UNDERSTANDING VIRGINIA NO-FAULT CAR INSURANCE
When you get car insurance in the Commonwealth of Virginia, one of the things that the insurance agent has to offer you is called Medical Expense Payments coverage, also known as medpay. However, many insurance agents do not do a very good job of telling you a) what it is, or b) why you should have it. There is a reason for this - because the insurance companies do not make too much money on it, so they do not really promote it! But it is one of the best things, and cheapest things, that you as a Virginia car driver can do to protect yourself in case you are hurt in a car accident.
What is medpay?
Medpay is a first party benefit, that means that it is something that comes from your own car insurance coverage, rather than the other person's car insurance, in the event of a car accident.
Virginia medpay helps you pay for medical expenses arising out of the use of a motor vehicle. That language is specifically important, as it does not necessarily need to be a car accident, when you were driving. If, for example, you are a pedestrian crossing the street and you are hit by a vehicle, you may be entitled to file a med pay claim, if you have car insurance at home! Medpay can cover you if you are in someone else's car, or even on a Metro bus!
Medpay is a kind of no fault coverage, that means that even if you are responsible for the accident, you can utilize this coverage to your advantage. This is very different from at-fault claims, where you want to file a claim against someone else (we call this a third-party claim).
One of the most misunderstood things about medpay, is that using it cannot make your insurance rates increase! It cannot happen! It is against the law! When you elect to utilize medpay coverage, because it is no fault coverage, an insurance company cannot charge you more when you renew your policy. If something like that ever happens, then you have the ability to immediately file a claim with the Virginia Insurance Commission (1).
Why do I need medpay if I have health insurance?
This is one of the most common questions that we get asked. Health insurance is something that you pay for, through payroll deductions or some other source, if you have it through work. If you are an older American, you may have Medicare, or perhaps you have Medicaid. Either way, this insurance is a source that is available for you anytime of the day. It is not dependent on whether or not you have a car accident.
As such, you always want to use your health insurance, when you go to a hospital or doctor's office after a car accident. But, having said that, you absolutely still want to get medpay coverage from your car insurance!
The main reason that you want to use your health insurance, and also get med pay coverage for your car insurance policy, is because a good personal injury attorney is going to be able to get you the benefit of both!
Both? What do you mean?
Yes, you can get the benefit of both your health insurance, and your first party car insurance benefits like medpay. This is why it is so important to talk to Blaszkow Legal after a car accident.
Let us consider an example to explain how this works:
You are sitting at a red light, and you are struck from behind with considerable force. You hit your head on the steering wheel, and a little while later, an ambulance comes to take you to the hospital.
When you are at the hospital, you will meet someone from patient registration, accounting, or some other office like that. When you tell them that you have been involved in a car accident, they are going to want all sorts of information about the accident, including the name of the car insurance companies that are involved, as well as policy numbers and such. You should not give this information to them. You give them your health insurance information only!
You see, most health insurance companies have policies that will pay for emergency treatment. This treatment is considered in-network. This means that the hospital has to reduce their bill, from slightly to a lot, and be completely happy with what the health insurance company paid. They are not allowed to then look to you for the balance (this is called balance billing, and is not permitted). What they do is take a contractual adjustment, or allowance.
What has happened in the emergency room with this person from patient registration, is the hospital is trying to go around your health insurance! If they don't bill your health insurance, they think that they will get more money out of the car accident insurance and your case, instead!
Are they allowed to do this?
No, definitely not! This is a violation of Virginia Code, 8.01-27.5 (2). This is the duty of an in-network healthcare provider to submit any and all bills to the health insurance company. However, the hospital has no duty to tell you that this law exists. That is up to you, and that is up to your Virginia car accident attorney.
So how does all this interact with medpay?
Well, while you're at the emergency room, despite all the questions that they ask about the car accident, you are going to continually to tell them to bill your health insurance. You're going to make that very clear. The hospital is then going to send the bills to your health insurance company to get paid.
An experienced Virginia car accident lawyer is then going to take that bill that was paid, and also submit it to the medpay carrier. That medpay carrier will pay the monies that were paid by your health insurance! That money comes to you, the injured person! It acts as something of a double recovery in Virginia.
Unfortunately, not all attorneys dedicate enough time to making sure that as much money as possible winds up in their clients pocket. That is not the Blaszkow Legal way, though! We run down these issues, on big cases as well as smaller ones, to maximize the recovery for every client that we have.
That sounds excellent! Does it work that way everywhere?
No, first party laws are very different from state to state. But this is how it works in Virginia. Maryland has a different kind of first party coverage called personal injury protection coverage. DC also has pip, but it works in a whole different way!
Is there anything else I should know about medpay?
In Virginia, the coverage stacks! It stacks up to four vehicles. So, if you have five vehicles on an insurance policy, and you have $2,000 of coverage per vehicle, you actually get $2,000, times four cars equals $8,000 of available med pay coverage. Here is the formula:
[Amount of Medpay] x [# of Cars (up to 4)] = total medpay coverage
Of course, we saved the best piece of information for last. Med pay coverage, just like health insurance coverage, is called a collateral source. That means it is inadmissible as a matter of law. When we are compiling your demand package for the third-party insurance company (or at-fault carrier), we redact all of the information relating to health insurance - they also don't get to know about the medpay! They are not entitled to this information, under any circumstances.
What this means, and it's very big, is that you can have your bills paid for by health insurance, and get those expenses paid for by the medpay carrier, and still claim the full value of that medical treatment against the third party insurance, or the car insurance for the person who caused your accident!
If you have been involved in a car accident, truck accident, or pedestrian accident, call a Virginia Car Accident lawyer who knows how all these laws work, and who is devoted you to getting you the maximum compensation available! Call Blaszkow Legal today - 703-879-5910
Virginia Insurance Commission Complaint: https://scc.virginia.gov/pages/File-an-Insurance-Complaint-(1)
Virginia Code 8.01-27.5: https://law.lis.virginia.gov/vacode/title8.01/chapter3/section8.01-27.5/