Fall River Personal Injury Law Digest: Mass. PIP and MedPay Part I

Insurance

Who pays for what after a Massachusetts auto accident? As a Massachusetts car accident lawyer, this is a frequent question.  In this Part 1 of our two part blog series, we examine the proper payment of medical expenses after a Mass. auto accident as explained by the Supreme Judicial Court of Massachusetts in Golchin v Liberty Mutual Insurance Co., 950 N.E. 2d 853 (Mass. 2011).  There, the Court examined the interplay between statutory auto personal injury protection (“PIP”) benefits, optional auto medical expense coverage (MedPay), and private health insurance.

new bedford car accident lawyerThis is how it works:

A standard Massachusetts auto insurance policy includes $8,000 in PIP coverage. When a person is injured in a MA car accident, the PIP auto carriers pays the first $2,000 in medical expenses of that $8,000. In Golchin, the Court examined the priority of payment after that first $2,000.00.

At this point, an injured person with private health insurance might think that they would still be eligible for payment of the MedPay insurance they elected to pay for, but they probably would not. The Court clarified that under a Massachusetts standard auto insurance policy, all $8,000 of the PIP benefit must be paid out before MedPay benefits kick in and can be paid.

But if only $2,000 of PIP will ever be paid for a truck accident injury victim with health insurance, the remaining $6,000 of the $8,000 in PIP will never be paid. And if the full $8,000 in PIP is never paid, then the MedPay benefits will not kick in and they will not be paid.

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Does this mean that those with health insurance should avoid MedPay? Probably not, if a person’s health insurance refuses payment for any reason. We further examine Golchin in our next blog.