Medical Payments Coverage: To Use or Not to Use

Medical Payments coverage, or “Med Pay” as it is commonly referred to in North Carolina, is most often first-party insurance to use toward your medical bills in the event of a motor vehicle accident. This means it is extra-contractual coverage under your own automobile insurance policy or the policy for the vehicle in which you are a passenger. Med Pay is considered extra-contractual because it is not required by law in North Carolina.

In some states, such as South Carolina, it is referred to as Personal Injury Protection or PIP. Other states, such as Florida, actually do require PIP coverage up to a minimum amount. At the Law Offices of Jason E. Taylor, PC, we recommend that you use this coverage if it is available.

Many clients are often reluctant to agree to use their Med Pay. The primary reason for the hesitation is that they associate this coverage with fault. However, Medical Payments coverage is not fault-based. The second reason clients may be wary about using their own automobile insurance coverage is that they are afraid their premiums will increase. However, because Med Pay is not fault-based, it is not supposed to increase your premiums.

If an insurance company increases your premiums as the sole result of a Medical Payments claim, let your attorney know and the North Carolina Insurance Commissioner.

We recommend that you use any Med Pay coverage available because it is technically available for reimbursement the instant a bill is incurred. This means that you can use med Pay to help reimburse for co-pays, deductibles, or balances not covered by your health insurance. Typically, a liability carrier does not “pay as you go,” even in cases where liability is accepted. As such, Med Pay can be a stop-gap between you and bill collectors.

Another reason we recommend you use Med Pay to the extent it is available because you are already paying for it. Because Med Pay is extra-contractual, as noted above, you have to pay extra to carry this coverage. Why pay for this coverage at all if you are not willing to use it?

Additionally, one of our jobs as the attorney is to maximize your recovery by using all available or applicable coverages. This includes Med Pay coverage. Ultimately, Med Pay can help reduce the overall amount you have to pay out of the liability settlement proceeds, translating into more money in your pocket.

Medical Payments coverage is also often available in premises liability claims. This can be confusing to claimants because Medical Payments coverage is not fault-based. It is common for commercial business liability policies to have Medical Payments coverage up to a maximum amount, such as $5,000.

A potential client often will call and believe that liability is accepted in a slip and fall claim because the handling adjuster has allegedly agreed to pay their medical bills. Later they find out that the adjuster is only offering to pay up to the Medical Payments coverage limit. An insurance company can agree to pay the Medical Payments coverage in a show of goodwill (as opposed to good faith) but still deny liability (fault). However, that does not take away from the other benefits of using Med Pay coverage noted above.

That is why we at the Law Offices of Jason E. Taylor, PC recommend you use any available (and paid for!) Medical Payments coverage, even if you are not at fault for the accident.

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