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What is Medical Payments Coverage, or “MedPay”?

Our clients often ask us “what is medical payments or MedPay coverage?” Just so we’re clear, medical payments coverage and “MedPay” coverage is the same thing. In this article our experienced Boulder personal injury attorneys will give you both a simple and a more complex answer about MedPay, with the hope that you will have a better understanding of MedPay coverage as you read on. If after reading our article you still have questions about MedPay and how it applies to you, we invite you to call us at 303-543-1000 for a free consultation about MedPay and any other issues pertaining to your auto insurance coverage.

Before we begin, please note that the nature of any MedPay coverage applicable to your situation depends on your auto insurance policy. For example, the details may vary slightly between insurance carriers like State Farm, Farmers, Progressive, GEICO, Travelers, Amica, etc. At Cook, Bradford & Levy, LLC, we recommend that you meet with one of our Boulder personal injury lawyers to help you understand the nature and nuances of your particular situation and your specific auto insurance policy. With that said, however, there are some basic rules that will apply to most MedPay policies in Colorado.

MedPay coverage generally offers you the following benefits:

  • Paying your health insurance deductible
  • Flexibility to help pay for out of network providers
  • Help paying the bills for emergency services like an ambulance or Emergency Room
  • You can use it regardless of who is at fault for the car accident
  • MedPay usually covers you and others in your vehicle
  • MedPay can be used if you are in an accident when in someone else’s vehicle
  • MedPay may protect you if you are a pedestrian or bicyclist injured after being hit by a car
  • MedPay can be used to pay back any subrogation you may owe from your health insurance

Because MedPay is such a great benefit, Colorado law requires that when you purchase car insurance you be given the option to buy MedPay coverage as part of your policy. Specifically, Colorado law requires that you be given the option to buy $5,000 in MedPay coverage at the time you buy your car insurance. If you do not want to buy MedPay, Colorado law also requires that you sign a written form showing that you were offered $5,000 in MedPay and that you affirmatively chose to reject MedPay coverage. While we do not recommend rejecting MedPay coverage, the insurance company has the burden of saving your signed MedPay rejection form. This is why when you are involved in a car accident, the first thing an experienced Boulder personal injury lawyer will do is request from your insurance carrier the amount of MedPay that you have, or the signed written rejection forms. If your insurance company is unable to produce your written MedPay rejection form, Colorado law reforms your insurance contract to give you $5,000 in MedPay benefits.

Limitations to MedPay Coverage

While MedPay is a good benefit for you and your family if you are involved in an accident, as mentioned earlier, it is important to know the limitations that apply to your MedPay coverage. For example, many MedPay policies have a time limit of 1, 2 or 3 years after which the carrier will no longer pay for your bills (up to the limit of your policy). For example, if your policy has a one-year limitation, that means that your policy will only pay for reasonable accident-related medical bills that were incurred within one year after the accident. This is another reason why we recommend that you speak with a knowledgeable Boulder personal injury lawyer about your policy and your benefits if you are having trouble using your MedPay coverage.

The Relationship Between MedPay and UM/UIM Coverage

An experienced Boulder personal injury attorney can also tell you that MedPay and UM/UIM benefits are two separate and unrelated types of insurance. A good way to think of it is that MedPay and UM/UIM are two separate benefits that you pay separate premiums for on your auto policy. This means that if you use your MedPay, your UM/UIM carrier cannot offset the amount it will pay you by the amount of MedPay that was paid out to you. For example, if you received $5,000 in MedPay to go toward your ER bill, and your UM/UIM claim is later valued at $100,000, your UM/UIM carrier cannot pay you $95,000 because it previously paid you that money. The rule against UM/UIM offsets for MedPay was set forth in the Colorado Supreme Court case of Calderon v. American Family Mutual Ins. Co., 383 P.3d 676, 678 (Colo. 2016).

At Cook, Bradford & Levy, we enjoy talking about auto insurance policies and helping our clients get the most from the coverage that they have purchased. If you have been in a car accident in the Boulder area, we encourage you to give the experienced Boulder personal injury attorneys at Cook, Bradford & Levy a call at 303-543-1000 to arrange a free consultation about your case, including how to best utilize your MedPay. We are friendly and knowledgeable and look forward to learning whether we can help you in your case.

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“A driver trying to get away from the police ran a red light and broadsided my car. My injuries affected me physically, emotionally and organizationally. Hiring Steve Cook allowed me to focus on healing while ALL the legal Issues were effectively handled by his firm. Steve's patience, honest, determination. competence and experienced evaluation of my case resulted in a great settlement without having to go to trial.”
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“I was injured in a car accident and I was having a hard time getting much of a response from the insurance companies. I never thought I would resort to calling an attorney, but I am so happy that I did, and that Jason Levy was that attorney. He was respectful, knowledgeable, and kind. When I was healing from major surgery, he arranged for my deposition to take place all the way out in Harford County, at a library near my home, rather than having me come into the city. He was also very persistent with the other driver's insurance company, finally negotiating an excellent settlement” Kate
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“I was rear ended by a driver on his cell phone. I started with another attorney, but was not receiving adequate attention to my case. I switched to Brian and everything changed. He was attentive to my situation, listened to all I had to say, and worked to resolve my case in a timely fashion. He continued to communicate and touch base even during slow parts of the process. After the settlement was resolved, he has still reached out to check in on my health and well being. I would highly recommend Brian Bradford as a lawyer.” Randy