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What is Medical Payments Coverage and When Should I Use It When Injured in an Auto Accident?

Commonly, insurance policies include an endorsement which provides the insurer “will pay reasonable expenses incurred for necessary medical and funeral services because of bodily injury caused by accident and sustained by an ‘insured.’”Medical payments coverage for car accidents is optional under Georgia insurance policies and is available to the insured regardless of fault.These endorsements typically provide for recovery up to a certain amount for a certain amount of time, generally three years.Furthermore, the insurance carrier must pay benefits within sixty days of the demand by the insured who has suffered a personal injury in a car accident.

The question of who is covered under a medical payments endorsement for medical bills incurred due to a personal injury in a car accident is set out by statute.OCGA § 33-34-2(1) provides: “Coverage shall be available to the named insured, resident spouse, and any resident relative while occupying the covered motor vehicle, and to any other person legally occupying a covered motor vehicle.”

Individuals injured in automobile accidents should look to their health insurance carrier for payment of their medical bills first, as coverage is provided under contract with the health insurance carrier.The injured should then look to the medical payments carrier which will pay funds directly to the injured party and will reimburse the injured insured for any out of pocket expenses not paid by the injured insured’s health insurance carrier.It is important to remember that most automobile policies contain notice provisions which will also apply to medical payments coverage and in all cases, the injured insured should notify their own insurance carrier as soon as possible.

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