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Medical Payment Benefits

Medical Payment Benefits

Colorado automobile laws were modified from a "No Fault" state to a "Tort" state in 2003, which eliminated coverages under automobile insurance policies for losses such as medical/rehabilitation expenses, wage losses, essential services, etc.  While these types of damages are ultimately the responsibility of the at-fault driver and/or their insurance carrier, it is important to understand that the mandatory bodily injury limits all drivers in Colorado must maintain ($25,000) are often insufficient to cover all the damages related to injuries sustained in a collision. (See Uninsured and Underinsured Motorists [UM/UIM] section for importance of obtaining good UM/UIM coverage for yourself and your passengers before you are in need of it). 

Under the "Tort" system, the insurance carriers for the at-fault party will NOT pay your medical expenses directly to your medical providers or to you as you receive medical care.  They will consider the medical expenses as a damage to be resolved at the end of the claim - after settlement negotiations are concluded or an award is made at trial/arbitration.  In the meantime, the injured person faces tough financial concerns - such as how to obtain access to medical care or how to pay for their ongoing medical expenses. 

Under Colorado law, consumers can purchase Medical Payment coverages ("MedPay") under the terms of their personal auto policy up to specific dollar amounts.  MedPay is an OPTIONAL but HIGHLY RECOMMENDED coverage. Colorado law requires MedPay to be utilized first to pay for medical expenses.  MedPay coverages DO NOT have subrogation claims/rights of reimbursement as opposed to health insurance policies (which generally DO require that benefits paid for collision-related medical expenses by repaid from proceeds at the time the claim is resolved).  Therefore, it behooves consumers to purchase MedPay (which is relatively inexpensive) as those monies will not need to be repaid.  Even if you have health insurance, you should strongly consider purchasing MedPay coverage (as it is less expensive, has no deductible or subrogation provisions).  It should be noted, however, that some insurance companies limit the scope and duration of MedPay coverages so be sure to check out the specifics of the MedPay coverages with your company.

Wage losses and essential service coverages (such as household chore assistance, etc.) are no longer available under automobile policies - though they are still considered to be a damage in terms of the overall value of your personal injury claim against the negligent party.  It is possible that some disability insurance policies will provide some level of benefits if you are unable to work as a result of your injuries (although these insurers will likely have a subrogation claim/right of reimbursement from any resolution of your claim). 

If an injured person does not have access to MedPay or health insurance, it can be extremely difficult to obtain medical care for collision related injuries. There are medical providers in the community who are willing to treat injured persons without access to such coverages on a "lien" basis (meaning that they will wait for payment until the claim has been resolved).  Additionally, there are companies that allow you to receive medical care with an agreement that they will be repaid once the claim has been resolved.  However, receiving treatment under a "lien" can be more expensive overall.  Therefore, it behooves you to utilize MedPay and/or health insurance coverage, if available.  

Payment of medical expenses is a complicated issue. Contact the legal team at Travis Legal Offices, LLC. for assistance in evaluating the specifics of your claim to determine how this should be best handled. 

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Travis Legal Offices, LLC is committed to answering your questions about vehicle collisions, uninsured & underinsured motorists claims, wrongful death claims and insurance bad faith claims in Colorado.

We offer a free consultation and we will gladly discuss your case with you at your convenience. Contact us today to schedule an appointment.