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Medical Payments Coverage – Why You Should Buy It

March 12, 2012 by The Sawaya Law Firm

Colorado Insurance claims are not fun, especially if you don’t have the right coverage. Nearly all of us, Denver drivers, drive to get from place to place. Most of us (the responsible ones) who drive have car insurance just in case we are in an accident. Many of us who have insurance don’t understand what types of car insurance we are paying for, how much coverage we have, or what the different types coverage are for. A good example of this is medical payments coverage, otherwise known as Medpay Coverage. Here’s why you should buy it.

If you are injured in an accident and you have medical payments coverage through your car insurance carrier, that Medpay coverage is the first coverage to kick in to pay for your accident related care. Most of us in Colorado have $5,000 of Medpay coverage. For example, if your total medical bills from an accident are $10,000.00, the first $5,000.00 would be paid by your Medpay, leaving $5,000.00 outstanding.

When the time comes to attempt to resolve your claim with a defendant and his insurance company, your Denver attorney will demand payment for the whole $10,000.00 in medical bills. Provided that all the bills are reasonable and related to the accident, which they are in this example, the insurance company must pay that $10,000.00 to you. However, you only owe $5,000.00 because of your Medpay.

In Colorado, this is subject to a few exceptions. The $5,000.00 of Medpay coverage paid by your car insurance company does not have to be repaid. Additionally, the defendant’s insurance company is not allowed to reduce any offer it is making, because you do not have to pay the $5,000.00 dollars back to your insurance company. This is often perceived as a wind fall to the injured party; because the defendant’s insurance company must consider and pay a plaintiff for bills incurred in the accident even though the bills are paid by Medpay, which is not going to be reimbursed.

The rational behind this is as follows:

  1. You, the plaintiff, bought and paid for your Medpay coverage, so if anyone is going to receive a benefit from that bargain it should be you and not the defendant or his insurance company.
  2. Medpay payments fall into what lawyers in Colorado refer to as the “contract exception to the collateral source rule.” This law states that when a bill is paid by a collateral source, meaning a source other than the defendant’s insurance company, and that payment is made because you entered into a contract and paid for those benefits, those payments may not off-set against you at trial.
  3. Because this offset is not permissible in trial, it should not be permissible is settlement negotiations either.
  4. the money goes to you.

Why should you buy Medpay in Colorado? Because if you are hurt in a car accident, Medpay coverage will help increase the amount of money you put in your pocket (and it is cheap). It will help settle your case, because the amount of money you get, not the doctors and not the lawyer, is what drives that decision. I believe that we all should have this coverage and have at least $25,000.00 worth. The standard $5,000.00 will help you some but does not get you very far considering the cost of medical care today. In short, BUY IT.

The Sawaya Law Firm is Denver’s personal injury law firm. With over 40 years of experience and a compassionate team prepared to listen to your story, The Sawaya Law Firm is here to help. Contact us anytime.

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