Did Your Auto Insurance Company Offer You Medical Payments Coverage? - Shook & Stone
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Did Your Auto Insurance Company Offer You Medical Payments Coverage?

Did Your Auto Insurance Company Offer You Medical Payments Coverage?

In Nevada, insurance companies must offer purchasers of auto insurance “coverage in an amount of at least $1,000 for the payment of reasonable and necessary medical expenses resulting from an accident.” See NRS 687B.145(3).

This coverage, also known as “Medical Payments Coverage”, must be offered on a form approved by the Insurance Commissioner, and a copy of the form must be included in each renewal provided to the purchaser.

The “Must Offer” Requirement can result in coverage when it’s not expected, and can significantly increase our clients’ net recovery in auto accident claims.

What Is Medical Payments Coverage?

It is used to pay for accident-related medical bills. However, unlike other forms of insurance, it has the secondary benefit that the insured is not required to pay it back from any recovery or settlement.

This coverage is also considered a “Collateral Source Benefit”, which the adverse will be prohibited from mentioning at the time of trial. As a result of these circumstances, we routinely recover Medical Payments Coverage for medical bills and additionally recover the value of those same bills from the at-fault driver.

If I Have Health Insurance or Personal Injury Protection, Do I Need MedPay?

We strongly recommend that everyone purchases full automobile coverage, including both Uninsured/Underinsured Motorist Coverage (generally referred to as “UM Coverage”) and Medical Payments Coverage because the benefits derived from these coverages far outweigh their cost.

In Nevada, approximately 20% of drivers are uninsured, obviating the need for UM and Medical Payments Coverage. Further, as noted above, Medical Payments Coverage allows for the potential of a double recovery, which inures to the benefit of the injured party.

What Does Med Pay Cover?

In the event of a car accident, medical payments coverage included in your car insurance policy can cover various expenses, including:

  • Medical expenses, such as doctor visits, hospital stays, lab tests, X-rays, and prescriptions.
  • Lost wages for time missed from work due to injury or illness caused by the accident.
  • Funeral and burial costs in the event of a fatal accident.
  • Rehabilitation expenses if necessary.
  • Home health care services if required.

Coverage limits include a maximum amount per person per accident and are typically between $1,000 and $10,000.

In conclusion, every auto insurance company in Nevada must offer purchasers medical payments coverage in an amount of at least $1,000 for the payment of reasonable and necessary medical expenses resulting from an accident.

Determining Your MedPay Coverage Needs

The amount of Medical Payments Coverage you need depends on a variety of factors, including the type of vehicle you drive and your medical history. In addition, if you have another form of coverage that pays for medical bills resulting from an accident (such as Medi-Cal or private health insurance), it may affect the amount of coverage you need.

To get an accurate estimate of the primary coverage you need, we recommend speaking with an experienced attorney at Shook & Stone who will review your specific situation and advise you accordingly.

How is MedPay different from PIP?

Medical payments coverage and personal injury protection (PIP) both provide financial support for medical expenses resulting from an auto accident. If you live in a 12-state region known as a “no-fault” state, having some form of either of these coverage is mandatory. MedPay is similar to PIP in that it pays for medical bills after an auto accident, but usually does not cover compensation lost from missing work due to the injuries sustained from the incident.

In contrast, PIP provides additional coverage beyond just medical bills and compensates the injured party if they have had to miss work due to their injuries. This type of coverage may also pay out additional benefits to any passengers involved in the accident that are covered by the policy itself. Ultimately, this broader scope of protection makes PIP coverage a more comprehensive option when compared with MedPay that typically focuses solely on covering direct medical expenses related to getting treated or hospitalized after an accident occurs.

How Do I Get Reimbursed for A Medical Payments Coverage Claim?

In auto accident claims, we always investigate Medical Payments, and demand that the carrier prove it has satisfied the Must Offer Requirement by offering Medical Payments Coverage. If the carrier cannot prove it made the offer (typically by presenting a Waiver Form), coverage will be extended.

It should also be noted that Medical Payments Coverage may be “stackable”, meaning that an individual possessing coverage on more than one vehicle may be entitled to the full coverage from both policies.

Medical care providers are usually required to accept payment from an applicable Medical Payments Coverage policy, and the injured party will typically have to submit any medical bills directly to the insurer. The insurer then reimburses the medical care provider for expenses related to services rendered.

If you have been in an auto accident and have questions about the amount of insurance coverage you have, contact Shook & Stone immediately – we know how to maximize your recovery.