MedPay coverage in Louisiana is the coverage on your automobile liability insurance policy that will pay for the cost of medical treatment, regardless of fault, up to a fixed dollar amount.
There is no requirement under Louisiana law that you have MedPay insurance. It is an extra charge, but the amount of coverage you get will be determined by your carrier and how much you want to pay for premium. It could be anywhere from $1,000 to $10,000, and we have even seen it at upwards of $50,000.
MedPay coverage could be helpful after an accident if you do not have health insurance. In Louisiana, there is no obligation for the party at fault to call their doctor, set up an appointment, and agree to pay their medical bills for the treatment. MedPay can take the place of health insurance, or it can cover your co-pays and deductibles.
There are a few ways you can address medical treatment in the absence of MedPay coverage. It could be covered by your own health insurance, Medicaid, or Medicare, which are entitled to be reimbursed at the conclusion of a claim against at-fault party—a process known as subrogation.
Thus, if someone is hurt in an automobile accident and they have Blue Cross Blue Shield insurance which pays for the emergency room and the ambulance ride, the injured party could make a claim against the at-fault party and its insurance company. Out of the settlement, Blue Cross Blue Shield would be paid back.
Sometimes an individual suffers a serious injury, and requires extensive medical treatment, but they have no health insurance or MedPay. Our personal injury attorneys could represent them on a contingency fee basis where we get paid out of the recovery, as per the Louisiana Code of Professional Responsibility.
As mentioned above, there is a nuance with MedPay coverage that is not well-known: just like how Blue Cross or Medicare pays for benefits, if MedPay coverage pays for medical treatments in at-fault accident, there will be a right of subrogation by the carrier to get back the money they paid on behalf of the injured person. However, if the at-fault party has limited insurance coverage and the injured party recovers the policy limits, there is no right of subrogation for the MedPay carrier.
In that instance, the subrogation is waived and the MedPay coverage is considered excess coverage, even though the cost of medical bills may have been part of the damage claim against the at-fault party.
MedPay coverage is a no-fault concept. You may be in an accident where you are 100% at fault, 50% at fault, or 0% at fault, and your medical treatment can be covered with MedPay, regardless.
If you get into an accident while working on the job, particularly an automobile accident, you should be covered by worker’s compensation, which pays for 100% of the medical bills. In that case, you would not even need MedPay. However, if you were not on the job (or the job does not have workers’ compensation) and you do not have health insurance, MedPay may be an economic way to cover the cost of recovering from an injury.
Under Louisiana law, if someone is in an accident that is somebody else’s fault, they must prove that they also had insurance coverage. If they do not have insurance coverage, there is a rule called “no-pay, no play,” which means that even if they hold no degree of fault for the crash, there will be a deductible of $100,000 for any personal injury claim.
When an injured person hires us, that will be one of the first lines of inquiry. Who do they have insurance with? Was the insurance in force and effect? What are the limits of liability on the insurance they have? Do they have MedPay? Do they have uninsured motorist coverage?
In concluding a case for someone who suffered personal injury with MedPay coverage, it is helpful for individuals who have health insurance to reimburse them for out-of-pocket expenses, deductibles, or co-pays. If they do not have insurance to pay their family doctor, the emergency room, ambulance service, chiropractors, physical therapists, surgeons, or pharmacists—any medical expense related to the motor vehicle accident can be paid for with MedPay funds.
Please call Kofler and Hermann now to discuss your avenues for compensation after a serious vehicle collision.
