MEDPAY 101

This guide is intended to provide a brief overview of medical payments coverage in Illinois, and is not intended to provide legal advice of any kind. Insurance requirements vary by state, and no portion of this guide applies outside of the state of Illinois. If you have out-of-state coverage questions, give our expert team a call, and we will be happy to refer you to a local attorney to assist you.

WHAT IS IT?

Medical payments coverage, commonly known as “med pay”, is an optional coverage that can be added on to an insurance policy and will pay for your medical bills up to a certain dollar amount if you are involved in a personal injury regardless of liability. This means the coverage applies even if you are deemed at-fault for the accident. Med pay covers medical expenses for you, other drivers listed on your policy, members of your household, and passengers if any of you were injured in a car accident. This coverage may also include payments towards funeral expenses and necessary dental care as a result of an accident. A few examples of expenses or losses not covered by med pay would be claims for wage-losses, child-care expenses, and non-related medical expenses. Medical payments coverage can be a useful and often essential tool to help cover the high costs associated with medical care following an accident. Med pay is not limited just to auto policies though – many commercial general liability policies (CGL) have med pay for customers who are injured on a business’s premises; again, this coverage would apply even if the business did nothing wrong.

WHO NEEDS IT ON THEIR AUTO POLICY?

If you are injured in an accident, medical bills can quickly pile up. While you may receive coverage from the other driver’s liability policy if they are found to be at fault, legally determining who was responsible for the accident can take months and is not guaranteed. Adding medical payment coverage to your existing policy, can be an affordable option to at least partially cover outstanding medical bills from a collision in cases where there might not be other coverage. Often times the difference between $1,000.00 and $5,000.00 of medical payments coverage can be as low as a few extra dollars a month added to your existing rate. For more information regarding what medical payments coverage options are available, contact your local insurance agent. For questions regarding the use of coverage, and how coverage may impact a potential claim, contact an expert auto accident attorney, like those on our team here at Marker & Crannell, and we would happy to answer any questions you might have.

DOES IT ONLY COVER AUTO ACCIDENTS?

Medical payment coverage also covers you (as well as others listed on your policy and members of your household) while cycling and walking if you are struck by a vehicle. This same coverage applies to cycling and walking as to car accidents and applies regardless of who is at fault in the accident.

HOW SHOULD I USE MEDICAL PAYMENTS COVERAGE?

Bill everything through your group health insurance whenever possible. You can submit bills to your health insurance for payment even if the provider refuses to your group health insurance (unless it is Medicaid or Medicare, those visits must be billed by the provider directly). This is important, as we hear countless new clients tell us they were informed they could not use their group health or had to extinguish any medical payments coverage before using group health, when generally speaking that is simply not correct. If you have providers refusing to submit bills to your group health insurance, contact an expert accident attorney right away. As explained in more detail below, these kinds of payment refusals can have a serious impact on your case and your ability to get the treatment you may need. Once you have successfully submitted your bills for payment through your group health insurance, then, reserve the use of med pay for “out-of-pocket” expenses, like copays and deductibles, as that will help you avoid being cash-flow-negative and help to maximize your recovery should you successfully pursue the at-fault driver.

Does using medical payment coverage impact a potential future settlement?

The short answer is yes. This is an area where so many variables impact the outcome, that to best answer this question, you should sit down and speak with an experienced injury attorney. The most important thing is for you to get the treatment you need and not have medical decisions dictated by another insurance company. Decisions you make early on, can have a substantial impact on your overall recovery down the line which is exactly why the sooner you can sit down with a qualified injury attorney the better. Call an experienced member of our team today, for a free and confidential consultation!


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