Medical payments coverage for personal auto insurance


Medical payments coverage for for personal auto insurance


1. Coverage, Who Is an Insured

Part B—medical payments coverage provides protection for the named insured, family members, and passengers in the named insured’s auto for injuries received in an accident, regardless of who was at fault.

 It is not a form of liability coverage for injuries sustained by passengers in another auto involved in an accident with the insured.

Part B covers reasonable expenses for necessary medical and funeral services incurred within three years of the date of the accident.

Insureds for medical payments coverage include:

■the named insured and any family member

——while occupying a motor vehicle designed for use on public roads or a trailer, or

——when struck by a vehicle designed for use on public roads or a trailer; and

■any other person while occupying the named insured’s covered auto.

Suppose the named insured ran a red light while driving his covered auto and hit another vehicle. 

The occupants of the car he hit were badly injured. 

The named insured, his daughter, and two of his daughter’s friends were in the insured’s auto and were also injured.

 Medical payments coverage would pay the medical bills for the named insured, his daughter, and her friends.

 It would not cover the medical bills of the other car’s occupants.

2. Exclusions

Medical payments coverage is subject to some of the same exclusions as liability coverage. There is no coverage for injuries:

■sustained while occupying a motor vehicle with fewer than four wheels;

■sustained while using a covered auto as a public or livery conveyance;

■that would be covered under workers’ compensation;

■sustained while occupying an uninsured auto owned by the insured or furnished for his regular use; 

■sustained while occupying an uninsured auto owned by a family member or furnished for the family members regular use (does not apply to the named insured);

■sustained while the insured is occupying a vehicle without the reasonable belief that he is entitled to do so  (does not apply to family members using covered autos owned by the insured);

■sustained while occupying a vehicle that is being used in the insured’s business; 

■caused by war or nuclear hazard;

■sustained while occupying a vehicle located for use as a residence or premises; or

■sustained during prearranged racing or speed contests.

3. Limits of Liability, Other Insurance

Medical payments coverage has a single limit of liability that applies to all injuries sustained by each person injured in any one accident.

 Typical limits are $1,000, $2,000, $5,000, or $10,000.

A person cannot collect duplicate payments for a loss that is covered under Part B and another coverage in the personal auto policy or under any underinsured motorists coverage provided by the policy.

The other insurance condition for medical payments coverage is identical to the one for liability coverage

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