Since by far the vast majority of personal injury cases in San Diego, as well as nationwide, arise as a result of car accidents it is worth examining the subject of Medical Payments benefits. Commonly referred to simply as
"med-pay", medical benefits are a coverage that many people have elected to have under their car insurance policies. These benefits will have a specific coverage limit, i.e. $1,000, $2,000, $5,000, etc.
If you are injured in a car accident, whether it is your fault, or the fault of the other driver, your insurance will be responsible for paying your reasonable and necessary medical bills up to the predesignated limit. Although some people will be reluctant to make use of their med-pay due to a fear that their rates will increase it should be noted that
insurance companies cannot raise your rates for accessing your insurance benefits if you were not at fault in the car accident.
Commonly, people will decline this coverage in order to save money on their monthly insurance premiums. Often people will not elect med pay coverage if they are otherwise covered with health insurance. It is my opinion that
med-pay is a worthwhile coverage to have in all cases. The additional premium costs of med pay is typically modest, and it provides an additional layer of medical benefits in those situations where the type of medical care is not covered under the health insurance policy or where it takes too long to access the health benefits(i.e. often it can take weeks or longer to secure a referral and subsequent appointment for physical therapy through your health care insurance). Also, it is extremely important for those individuals without health insurance as it gives them a means of paying for their car accident related medical bills up to the med-pay limit.
At one time here in California people involved in car accidents due to the fault of a 3rd party were able to get their medical bills paid for by their own car insurance, and collect the medical bills once again from the insurance company of the defendant driver thereby securing a double recovery. This was entirely legal as the law believed that it was more appropriate for the injured party to receive a double recovery than for a defendant driver to be relieved of responsiblity to pay medical bills merely because the injured party had the wisdom and foresight to provide for their own medical coverage. Car insurers some years back, however, decided to amend their policies to require reimbursement to them of the medical bills paid out in the event of a 3rd party settlement, thereby eliminating the double recovery for car accident victims. Where one is represented by counsel the med-pay insurer must reduce their reimbursement requirement to share in the attorneys fees paid for by their injured insured. Specifically, the insurance company must reduce its reimbursement by at least the amount of attorneys fees paid by their insured. In other words, if their insured paid attorneys fees of 1/3 on the gross recovery then the med-pay insurer must reduce it's reimbursement amount by the same 1/3. Often, however, your attorney will be able to negotiate a greater reduction on your behalf thereby securing a greater net settlement for you.
It should be noted, however, that whether or not the med-pay is, or is not, reimbursable depends on the existence and legality of a reimbursement clause in the actual insurance contract. There are still a few companies that do NOT require reimbursement.
If you have suffered personal injury in a car accident here in California and have med-pay benefits it will provide peace of mind that your medical bills will be covered up to the limits of your policy. All
personal injury attorneys are expert at handling and resolving med-pay questions as such issues are a common part of the everyday practice of personal injury law for attorneys in California.
