MedPay Coverage in South Carolina

By: Attorney Wil Alexander
MedPay (Medical Payments Coverage) is no fault insurance coverage. This means it can be used by an individual to cover medical bills no matter who is at fault in the car accident. (whether or not you caused the accident). MedPay coverage is generally paid out quickly by your insurance company, helping to cover some of the first medical bills you encounter after your personal injury.

MedPay coverage covers an individual up to the amount of coverage purchased (this amount is generally between $1,000 and $5,000). In South Carolina, MedPay coverage is not mandatory therefore you only have MedPay coverage if you choose to. Not everyone chooses to have MedPay coverage in their car insurance policy, so it is not available to all individuals who are injured in car accidents.  If an individual was not at fault in the car wreck, MedPay coverage will cover medical bills in addition to what the at-fault drivers’ insurance company pays out.

Sometimes individuals are confused as to why their insurance company (the company they have purchased insurance from) is the first to pay out money for their injuries in a car wreck if they are not at fault. This is typically because the individual has MedPay coverage. Generally, your personal injury lawyer will help you navigate through MedPay coverage. Importantly, your lawyer will not take a percentage of MedPay as part of their contingency fee.

So how does med pay work in reality? Many times it is helpful to think of insurance coverage in a simple example scenario.  

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Let’s say you are unfortunately involved in a car wreck and are injured due to the wreck. You are treated at the local emergency room and visit your primary care physician right after your accident. When you purchased car insurance you chose to have MedPay coverage of $5,000. Shortly after the accident you hire an attorney to represent you in your personal injury claim. While continuing to be treated through physical therapy for your injuries, your lawyer receives the bills for your EMT, emergency room visit and tests, and your primary care physician. These bills are in excess of $7,000 and your lawyer submits the bills to your car insurance provider.

Your insurance provider remits payment (writes a check) which is placed in your lawyers’ trust account. Your lawyer writes you a check for $5,000 (the total amount of MedPay coverage you had) for some of the EMT, emergency room, and primary care physician bills you have already received. MedPay helps to cover a portion of the medical bills you have already been billed while you continue to get treated for your injuries and your lawyer works to negotiate your claim with the at-fault insurance company. Your MedPay coverage is in addition to whay you may receive from the at-fault insurance carrier*.

*Please understand this is a simple, straightforward example and you should always consult a lawyer for your own car accident injury claim. While in the example above the application of MedPay coverage is seemingly straightforward, there are many facts and circumstances to consider. (and real life scenarios are much more complex)  It is important to talk with a lawyer about your car accident situation to help navigate this MedPay application as well as other insurance coverage in your personal injury claim.