Medical payment coverage provides for reimbursement or payment of medically necessary and reasonable medical expenses to the insured. Medical payment coverage may be $1,000.00, $2,000.00, or $5,000.00, or even more depending on the type of coverage purchased by the motorcyclist or insured.
There are two types of Medical Payment Coverage, “Primary” and “Excess.” “Primary” insurance coverage is where the insured can send the medical bills directly to their own insurance company for payment of their own policy of insurance. Again, the insurance companies will only pay for medically necessary and reasonable medical bills. They may not pay for the costs of duplicative X-rays or medical reports.
The second type of Medical Payment Coverage is called “Excess.” This type of medical payment coverage is excess to primary insurance coverage. As such, the medical bills must be sent or submitted to the primary care health insurance for payment. Then, the primary health insurance company may pay part or all of the medical bills. If any of the medical bills are unpaid or rejected, you are required to get an Explanation of Benefits (EOB), showing that the medical bills have been submitted to the primary health insurance company and rejected. You then send the medical bills and the rejection or EOB to your own insurance company for payment under the Excess Medical Payment Coverage.
There is also reimbursement for the payment of medical expenses. Most medical payment coverage seeks reimbursement if there is any recovery from a third party case. This means, if your own insurance company pays $5,000.00 in medical payment coverage for your outstanding medical bills, upon settlement or judgment or award from any third party or driver at fault, you will be required to reimburse your own insurance company for those medical bill payments advanced earlier. As such, this is truly not free money as you have an obligation contractually to reimburse your own insurance company for payment of the medical bills.
Sometimes, a qualified motorcycle attorney can negotiate the reimbursement with your insurance company reducing the reimbursement by thousands of dollars.
California Motorcycle Lawyer