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MA AUTOMOBILE POLICY AND MEDICAL PAYMENTS COVERAGE

Massachusetts automobile insurance policies are complex legal documents with confusing terms and conditions. Understanding what you are covered for, after you are injured in an accident, can be tricky.  Whether you reside in Middlesex County, Essex County, Suffolk or elsewhere in the Commonwealth, knowing which coverages are required, which are optional and what coverage may be best for you, is complicated.  All too often, car owners’ pay the monthly or annual auto insurance premium without thought to the extent of coverage. It only comes into play after an accident, perhaps  driving along Route 1 from Peabody, Danvers and Lynnfield into Boston; or Route 128 to the North Shore Mall. Only after an accident do most of us look at the level of coverage in the auto insurance policy and then it is too late to increase values.  Once the accident occurs you cannot retroactively alter your coverage.

commerce-acts-books-477966-mThe standard form of the Massachusetts auto insurance policy can be found by clicking the following link: here.  In Massachusetts, the standard policy has a section entitled “Compulsory Insurance” coverage and a section entitled “Optional Insurance” coverage.  “Compulsory” means mandatory. You must have them. Mandatory coverages have the following minimum limits:

  Required coverages (types) for Massachusetts auto insurance, and the required minimum limits (dollar amounts) for each coverage.
Required Coverage Required Minimum Limit
Bodily Injury to
Others
$20,000 per person;
$40,000 per accident
Personal Injury
Protection (PIP)
$8,000 per person, per accident
Bodily Injury Caused
by an Uninsured Auto
$20,000 per person;
$40,000 per accident
Damage to Someone
Else’s Property
$5,000 per accident

Be sure to discuss with your insurance agent whether or not your circumstances warrant increasing those limits beyond the minimum requirement.  In addition, when it comes to “Optional” coverages, particularly with respect to coverage for medical bills and treatment related to an auto accident, being pennywise may be foolish.

The above chart shows that Personal Injury Protection “PIP” coverage is mandatory.  PIP covers medical expense costs and lost wages of occupants of the insured vehicle resulting from an accident regardless of who is at fault.  However, PIP coverage only pays up to $8,000.00 and only pays up to $2,000.00 if you have health insurance.  And then, what if your health insurance has a $2000.00 deductible and 20% co-pay?

Medical Payments coverage, or MedPay, is optional.  It is Part 6 of the current Massachusetts Automobile Insurance Policy.  If you have MedPay coverage it will help pay medical expenses in the event of an accident. Like PIP, Med Pay coverage applies regardless of who is at fault.

MedPay coverage can be used after PIP Coverage and health insurance limits are exceeded. Given the small added premium, it is an option most drivers’ should consider.  MedPay also covers out of pocket expenses that may not be covered by your health insurance, such as dental bills, prosthetics, over the counter medical costs and, in worst case scenario, funeral expenses.

In a recent Massachusetts Superior Court case,  DeOliveira v. Liberty Mutual Insurance Company, the insurance company refused to reimburse its insured under her MedPay coverage for medical expenses she paid out of pocket.  The insured sued the insurance company.  The Superior Court Judge denied the insurance company’s motion to dismiss the insured’s claim.  Suffolk Superior Court C.A. No. 17-00218-BLS1.  The Judge in DeOliveira relied upon an earlier case, Kirby v. Liberty Mutual Insurance Co., 89 Mass. App. Ct. 1136 (2016).  In Kirby, the plaintiff was injured in an auto accident.  She had health insurance.  Her auto insurance company paid the first $2,000 in medical expenses under her PIP coverage.  Her health insurer then paid an additional $4,956.67 but placed a lien on her negligence claim against the at-fault driver.  She paid the $4,956.67 back to her health insurance carrier to satisfy the lien and then submitted a claim under her own MedPay coverage for reimbursement of the $4,956.67.  Her auto insurance company refused to reimburse her.  The Appeals Court in Massachusetts affirmed judgment in her favor and ordered her auto insurer to reimburse her under her MedPay coverage.

Optional coverages available to you under your automobile policy may increase your premium payment can but prove invaluable if you need to submit a claim for medical expenses from a car accident. MedPay is just one of the important options every MA licensed driver should consider.