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JANUARY, 2009
A RECENT SUPREME JUDICIAL COURT (SJC) DECISION HAS DEFINED HOW HEALTH
INSURERS AND AUTOMOBILE INSURERS COORDINATE AND PAY MEDICAL BENEFITS TO VICTIMS
OF AUTOMOBILE COLLISIONS. IN METROPOLITAN PROPERTY & CASUALTY INS. CO. v. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. THE SJC HAS DETERMINED THAT WHEN A PERSON HAS PURCHASED BOTH PERSONAL INJURY PROTECTION (PIP) AND MEDICAL PAYMENTS COVERAGE (MEDPAY), AND ALSO HAS HEALTH INSURANCE COVERAGE, THAT PIP AND MEDPAY COVERAGE ARE PRIMARY FOR PAYING REASONABLE AND NECESSARY MEDICAL BILLS AND ONLY AFTER THOSE COVERAGES ARE EXHAUSTED DO HEALTH BENEFITS APPLY. FOR EXAMPLE, IF A PERSON PURCHASES $8,000 IN PIP AND ADDITIONAL MEDPAY BENEFITS (FROM $5,000 TO $25,000) ON THEIR MASSACHUSETTS AUTOMOBILE POLICY, AND IS THEN INJURED IN AN AUTOMOBILE COLLISION PIP WILL PAY THE FIRST $8,000 IN BENEFITS, MEDPAY WILL THEN PAY ADDITIONAL MEDICAL BILLS OVER THE $8,000 AND THEN, IN THE EVENT MEDPAY IS EXHAUSTED, HEALTH INSURANCE WILL PAY ADDITIONAL BENEFITS COVERED UNDER THAT POLICY. THE DECISION IS IMPORTANT BECAUSE NOW HEALTH INSURANCE BENEFITS ARE PAID OUT AFTER AUTOMOBILE INSURANCE BENEFITS ARE EXHAUSTED. SINCE HEALTH INSURANCE COMPANIES ARE ABLE TO RECOVER ALL BENEFITS THEY PAY OUT TO ACCIDENT VICTIMS, THE LIKELIHOOD OF REIMBURSING THEM AT THE TIME OF SETTLEMENT IS DIMINISHED NOW THAT THEY PAY BENEFITS LAST. IF YOU OR SOMEONE YOU KNOW IS INJURED AS THE RESULT OF AN AUTOMOBILE COLLISION CONTACT ATTORNEY CURTIS AT DON N. WEBER & ASSOCIATES FOR A FREE CONSULTATION. |
