Written by attorney Matthew Paul Krupnick

Are you familiar with "Med Pay"???

Med Pay is short for what we use to refer to the Medical Payment Provision that is in many insurance contracts. For example, on a premises liability case, the owner of the property or entity where the incident occurred might have a provision in its liability insurance policy (which requires proving negligence before the insurance company becomes obligated) for the reimbursement of medical bills up to a certain (pre-determined) amount if a person gets hurt on the premises. Those medicals bills are to be paid through the Med Pay provision regardless of fault or what caused the person to be injured. Generally, if there is a Med Pay provision for $5,000.00, for example, and a person gets hurt on the property, he or she can collect up to that $5,000.00 amount so long as the medical treatment and bills are incurred and reported to the insurance company (usually within one year) and the treatment appears to be reasonable and necessary as a result of an injury that occurred on the premises. Most importantly, money collected through a Med Pay provision is IN ADDITION to any other money collected by other parts of that or any other applicable insurance policy (such as the liability portion). Med Pays can exist in insurance contracts other than those associated with properties. For example, any person can have a Med Pay provision in their automobile insurance policy as well. That means that anyone who gets injured in an accident that is covered by the insurance policy will be able to collect the Med Pay if they submit their medical records and bills to the insurance company. However, for auto cases, the Med Pay only applies (meaning a person can only collect money through that provision) if they were in the vehicle covered by that insurance policy. You can’t get Med Pay reimbursement from the other driver’s insurance company even if the other driver had a Med Pay provision in his contract. I hope that made sense… The bottom line is, ALWAYS check to see if there is Med Pay available on every case you work on ;-

Additional resources provided by the author

The insurance code would have actual rules regarding med pay; Jury Instructions regarding Bad Faith Lawsuits against insurance companies, and just using Google to find out more specifics. You can also call our office any time for any reason, including questions on Med Pay.

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