With a high incidence of motor vehicle accidents in Colorado, having a reliable financial cushion beyond your standard auto insurance policy to cover unexpected medical bills is vital. This is what Med Pay is for. Medical Payments insurance is a form of car insurance that provides for medical expenses arising from motor vehicle accidents regardless of who is at fault. 

Unlike in some states where similar benefits are included under personal injury protection (PIP) laws, Colorado requires drivers to get additional protection in the form of Med Pay, which bridges the gap between health insurance and out-of-pocket costs. (Note: Med Pay requirement is mandatory by default. Although you are allowed to waive it, doing so may significantly impact the financial consequences of an accident. Therefore, a waiver is generally not recommended.) 

What is Med Pay?

When an accident occurs, determining who is really responsible for the crash may take time. Insurance adjusters and any attorneys involved have to go through police reports, witness statements, and other available evidence to establish this single fact. During this time, medical bills pile up, and immediate financial support becomes necessary, especially if the injured victim is unable to go to work.

Med Pay covers these expenses without the bureaucratic red tape and lengthy investigations tied to determining who caused the accident. It operates on a “no-fault” basis, so you do not need to wait for an investigation or settlement to receive benefits. If you have Med Pay, your injury-related treatment costs will be paid for immediately by your insurance company – even if it is later determined that you were at fault. 

Med Pay Coverage for Healthcare Services After a Motor Vehicle Accident

  • Ambulance fees
  • Emergency room visits
  • Hospital stays
  • Surgeries
  • Intensive care treatments
  • Visits to primary care physicians and specialists
  • Follow-up appointments
  • X-rays, MRIs, CT scans, and other imaging services
  • Laboratory tests and diagnostics
  • Physical therapy, occupational therapy, speech therapy
  • Prescription medications
  • Mobility and prosthetic devices (crutches, braces, wheelchairs)
  • Emergency dental treatments
  • Funeral and burial expenses (in case of a fatal accident)

The Medical Payments coverage protects the policyholder, passengers in the policyholder’s vehicle, and any pedestrians struck by the car.

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How Does Med Pay Work in Colorado?

As per the reforms made to the state’s auto insurance system on January 1, 2009, Med Pay is a required, mandatory coverage. Insurance companies must automatically include at least $5,000 in Medical Payments in every auto insurance policy they issue or renew. However, drivers have the option to waive it. If a policyholder decides they do not want or need Med Pay, they can opt-out, but they need to do so in writing.

When you select Med Pay as part of your auto insurance, the amount you choose represents the maximum limit that your insurance will cover per person for medical expenses resulting from an accident. You get to decide how much coverage you feel is needed based on your existing health coverage and what you need to protect yourself and your passengers better. If you already have health insurance, Med Pay will still cover the deductibles and copays that might not be included under your plan or may be exceptionally high for some treatments. 

Stacking Med Pay is Allowed in Colorado

Review the terms of your insurance policy to see if it explicitly allows for the stacking of Med Pay benefits. Stacking means you can increase your plan limits by combining the Med Pay from multiple vehicles under your policy. For example, if you have two cars, each with a Med Pay limit of $5,000, you could combine both these limits and get up to $10,000 in Med Pay after an accident.

What Med Pay Will Not Cover in Colorado

Med Pay does not include any provisions for:

  • Pain and suffering
  • Lost income (if your injuries prevent you from working)
  • Property damage
  • Long-term rehabilitation or long-term nursing care
  • Home modifications (e.g., wheelchair ramps)
  • Legal costs
  • Survivor’s loss

Are You Required to Reimburse Your Med Pay Insurance Provider if You Settle Your Claim with the Other Party?

No, you are not required to reimburse your Med Pay insurance company if you settle with the at-fault motorist in Colorado. This aspect sets Med Pay insurance apart from other types of insurance.

Most insurance policies include a right to reimbursement. This means that if another driver injures you, and you use your insurance for medical costs, and then you settle or win a lawsuit against the at-fault driver, your insurance company can claim a portion of that recovery.

Example Scenario 1: John incurs $20,000 in medical bills after being injured by Sarah in a car accident. His medical insurance covers these costs. Later, John settles a lawsuit with Sarah for $50,000. His medical insurance company can then claim $20,000 from his settlement.

