Does Med Pay on My Policy Cover Me in Any Car I Drive?

[jmr30183]

Here's the scenario-

A woman driving her adult son's vehicle is injured in a not-at-fault accident (rear-ended while stopped). The at-fault driver's policy paid out the maximum bodily injury amount, which was insufficient to cover the mom's injuries.

The son's auto policy did not have Medical Payments coverage, but it did have Uninsured/Underinsured Motorist coverage. The mom's auto policy had $50,000 Medical Payments coverage but NO UM/UIM Bodily Injury coverage!

Should mom's Med Pay have paid even though she wasn't in her own vehicle? Or should the son's UM/UIM coverage pick up the balance?

Thanks for your input!

 

[NCAgent]

Here's the scenario-

A woman driving her adult son's vehicle is injured in a not-at-fault accident (rear-ended while stopped). The at-fault driver's policy paid out the maximum bodily injury amount, which was insufficient to cover the mom's injuries.

The son's auto policy did not have Medical Payments coverage, but it did have Uninsured/Underinsured Motorist coverage. The mom's auto policy had $50,000 Medical Payments coverage but NO UM/UIM Bodily Injury coverage!

Should mom's Med Pay have paid even though she wasn't in her own vehicle? Or should the son's UM/UIM coverage pick up the balance?

Thanks for your input!

It depends on a lot of factors, but there are a lot of policies where it would have paid for the named insured to be covered. She can talk to an adjuster to make sure, or you can read her policy contract under medical payments. However, I don't know as much about GA claims adjusting as I do for NC so...

 

[jmr30183]

It depends on a lot of factors, but there are a lot of policies where it would have paid for the named insured to be covered. She can talk to an adjuster to make sure, or you can read her policy contract under medical payments. However, I don't know as much about GA claims adjusting as I do for NC so...

I am actually the "son" in this situation and my mom was involved in this accident back in July 2010. It was actually dealing with the at-fault driver's insurance company (who was also my mom's insurer at the time) that inspired to get my P&C license and become an independent agent!

About six months after the accident, I got my license and immediately went to work for a local agency. My mom and step-dad were my first customers and when I was reviewing their prior auto coverage, I discovered that mom had NO UM/UIM Bodily Injury coverage! The other four vehicles on the policy had UM/UIM and mom's previous vehicle also had it, but the agent failed to include when she bought her new vehicle in 2009. But the did include $25k in UM/UIM Property Damage on it....crazy if you ask me?!?!

All of their vehicles didn't have matching Liability Limits for Bodily Injury either- two only had 50/100 and the other three were 100/300. But they all had $50k in MedPay which cost a pretty penny!

Back to the original subject, mom ended up requiring a two-level cervical spine fusion almost 18 months after the accident. That was following intense physical therapy, countless spinal epidurals and being in constant pain. The surgery kept her out of work for almost five months. So the at-fault driver's Bodily Injury Liability limit was maxed out after the surgical expenses.

Her attorney wanted to pursue mom's UM/UIM coverage for an additional $50k. When she explained that her vehicle didn't have UM/UIM coverage, he moved on to the UM/UIM on my policy. My insurer settled for $38k, so she was compensated, which is the most important thing.

But it really ticks me off that her old agent screwed up and didn't include UM/UIM as she should have! I'm also not thrilled that I have a now have a $38k claim on my previously spotless CLUE Report- even though most/all standard insurers wouldn't surcharge me because of it. It's just a principal issue that it's on there....

So I'm trying to figure out if my insurer could recover some/all of their $38K from mom's $50k Med Pay coverage via subrogation? I'm no longer insured with that company, but they are one of the six companies that I represent. But more than anything, I will never pass up an opportunity to mess with a certain insurance company that was both the at-fault driver's and mom's insurer at the time of the accident. I won't say any names, but if they're like a good neighbor, I'd hate to meet a bad one!!!

 

[NCAgent]

I am actually the "son" in this situation and my mom was involved in this accident back in July 2010. It was actually dealing with the at-fault driver's insurance company (who was also my mom's insurer at the time) that inspired to get my P&C license and become an independent agent!

About six months after the accident, I got my license and immediately went to work for a local agency. My mom and step-dad were my first customers and when I was reviewing their prior auto coverage, I discovered that mom had NO UM/UIM Bodily Injury coverage! The other four vehicles on the policy had UM/UIM and mom's previous vehicle also had it, but the agent failed to include when she bought her new vehicle in 2009. But the did include $25k in UM/UIM Property Damage on it....crazy if you ask me?!?!

All of their vehicles didn't have matching Liability Limits for Bodily Injury either- two only had 50/100 and the other three were 100/300. But they all had $50k in MedPay which cost a pretty penny!

Back to the original subject, mom ended up requiring a two-level cervical spine fusion almost 18 months after the accident. That was following intense physical therapy, countless spinal epidurals and being in constant pain. The surgery kept her out of work for almost five months. So the at-fault driver's Bodily Injury Liability limit was maxed out after the surgical expenses.

Her attorney wanted to pursue mom's UM/UIM coverage for an additional $50k. When she explained that her vehicle didn't have UM/UIM coverage, he moved on to the UM/UIM on my policy. My insurer settled for $38k, so she was compensated, which is the most important thing.

