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George Fusner
George Fusner
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Tennessee Auto Insurance 103 (Med Pay Coverage)

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In this part of the ongoing Tennessee automotive insurance series, I’ll go over medical payments coverage, and some of the less than fair tactics insurance companies will use to limit an accident victim’s recovery.

Medical payments coverage, often called “MedPay” (as I refer to it) or “personal insurance protection,” will pay for health services required as a result of an accident without regard to fault. The coverage “follows the vehicle,” meaning anyone in the insured vehicle is covered under the insured vehicle’s policy. Coverage usually extends to:

  • § Policyholder
  • § Policyholder’s relatives in the same household
  • Passengers
  • Other authorized drivers
  • Policyholder and family members if they are injured while riding in someone else’s car or as a pedestrian when struck by another vehicle. (in some states)

There are limits, though. MedPay will only cover what is deemed “reasonable” for the situation, and coverage is limited to things directly resulting from an accident. Additionally, something many people don’t know (because insurance companies don’t make this clear to them) is that if you are injured in another person’s vehicle that also has MedPay coverage, any amount you receive from their MedPay coverage limits your ability to recover from your own MedPay coverage. In other words, if you are injured in someone else’s vehicle, any money your own MedPay coverage pays you will have to be paid back if you are fully compensated under the vehicle owner’s coverage.

There is no legal requirement in Tennessee to have MedPay coverage, but is a worthwhile investment. The premiums are extremely low in relation to the coverage. Thousands of dollars of coverage can be had for only a few dollars a month. Even for those with health insurance, MedPay coverage covers injuries not covered under most health insurance plans. For example, many health insurance policies don’t cover a visit to a chiropractor, and are in the least reluctant to cover soft tissue issues, whereas MedPay covers these types of health care. The health insurance companies limit early treatment when often early diagnoistic treatment can be very healpful.

Even with MedPay coverage, getting your insurance company to pay the medical bills resulting from an accident will not always be easy. Something I see often in my practice is accident victims being delayed by their insurance company in receiving an MRI. My clients often complain of soft tissue damage resulting from an accident. While some soft tissue damage is readily observable, such as open wounds and bruising, some extremely painful and debilitating soft tissue damage (such as whiplash) is only detectable by an MRI. My clients often find their insurance company is unwilling to order an MRI, or delay the MRI for an arbitrary reason. The real reason behind this delay, though, is to decrease the accuracy of the MRI and decrease the chance the MRI will detect the damage appropriately. This could potentially limit the victim’s ability to claim whiplash or other soft tissue damage related pain and suffering.

It is important to talk to an attorney in any accident resulting in pain and suffering or injury. Accidents are often unfamiliar territory for victims, who aren’t aware of the tactics utilized by insurance companies.