Few people have a thorough understanding of the breadth of coverage available to them under their car insurance policy. Whether your selections were made online or through a local insurance agent, the primary consideration is usually the total annual cost.
But in the aftermath of a motor vehicle collision, your selections for insurance coverage will take center stage. If the accident causes physical harm, medical costs will begin to mount. You may have to refrain from working, and recovery can stretch into weeks or even months.
While everyone has a general understanding that their insurance policy will protect them, the nuances differ. If a driver is injured and decides to pursue a personal injury case, it’s greatly beneficial to also have medical expense coverage through your insurance policy.
Why should I purchase medical expense coverage?
Medical expense benefits, also known as “med pay,” purchased through your auto insurance policy, will cover the immediate cost of medical treatment while your case is pending. Resolving a personal injury claim takes a bit of time to be done thoroughly. There is no exact timetable, as the variables from each case vary. One thing is for certain: the medical bills will arrive much sooner than a verdict or a settlement.
Does every auto insurance policy in Virginia offer medical expense coverage?
Every licensed insurance company that sells automotive policies in Virginia must provide its customers the opportunity to purchase medical expense benefits.
Por Virginia code, this coverage is available to pay “all reasonable and necessary expenses for medical, chiropractic, hospital, dental, surgical, ambulance, prosthetic and rehabilitation services and funeral expenses,” resulting from a motor vehicle collision. These ‘expenses’ include both out-of-pocket costs and the amount a health insurance company pays directly to the provider.
Do you need medical expense coverage if you already have health insurance?
Many consumers opt out of medical coverage expenses on their auto policy since they assume their health insurance plans will fill in the blanks. However, not all health insurance plans are created equal, and the following questions must be considered:
- Does your health insurance plan have a deductible, co-pays, or co-insurance that would be out-of-pocket expenses?
- Si su plan de salud es a través de su empleador, ¿qué tan seguro está de que permanecerá con ese empleador?
- Does your health insurance have a subrogation interest? In other words, will you have to reimburse your health insurance for payments they made out of any settlement or judgement? Collecting medical expense coverage could take the sting out of having to make that reimbursement.
- ¿Su seguro médico paga el tratamiento quiropráctico?
- How often are others riding along in your car?
The last bullet point is significant, especially if you often carry passengers in your vehicle. Naturally, you will want to protect loved ones riding along, but your health insurance covers only you. If you aren’t guaranteed that each of your passengers has a thorough insurance plan, they could be at risk.
Does medical expense coverage cover passengers in my car?
Yes. This coverage protects anyone named on the policy (the “named insured”), whether a spouse, a relative residing in the household, or anyone occupying a vehicle on that policy. It will pay the medical expenses regardless of any other insurance and regardless of who is at fault. It covers medical expenses incurred within 3 years after the date of the collision or injury.
What if I was injured in someone else’s vehicle?
Good news: Medical expense coverage will “follow” you! If you are a passenger in another person’s vehicle that does not have this coverage, your own policy would apply. If they do have this coverage, normally your medical expense coverage will provide additional (excess) coverage if your medical expenses are higher than their limit of coverage. Also, if you are a pedestrian and you are injured by a motorist, this coverage will aún extend to you.
Should I use my medical expense coverage if the other driver is at fault?
Absolutely. Receiving immediate and thorough treatment for your injuries should be a personal priority. It’s also vital for your personal injury claim that you adhere to your medical plan. If the other driver is at fault, they will still compensate you for your medical treatment, even if it is covered by your insurance. This is because Virginia law includes the “regla de fuente colateral. "
Medical expense limits
The minimum medical expense coverage limit is up to $2,000 per person, though the insurer and insured are free to set the limit on any amount they agree upon. Virginia law also allows for stacking of up to four vehicles. For example, if the insured has a personal policy with medical expense limits of $5,000 listing five vehicles, and incurs medical bills of $50,000 through being insured while occupying one of those vehicles, the policy would pay $20,000 ($5,000 per vehicle x the limit of four vehicles).
What is the collateral source rule?
The fundamental premise of this rule is that the defendant (the at-fault party) should not be able to reduce the damages they owe to our client, simply because the plaintiff received compensation from insurance or other sources that aided them in recovery.
This means that any benefits or payments the plaintiff receives from sources like health insurance, Medicare, Medicaid, workers’ compensation, Social Security disability, a pension, or any other source should not be deducted from the damages awarded in a personal injury or wrongful death case.
The rationale behind the collateral source rule is rooted in principles of fairness and justice. This practice is meant to prevent wrongdoers from benefiting or reducing their liability simply because the person they injured is insured. The guilty party should not benefit from the plaintiff’s prudence in choosing medical expense coverage and other benefits. Nor should they benefit from the added investment our clients paid to be protected by this coverage.
Essentially, the collateral source rule ensures that the liable party remains fully responsible for the harm they have caused, regardless of whether the injured party has additional sources of compensation. And there is good news: This collateral source recovery is often available before the personal injury case against the defendant is resolved.
¿Cómo sé si tengo beneficios de gastos médicos?
Simply open your declarations page (or “dec page”) on your insurance policy. Review the line itemization of costs contained on your declarations page. If your policy has medical expense benefits, they will be listed along with your liability coverage limits and your uninsured motorist protection.
I have been injured, and have questions about coverage.
There are many other nuances and rules regarding medical expense benefits. At Allen & Allen, we process and handle medical expense benefits claims as a service to our clients in conjunction with their personal injury cases. If you or someone you know is injured through no fault of their own, our abogados con experiencia en lesiones personales can help. For a free case evaluation, call us today at 866-388-1307.
