Medical Payments: Requirements for Virginia Car Insurance Companies | Shapiro, Washburn & Sharp

Anyone who has suffered a serious injury in a car accident knows that recovering financially can be as painful as, and often take longer than, recovering physically. Getting an insurance company to pay for medical expenses and offset lost wages is essential to helping accident victims return to their normal lives.



Virginia (VA) law, in Sec. 38.2-2201, lays out the requirements for automobile insurance companies to provide an option called medical payments coverage–“med pay,” as lawyers call it–which obligates the company pay medical expenses following traffic accidents. Any automobile insurer doing business in Virginia must make this kind of policy available for purchase with any other type of car insurance.

Here is a plain-language breakdown of the provisions of that section of the Virginia Code:

  • Every company that sells an automobile insurance policy must offer coverage for injuries requiring medical treatment. The coverage must extend to the driver and any passengers in a covered car, as well as to any person in another vehicle injured in an accident involving¬† covered car. Any pedestrian injuries related to an accident involving a covered vehicle will also be recoverable under medical payments coverage.
  • The minimum cash value for medical payments coverage through this part of the automobile insurance policy is $2,000. Drivers can request higher amounts of this coverage.
  • Drivers do not have to purchase medical payments coverage as part of their car insurance policies.
  • An insurance company that has issued a medical payments coverage policy is liable for paying medical expenses up to the coverage limit for any “medical, chiropractic, hospital, dental, surgical, ambulance, prosthetic and rehabilitation services, and funeral expenses.”
  • Claims for medical expenses can be filed with an insurance company within three years of the accident for any accident-related medical expense incurred.
  • Payments from the insurance company must be made to the party who bore the expense of required medical treatments. This can be the injured person if he or she paid out of pocket for care, a private health insurance plan, Medicaid or Medicare.
  • The med pay insurer must pay “usual and customary fees” for treatments if there is a question about the amount of the charges for medical treatments.
  • Income lost due to car accident-related injuries may be recoverable under automobile insurance medical coverage. Temporarily disabled accident victims can collect up to $100 a week from the insurance company for up to one year following the accident.
  • People injured in a car accident do not need to notify an insurance company of their injuries immediately in order to collect on medical payments claims.
  • If a driver has medical coverage under more than one automobile insurance policy, claims for treatments for car accident-related injuries can be filed against each policy. This provision of Sec. 38.2-2201 applies only to drivers of personal-use vehicles (i.e., no company cars or trucks) and to policies that cover four or fewer vehicles.

So that is what Virginia law requires automobile insurance companies to offer for additional med pay coverage, regardless of fault in an accident. Of course, insurers will not often be eager to pay out claims for medical claims. They are often slow and difficult about honoring these claims.

An important thing to recognize about medical coverage provisions in automobile insurance policies is that the coverage extends to the policy holder at all times. Even if the person is riding in someone else’s car when he or she gets injured, the policy holder can file a claim with his or her insurer. Also, even if a driver gets injured when only driving his or her car–that is, has a single-car accident–the insurance company must pay medical expense under a valid policy.

Med pay covers bills that are also to be paid on by the liability policy of a driver in another car who has caused a wreck. In that case, the at-fault driver’s insurer still has to pay the full amount the at-fault driver’s bills, and the company does not pay less because the injured person who was not at fault had his or her own medical payments coverage.

This broad liability often makes insurance companies reluctant to encourage drivers to purchase medical coverage. Insurance companies may “undersell” medical coverage because the coverage is optional under Virginia law. Still, it is wise for any driver to insist on having this coverage. It is also a good deal for the consumer.

The best way to ensure insurance companies meet their legal responsibilities to cover medical expenses resulting from car accidents is to hire a lawyer with experience in holding insurance companies accountable. My colleagues and I have that experience, and we normally will not charge doing med pay claims as part of a car accident injury case. Holding insurance companies to their legal and contractual obligations is crucial when it comes to reimbursing traffic accident victims’ medical expenses and lost wages.