Medical Expense Benefits: What are they and how do they work?

Few people have a complete and thorough understanding of the various types of coverage afforded under their personal motor vehicle insurance policy. Whether the policy is purchased online or through a local agent, the primary consideration for most consumers is total annual cost. Once a policy is selected and these premiums are paid, the issue of automotive insurance is understandably set aside in favor of more pressing every day concerns. In the aftermath of a motor vehicle collision, insurance coverage once again takes center stage as medical costs begin to mount, time is missed from work and painful days turn into weeks and even months.

While everyone has a general understanding that their insurance policy will protect them if they cause an accident and many people understand that their policy will also protect them if they are injured by someone without adequate coverage, it is important to know that many automobile insurance policies also afford medical expense benefits to cover the immediate costs of medical treatment while a personal injury case is pending.

Insurance companies offer medical expense benefits

Every licensed insurance company that sells automotive policies in Virginia must offer its customers the opportunity to purchase these medical expense benefits.[1] 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 for a motor vehicle collision.[2] These ‘expenses’ include both out-of-pocket costs and the amount a health insurance company paid directly to the provider.[3]

Absent an assignment of benefits given to a treating medical provider, Virginia law requires the auto insurance company to pay these medical expense benefits directly to the injured person in addition to any recovery they make against the at-fault driver. In addition, this collateral source recovery is often available before the personal injury case against the defendant is resolved.

How do I know if I have medical expense benefits?

To find out if you have medical expense benefits under your current automotive insurance policy simply check 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. Adding medical expense benefits before you are involved in a motor vehicle collision may provide valuable financial assistance with out-of-pocket medical costs in the event of an injury.

At Allen and 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, call us for a free consultation.