Medical Expense Benefits Coverage / MedPay in Your Virginia Car Insurance Policy

Personal injury clients often ask about the different types of insurance coverage that an injured victim can use to help pay for medical expenses and other costs. Questions frequently relate to Medical Expense Benefits Coverage — also referred to as MedPay — which is available in Virginia, and include whether MedPay is the same as Personal Injury Protection or PIP coverage.

Basics of Virginia MedPay

When you are injured in an accident in Virginia, there are three different potential sources for compensation:

• Your own health insurance policy, if you have one;
• MedPay provisions in your car insurance policy, if you have coverage;
• Another person (and that person’s insurance company), if someone else was at fault for the accident.

MedPay is a type of optional insurance coverage that a policyholder may choose to include as part of a car insurance policy. A Virginia statute requires insurance companies to offer the coverage, but policyholders are not required to purchase it.

If you have MedPay coverage in your policy, the specific provisions in your individual policy govern what is covered and how much coverage you have. The law requires insurance companies to offer $2,000 per person minimum coverage, but you may choose to include more coverage than the minimum.

MedPay is sometimes referred to as “no fault” coverage, because it pays your medical expenses — and those of your passengers — regardless of who is at fault for the accident. Under the statute, the minimum coverage includes:

• “Reasonable and necessary” medical and treatment expenses, services provided by emergency medical services vehicles, and funeral expenses, up to $2,000 per person, for a period of three years after the accident; and
• Loss of income up to $100 per week for covered individuals, for a period of up to one year after the accident.

The coverage applies to injuries received in an accident while in a vehicle or as a pedestrian. It covers the policyholder and relatives living in the insured’s household, including his or her spouse. Both types of coverage are optional and must be included in your policy for you to be able to submit MedPay claims. Your policy provisions will govern coverage amounts, claims, and payments.

MedPay Advantages and Limitations

An advantage to having MedPay coverage is that claims are generally paid fairly quickly, so you avoid having outstanding medical bills to pay. Unlike health insurance policies, MedPay coverage generally does not have co-pay or deductible amounts.

Filing a MedPay claim does not preclude you from getting coverage under your health insurance or holding another person responsible when that other person was at fault in the accident. Claims against another person can require considerably more time to pursue and sometimes require retaining a personal injury attorney to get fully compensated. However, coverage under MedPay provisions is generally only for medical expenses and limited lost income. When another person caused the accident, the compensation that can be recovered includes much more than just medical expenses and lost income.

One situation in which MedPay coverage may not be available — even if you have it in your policy — is when you are injured in a car accident while you are on the job. In that case, your claim may be under Workers’ Compensation insurance, rather than your MedPay coverage.

Your own insurance policy may include exclusions and conditions. When you, your family members, or your passengers have a potential MedPay claim, consulting your individual policy about coverage and claims is essential.

If you choose not to include MedPay coverage in your policy, you will not have MedPay coverage. The statute only requires insurance companies to offer MedPay coverage. It does not require the coverage to be included if the policyholder does not choose it as an option.

What Is the Difference Between MedPay and PIP Coverage?

Virginia’s statutory provisions relating to Medical Expense Payments Coverage (MedPay) are similar to auto insurance coverage in the District of Columbia and Maryland that is commonly referred to as Personal Injury Protection or PIP.

Importantly, the statutory provisions that apply to PIP in D.C. and Maryland are substantially different from the laws applicable to MedPay in Virginia. Individual states and D.C. have the authority to set specific auto insurance requirements for residents and insurance companies within their respective jurisdiction. While MedPay and PIP coverage are similar, the coverage works differently in each jurisdiction where it is available.

When You Need to Talk With a Virginia Car Accident Attorney

If you have been seriously injured in a car accident in Virginia, and the accident was another person’s fault — or if a loved one has been severely injured or died in an accident caused by someone else, Virginia Beach car accident attorney Jeff Brooke is here to help make sure you recover all the compensation you deserve. Contact us by phone at (757) 785-0837 or by using our online contact form.

Jeff Brooke is a personal injury attorney devoted to helping individuals who have suffered serious and catastrophic injuries or lost a loved one as a result of someone else’s negligent and careless actions. The Jeff Brooke Team serves all of southeastern Virginia. The firm helps clients in the Greater Tidewater and Greater Hampton Roads areas, including in Virginia Beach, Norfolk, Portsmouth, Chesapeake, and Chesterfield. The Jeff Brooke Team also handles cases in northeastern North Carolina, including the Outer Banks.