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Medical Payments Coverage

There may be a type of insurance coverage you have forgotten or didn’t even know you had.  Outer Banks lawyers, especially those who handle personal injury claims involving wrecks, may refer to it as Medical Payments Coverage or “Med Pay.”Medical Payments Coverage

Med Pay is intended to pay for necessary and reasonable medical expenses.

It may also include terms of coverage for funeral expenses and the costs for treatment up to the policy limits.  The most common amounts purchased in North Carolina tend to be in the range of $1,000 to $10,000.

Medical payment coverage in North Carolina can, therefore, serve as a helpful “first party insurance” coverage for immediate use in paying medical bills.

It’s a form of insurance coverage that works in addition to that available under the tortfeasor’s liability policy and your UM/UIM coverage.

Med Pay may also be available in instances where you are the passenger of a vehicle that has the policy coverage.

Med Pay is not required under the NC insurance laws.  It is considered to be, “extra-contractual” or part of the contract between the insured and the insurance company.

That’s different from basic automobile policies, where “minimum liability” coverage is very much required and part of operating a vehicle in North Carolina.

North Carolina’s insurance laws often differ from those in other states.

For example, the State of Florida may require something similar called “PIP” coverage – Personal Injury Protection.  South Carolina has its own form of personal injury protection as well.

If you are covered under Med Pay, it can be a valuable tool to help pay important, pending medical bills.  Having said that, we believe it’s a good idea to talk to a lawyer before doing anything – Danny Glover, OBX Lawyer

Should I use Medical Payments or “Med Pay?”

Given North Carolina is a Contributory Negligence state, it’s understandable that some people are concerned with making a claim under their own automobile policy.  That makes sense.

If you are not at fault for the wreck, why would you expect to make a claim under your policy?  Clients ask, “Won’t that make my rates go up?”

Med Pay in North Carolina is not considered fault-based.  Under the NC insurance laws, rates are not supposed to be increased when/if a claim is made under the Medical Payments provision of the insurance policy.

If that happens, either you or your personal injury lawyer can contact the North Carolina Commissioner of Insurance.

Med Pay coverage should be available for immediate reimbursement of medical bills.  It can be applied to deductibles, co-pay, and balances for treatment “not covered” by your health insurance.  Obviously, that applies too in instances when you do not have health insurance or major medical coverage or Obamacare.

As such, given many insurance liability companies refuse to “pay as you go,” meaning they prefer to work out a full and final settlement rather than pay bills as they come in, Med Pay can help pay bills until a settlement can be achieved.

Furthermore, given Medical Payments insurance is not fault-based, it provides coverage in the event contributory negligence is alleged and/or proven by the tortfeasor (the person who caused the wreck).

Should I give a statement to MY insurance company?

It happens so often that it has become standard, accepted language.

“You are required to give a statement.  Failure to do so could result in denial of your claim.”

Frankly, it’s an effective tool for insurance adjusters.

We live in the South.  People want to be helpful and cooperative.

They believe in doing right and fair play.

As such, when they make a claim for damages that have resulted from an at-fault wreck, they assume the insurance company proceeds with the same good faith and sense of fair dealing.

That is not always the case.

In North Carolina, you are NOT required to give any form of a statement to the insurance company who covers the person who caused the accident.

While the insurance laws may require some form of cooperation with YOUR carrier, that does not always include providing a statement, let alone a recorded statement.

Prior to doing anything, we recommend people speak with an experienced lawyer.

Our goal is to guide clients through the complexities of the NC insurance laws.  We believe it’s smart to have legal counsel be the primary source of contact with carriers – Danny Glover, OBX Lawyer 

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