Medical Expense Insurance Coverage


One of our primary concerns, in reviewing a client's motor vehicle insurance policy, is to determine whether the client has sufficient medical expense coverage to take care of medical provider bills resulting from injuries. If you are injured in a motor vehicle accident, your own insurance carrier (YES, your own carrier) is responsible to pay your medical bills. The other party or his insurance carrier is NOT responsible to pay your medical bills even though the other party may be 100 percent negligent in causing your injuries.

The minimum amount of medical expense insurance coverage that can be purchased is $5,000.00. Many people opt for the minimum $5,000.00 to $10,000.00 coverage because they feel they are saving substantial monies in premiums. Do you know how far $5,000.00 or $10,000.00 will go if you are transported to the hospital and spend several days to several weeks in the hospital? A helicopter ride to the hospital from the scene of the accident could run as high as $6,500.00. The daily rate for a hospital room in the Pottstown tri-county area, without medications, is over $1,000.00.

Many people rely on the medical expense insurance coverage provided by their employers to cover any expenses resulting from a motor vehicle accident that exceed the coverage under their motor vehicle insurance policies. Such reliance may be misplaced, particularly if the employer-provided insurance is HMO, which is becoming more and more common in the work place. Under HMO insurance plans, the HMO has the right to subrogate. This means that the HMO, if it pays for any personal injury medical provider bills incurred by a person in a motor vehicle accident, stands in the shoes of the injured party and can collect the amount it pays from any award, which the injured person may obtain from a claim against the negligent party. In other words, any award obtained by the injured party may be reduced by the amount which the HMO pays for the medical provider bills.

Quite frankly, you may be surprised at how small your motor vehicle insurance premium will increase if you buy $100,000.00 of medical expense coverage versus the minimum $5,000.00 coverage. Check your insurance policy declaration sheet (which you get every six months with your insurance premium notice) to see exactly how much medical expense coverage you have. If the coverage is less than $100,000.00, call your insurance agent to see how much more it would cost you to increase it to $100,000.00. The additional premium for the increased coverage will be well worth your investment.