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1)  What is "medical payments” coverage?

Medical payments coverage is optional coverage on an automobile insurance policy that helps cover medical expenses. 

 

Frequently referred to as "MedPay" coverage, medical payments acts like health insurance in that it pays for medical expenses that result from a motor vehicle collision.

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2)  Is medical payments coverage required in Georgia?

Medical payments is not required by law in Georgia.  Instead, it is optional medical coverage that you can pay extra to receive. 

 

Most Georgia drivers do not have medical payments coverage.

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3)  Who is considered an "insured" under medical payments coverage?

Georgia's statute states that an "insured" on a car insurance policy includes: 

 

  1. the person named on the insurance policy;

  2. resident spouse;

  3. a resident relative that is occupying the vehicle at the time of the collision; or

  4. a person who is lawfully occupying the vehicle.

As an example, if you are involved in a motor vehicle collision while a passenger in a friend's vehicle, you are not entitled to medical payment benefits from your motor vehicle insurance.  However, if your friend has medical payments coverage, you are entitled to medical payment benefits through their policy.

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4)  What does medical payments coverage pay for?

In short, MedPay provides coverage for medical expenses related to treatment for injuries resulting from a motor vehicle collision. 

 

Examples include:

  • EMT and ambulance fees;

  • Hospital and ER visits;

  • Doctor visits;

  • Surgery;

  • Radiology costs;

  • Professional nursing services; and/or

  • Prosthetic limbs.

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5)  Does medical payments coverage compensate for pain and suffering?

MedPay does not cover pain and suffering.  It is strictly limited to covering medical expenses related to treatment from a motor vehicle collision.

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6)  Do I need medical payments coverage if I have health insurance?

Just because you have health insurance doesn't mean medical payments coverage is worthless. 

 

Infact, the two work well together to help maximize your recovery if you are the victim of a motor vehicle collision.

That's because health insurance is entitled to subrogation - or reimbursement - out of any motor vehicle collision settlement.  But, if you have medical payments coverage, this can be used to help reimburse your health insurer for treatment costs related to the collision.

For example, let's assume you are in a motor vehicle collision and accrue $10,000 in ER bills.  Your health insurance covers these bills, but they pay an adjusted, contractual rate of only $5,000.  Technically, you still have to reimburse your health insurance for the $5,000 once you reach a settlement.  But, if you have $5,000 in medical payments coverage, this money can be used to reimburse your health insurer.  That means $5,000 more in your pocket.

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7)  Will medical payments coverage reimburse funeral costs?

Yes, if the death is the result of a motor vehicle collision, the medical payments coverage can be used to help pay for funeral costs.

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8)  Are there time limits to medical payments coverage?

 

Georgia's MedPay statute states that the medical expenses covered under medical payments coverage must have been incurred within 3 years from the date of the collision.

This means, any medical expenses after three years are not reimbursable by medical payments coverage.

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9)  Must I reimburse of medical payments out of my settlement?

 

In Georgia, your car insurance is not entitled to reimbursement out of your settlement.  Stated another way, it is not subrogatable in Georgia.

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10)  Does medical payments “set off” my UM/UIM coverage?

 

Any payments made under a medical payments policy offsets the available UM/UIM coverage available. 

 

This is so even if the UIM coverage is an "add on" policy.

For instance, let's say you are involved in a motor vehicle collision and your case is worth $35,000.  And, the at-fault driver has the bare minimum liability insurance coverage of $25,000.  Finally, let's also assume you have $25,000 in available UIM as well as $5,000 in available medical payments coverage.  The $5k from medical payments would go to pay for outstanding medical bills, thereby "offsetting" or reducing the total available UIM coverage obligation to only $5,000 - or the amount to pay the full $35,000.  These numbers are broken down below:

$35,000 - total damages

($25,000) - total liability limits of at-fault driver

($5,000) - total medical payment coverage benefits

($5,000) - total UIM payment obligations

 

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