But it really ticks me off that her old agent screwed up and didn't include UM/UIM as she should have! I'm also not thrilled that I have a now have a $38k claim on my previously spotless CLUE Report- even though most/all standard insurers wouldn't surcharge me because of it. It's just a principal issue that it's on there....

So I'm trying to figure out if my insurer could recover some/all of their $38K from mom's $50k Med Pay coverage via subrogation? I'm no longer insured with that company, but they are one of the six companies that I represent. But more than anything, I will never pass up an opportunity to mess with a certain insurance company that was both the at-fault driver's and mom's insurer at the time of the accident. I won't say any names, but if they're like a good neighbor, I'd hate to meet a bad one!!!

You really need to talk to an adjuster. med pay is usually a first-party payment so your mother could get it, but I don't believe the insurance company can subrogate against it. NC makes it so that doesn't happen, GA is probably different. I don't think you're going to get the answer you are looking for here. The claim is already filed, might as well as these questions for it.

 

[VolAgent]

I'm surprised the attorney hasn't looked at the agent and his E&O. It is very interesting that the coverages are all over the place. In TN you have to explicitly waive UM/UIM, no idea what it is in GA.

 

[jmr30183]

You really need to talk to an adjuster. med pay is usually a first-party payment so your mother could get it, but I don't believe the insurance company can subrogate against it. NC makes it so that doesn't happen, GA is probably different. I don't think you're going to get the answer you are looking for here. The claim is already filed, might as well as these questions for it.

I wasn't expecting to get a definite answer here. My main reason for posting was really to discuss whether MedPay covers an insured when they are driving a non-owned vehicle. To be honest, MedPay is probably the type of coverage that I know the least about. Whether they can subrogate against MedPay to recoup UM/UIM is definitely a question I'll let their attorneys figure out!

Actually, another question just occured to me. Even if mom did have UM/UIM coverage on her policy, would her UM/UIM or my UM/UIM be primary (pay first) since she was driving my car???
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I'm surprised the attorney hasn't looked at the agent and his E&O. It is very interesting that the coverages are all over the place. In TN you have to explicitly waive UM/UIM, no idea what it is in GA.

We have two types of UM/UIM coverage in Georgia- "Reduced By" which is reduced by any amounts received from the at-fault driver's insurer OR "Added On" which will pay up to the max limits selected, in addition to any payments from the at-fault's insurer. The third option is to reject UM/UIM coverage entirely.

The state requires that we we have one completed and signed by the insured for every auto policy we issue. If the insured chooses the "Reduced By" option or Declines UM coveage altogether, we are required to send a fax or scan of the form to the issuing company within 10 days. If we fail to send it, they automatically change it to the "Added On" coverage back to the date of issue.

It takes more time to explain that form to most customers than all of the other policy documents and coverages combined! To be honest, most agents (myself included) put the little "Sign Here" tab on the "Added On" coverage and tell them to sign.

 

[NCAgent]

I wasn't expecting to get a definite answer here. My main reason for posting was really to discuss whether MedPay covers an insured when they are driving a non-owned vehicle. To be honest, MedPay is probably the type of coverage that I know the least about. Whether they can subrogate against MedPay to recoup UM/UIM is definitely a question I'll let their attorneys figure out!

Actually, another question just occured to me. Even if mom did have UM/UIM coverage on her policy, would her UM/UIM or my UM/UIM be primary (pay first) since she was driving my car???
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We have two types of UM/UIM coverage in Georgia- "Reduced By" which is reduced by any amounts received from the at-fault driver's insurer OR "Added On" which will pay up to the max limits selected, in addition to any payments from the at-fault's insurer. The third option is to reject UM/UIM coverage entirely.

The state requires that we we have one completed and signed by the insured for every auto policy we issue. If the insured chooses the "Reduced By" option or Declines UM coveage altogether, we are required to send a fax or scan of the form to the issuing company within 10 days. If we fail to send it, they automatically change it to the "Added On" coverage back to the date of issue.

It takes more time to explain that form to most customers than all of the other policy documents and coverages combined! To be honest, most agents (myself included) put the little "Sign Here" tab on the "Added On" coverage and tell them to sign.

Typically the insurance follows the car, meaning your insurance would be first and then her insurance would be in excess, assuming a true ISO form and no state law altering this fact.

Going with that same assumption, medical payments follows the named insured and covers them "occupying" a car, which is usually defined as in, upon, getting in, out, on, or off. She was "in" so she should be okay as long as she was "named" in her own policy in a "covered vehicle" which is sounds like she was since part of the definition means a vehicle designed for public use. There are exceptions depending on what she was doing when she got hurt (public livery and conveyance comes to mind, meaning transporting goods or people for a fee other than a carpool with shared costs), AND the state laws supersede anything in an auto policy.

Also, don't most companies require similar liability limits for all cars on the auto policy? none of my companies let me change those limits, even in GA. Were there more than one auto policy?

Sounds like you might want to talk to someone more knowledgeable in the state of GA, my friend. Something doesn't sound right with all the information provided, so I can't say for certain what happened.

Also, in GA you can get UM/UIM added on, or reduced. Added on, from what I understand, means you can use your UIM coverage above what the other person has, though I haven't read the policy forms on it since I do so little in GA. Which one did you and your mom have?

EDIT: looks like I was typing as you were typing with the UM/UIM coverage...