, your freedom to choose the exact health care necessary is enhanced when you have medical payments as the doctors know they are going to get 100% payment very soon.

Say you have $5,000 in medical payments; the $5,000 is for each person. In the example of you being injured with the two children each person is entitled to $5,000 coverage or an aggregate of $15,000.

One question repeatedly asked by our clients is, “If I make a medical payments claim will it raise my rates?” The answer is; if the accident was not your fault, Insurance Code 491 expressly forbids the insurance company from raising your rates.

This legal message is sponsored by The Law Offices of Bill Kuziara. This information is not a guarantee of outcome as each case varies and consultation with an attorney is advised.


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