However, Med Pay insurance does not allow for such reimbursement. When you receive compensation from an at-fault driver, you get to keep the entire amount.

Example Scenario 2: John uses his Med Pay coverage to pay for $20,000 in medical costs. He later settles his car accident claim with Sarah for $50,000. His Med Pay insurance provider cannot reclaim the $20,000 it paid.

How do you file a medical payments claim in Colorado?

Step 1: Organize Your Documents

Before you start the claim process, compile the following information in one place:

  • Your car insurance policy number
  • The date, time, location, and description of the accident
  • Bills, treatment records, and other documents from healthcare providers
  • Police report (if available, this will support your claim)
  • Contact information of the other driver involved passengers, as well as any witnesses.

Step 2: Consult a Personal Injury Lawyer

Hiring an attorney is not legally mandatory, but if you have sustained significant injuries or the question of “who is liable” seems complex in your situation, they can help. A car accident lawyer with a thorough knowledge of Colorado’s insurance laws will guide you on how to proceed and protect your rights.

Step 3: Contact Your Insurance Company

If your insurance company offers an online notification option to report accidents, it is recommended to do so within 24 hours of being injured. You should call their customer service or claims department within a week. Still, it should be done under the guidance of your lawyer because they can ensure your conversation is documented properly.

Remember, most insurance providers record calls and your statements can be used to process your claim. An experienced car accident attorney will advise you on what information to include and what to withhold to protect your interests. Your goal here is to be unambiguous and reduce the risk of disputes over the facts later on.

At Fuller Personal Injury Law, we give our clients the following tips to frame the narrative in their favor:

  • Never say anything that could be considered an admission of fault or partial fault. Statements like “I think I might have…” or “It was partially my fault because…” may be used against you. Even saying, “I am so sorry this happened,” could be construed as an admission of guilt.
  • Avoid any discussions about your injuries. Avoid saying, “I am feeling okay” or “It is not that bad,” as these may be used to undervalue your claim. Even if you feel unscathed initially, some injuries manifest later. Do not provide a definitive statement about your condition without consulting your doctor and a personal injury lawyer.

Step 4: Complete Claim Forms

A claims adjuster will be assigned to your case at this point. They will send you forms to fill out and ask for:

  • Invoices from hospitals, doctors, and specialists
  • Doctor’s notes, diagnostic reports, and other documentation of treatments received
  • Proof of payments you have made from your pocket
  • Police report (if you have it)

Your attorney will handle this part, but do not forget to keep a copy of all documents for your records before sending them to the adjuster.

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Step 5: Keep Communications Open

Contact the adjuster to confirm they have received everything you sent; ask for written confirmation, if possible. Sometimes, they ask for additional information, like:

  • Referral letters to specialists from your primary care physician
  • Bank statements showing payments made to healthcare providers if receipts are not available
  • A signed consent form authorizing your insurance company to obtain your medical records directly from the hospital

Choose Fuller Personal Injury Law to Maximize Your Med Pay Claim in Colorado

Medical Payments is an affordable supplemental coverage that provides a safety net in many situations:

  • If you get injured in a car accident, even if you were responsible for it
  • If your passengers are injured
  • If you or a family member are hit by a car while walking
  • If you are hit by a vehicle while riding your bicycle
  • If you are injured while riding in a rideshare vehicle (e.g., Uber or Lyft)

However, it does not guarantee that you will be rightfully compensated for your post-crash medical damages, considering insurance adjusters do not always have your best interests in mind. Also, Med Pay does not pay for damaged property, lost earning potential, and any long-term care you may need because of the debilitating injury (or the disability caused by it).

At Fuller Personal Injury Law, we will handle the Med Pay claims process on your behalf and go one step further to explore all possible avenues for maximum financial recovery. If Med Pay or your health insurance will not fully compensate for all the damages you have incurred, we may be able to file a personal injury lawsuit against the individual(s) responsible for covering the remainder of your losses or a third-party claim against their insurance company to recover financial compensation. Call us at (720)-770-3832 or get in touch online to schedule a free case evaluation today.