What are Medical Payment Benefits (or Med-Pay) in Virginia?

Medpay Coverage Generally

Medpay Coverage generally, is a policy of insurance usually issued by your own carrier, to protect you in the event you are hurt in a motor vehicle accident. Specifically, the coverage can be used after an accident to pay for medical bills and lost wages. Furthermore, such coverage can be used regardless of who was at fault in causing the accident. This is sometimes referred to as "No Fault" coverage.

 

In Virginia, every automobile insurance company must offer medical payment insurance along with the policy they are selling. If an insurance company fails to do this, it may be acting in Bad Faith and/or subject to sanctions. Notwithstanding the above, purchasers of insurance in Virginia are not required to buy this coverage, but it must be offered. Virginia Medical Payments Benefits are discussed extensively in the Virginia Code , § 38.2-2201

 

I. Benefits of Med-Pay Coverage

1. Med Pay coverage is generally inexpensive. This coverage usually only costs a few dollars per year. In exchange you get the benefit of thousands of dollars of coverage which can be used to pay medical bills in the event you are injured in an accident.

 

2. Med Pay coverage can be utilized regardless of who is at fault in causing the accident.

 

3. Med Pay claims are not typically disputed by the Insurance Carriers. These claims are generally paid quickly, upon submission of the proper documentation to the carrier.

 

4. Collecting Med-Pay benefits does not preclude you from making a 3rd party personal injury claim against the at fault driver who caused your injury. You can actually make both claims.

 

5. Med Pay coverage does not depend on who is at fault for causing the accident. This means that you or your lawyer can collect Med Pay for you even if the accident was your fault.

 

6. Med Pay coverage is also available to passengers in your vehicle. Even if the driver of the vehicle was at fault, the driver and the passengers may still be able to make valid med-pay claims and obtain the insurance proceeds

 

7. Virginia Allows the “Stacking” of Medical Payments Coverage. What this means is that if you are involved in an accident, and you own multiple cars, each with it’s own medpay coverage, depending on your policy language, you may be able to multiply the coverage amount by the number of cars that are insured, up to a maximum of four. Thus, if you have 5000.00 in med pay coverage and own three vehicles, you may have a maximum of $15,000.00 in medical payments coverage available to you and your family.

 

8. Ethical rules generally prohibit a lawyer from taking a fee from the medpay proceeds unless the claim is disputed or denied by the medpay carrier.

 

II. Limitations on Med Pay Coverage

  1. Med Pay is generally not applicable if you are injured in a vehicle while you are on the job. The law affords a different remedy here in lieu of Med-Pay coverage and that is a Workers Compensation claim. (This is the subject an entirely different article – click here for more information.)

 

  1. Medical Payments Claims must generally be made within a certain time period after the accident called the "Statute of Limitations. This time period may vary depending on whether or not there is a denial of benefits by the medpay carrier. Therefore, it is always a good idea to contact a Virginia personal injury lawyer to discuss your options.

 

  1. Medical Payments Benefits can only be used for what the insurance company defines as “reasonable and necessary” expenses that are “related” to the subject collision. Insurance companies sometimes review med pay claims and determine that certain bills or charges are “unreasonable, unnecessary” or “unrelated,” to the accident. You may need a lawyer to help you negotiate with the insurance carrier in order to help get your claim accepted and paid. Many good lawyers will not charge you a fee to handle Med-Pay claims and will simply handle the claim as a courtesy to you when they represent you for a third party accident claim.

 

  1. If the insurance company makes any of the above determinations, it is also possible they will altogether deny your claim, or offer you an unsatisfactory sum to compensate you. If this occurs, you can always file a lawsuit against the insurance carrier.

 

  1. Your specific insurance policy may also contain other exclusions which are beyond the scope of this brief and general article. You should always consult your policy or a lawyer to determine what if any other limitations there may to your med-pay coverage.

 

Once again, the VA Statute coveraging Med Pay benefits is Virginia Code , § 38.2-2201