Accidental Medical Expenses Cover In Car Insurance

Updated On: 2023-06-21

Author : Team Policybachat

Medical expenses cover is an optional feature in car insurance. It covers the medical expenses of the driver and passengers in case of an accident. The medical expenses cover is not a compulsory part of car insurance, but it does provide peace of mind for drivers and passengers. The coverage will pay for the medical costs incurred by you, your passengers and other people injured in the accident, up to a certain limit.

In case of an accidental injury caused to the driver or a third party, this cover pays for the ambulance or medical costs. It can include the cost of hiring an ambulance as well as emergency treatment at the hospital.

Medical payments coverage is the part of your car insurance that covers medical expenses to treat injuries to you or your passengers from an accident involving your vehicle, up to your policy limits. It doesn’t matter whether the accident was your fault or not. It also covers you as a pedestrian if you are injured when another vehicle hits you. Coverages do vary by state, so be sure to check with your insurance representative to verify what your policy covers.

What is Medical Expenses Cover?

Medical expenses cover is a type of insurance that helps you to cover the cost of medical expenses incurred by you or your dependents in case of an emergency. It is usually offered as an add-on to your car insurance policy.

If you have a medical expense cover, it will help to offset the cost of expensive medical treatments, such as surgery, which are not covered by your health insurance plan. Medical expenses cover also covers some non-medical costs like dental and optical care.

This coverage helps pay for medical expenses that result from a car accident including:

  • Treatment
  • Rehabilitation
  • Funeral costs
  • Dental care.

Why it is Important to have Medical Expenses Cover in Car Insurance?

Medical expenses cover is an important factor to consider when buying car insurance. In some cases, the medical expenses cover can be a crucial deciding factor on whether or not to buy car insurance.

The medical expenses cover will pay out a set amount of money in the event that you are involved in an accident and need to seek medical treatment. The amount of money paid out will depend on the type of policy you have and the level of coverage that you have chosen.

The cost of your medical expenses cover will vary depending on what type of policy you choose. You can either opt for a fixed amount or a percentage, with the latter being more expensive but offering greater protection in case of injury.

Who Is Covered in Medical Expenses in Car Insurance?

This insurance protection applies to the driver and passengers in a car at the time of the accident. It also helps protect you as a pedestrian. This means it can help pay for medical treatment if:

  • You’re injured as a passenger in a friend's car
  • You or one of your family members injures your passengers in a car accident
  • You’re hit by a car while walking across the street.

What is covered under Medical Expenses Cover in Car Insurance?

If you're involved in a car accident, medical payments coverage can take care of expenses such as:

  • Doctor visits
  • Hospital visits or stays
  • Nursing services and care
  • Ambulance and EMT fees
  • Prosthetic limbs
  • Health insurance deductibles and co-pays
  • Funeral expenses
  • Dental procedures needed as a result of an accident
  • Injuries sustained as a pedestrian or riding a bicycle if a vehicle hits you
  • Surgery, X-rays, and dental procedures.

What is not covered under this Medical Expenses Cover in Car Insurance?

1. Where the Own Damage Claim made by you against us under the Motor Insurance Policy is not payable

2. Accidental Bodily Injury that you/your family members met with:

  1. Through suicide, attempted suicide or self-inflicted injury or illness
  2. While under the influence of liquor or drugs
  3. Arising or resulting from you/your family members committing any breach of law with criminal intent
  4. Whilst participating as the driver, co-driver or passenger of a motor vehicle during motor racing or trial runs
  5. As a result of any curative treatments or interventions that you/your family members (named in the Policy Schedule) carry out or have carried out on your body
  6. Arising out of participation in any naval, military or air force operations whether in the form of military exercises or war games or actual engagement with the enemy, whether foreign or domestic.

3. Consequential losses of any kind, be they by way of loss of profit, loss of opportunity, loss of gain, business interruption, market loss or otherwise, or any claims arising out of loss of a pure financial nature such as loss of goodwill or any legal liability of any kind whatsoever

4. Any injury/disablement/death directly or indirectly arising out of or contributed to any pre-existing condition

5. HIV (Human Immunodeficiency Virus) and/or any HIV related illness including AIDS (Acquired Immune Deficiency Syndrome) and/or mutant derivatives or variations thereof however caused

6. Pregnancy, resulting childbirth, miscarriage, abortion, or complications arising out of any of these

7. War (whether declared or not), civil war, invasion, act of foreign enemies, rebellion, revolution, insurrection, mutiny, military or usurped power, seizure, capture, arrest, restraint or detainment, confiscation or nationalization or requisition of or damage by or under the order of any government or public local authority

8. Nuclear energy, radiation

NOT to do after an Accident:
  • Move any injured persons.
  • Apologize for the accident.
  • Tell any party how much insurance you carry.
  • Accept any money. If you do, you damages your right to file a claim.
  • Agree to forget about the accident. Later on, the other person may file a lawsuit against you.

How Medical Payments Coverage Works?

Medical expenses in car insurance provides coverage for you and other passengers in your vehicle and can help pay some or all of your medical expenses in the event of an accident. The key is that this coverage kicks in regardless of who was at fault in the accident.

It can also cover your medical bills if you're hit by a vehicle as a pedestrian. The types of medical expenses your Medical expenses covers may include:

  • Deductibles and copays for your health insurance plan
  • Doctor and hospital visits
  • Ambulance and emergency fees
  • Medical treatments, procedures and surgeries
  • Prostheses
  • Dental procedures
  • Extended hospitalization or nursing services
  • Funeral costs.

How Medical Bills are paid after a Car Accident?

When you buy auto insurance consider what actually happens when you're in a car crash and need to use it. Here are the basic steps of what you need to know when you're injured or you injure someone else in an auto accident.

  • If it is my fault: If you cause an accident you are financially responsible for the victims' medical and repair bills. Do not admit fault in the accident because your insurance company will do an investigation on your behalf and determine fault and claims settlement. You are required by law to buy minimum limits of liability coverage that will help pay for the victims damages. That's why it is so important to weigh the potential exposure to your personal net worth when you are deciding how much liability coverage to buy.
  • If I am injured by a driver who doesn't have insurance or doesn't have enough insurance to cover my damages: The person who caused the accident is financially responsible for medical and repair bills, but if someone doesn't have insurance it may be difficult to recover any damages. Uninsured/underinsured motorists coverage acts like a liability policy from your own insurance company to help pay for your damages when you are hit by an uninsured or underinsured driver.
  • Medical Payments Coverage pays for you and your passenger’s medical bills no matter who causes the accident. Things to consider:
    • May cover health insurance co-payments and deductibles.
    • May cover treatments excluded by health insurance.
    • Convenience of having your own auto insurance company pay medical bills while you work out a final settlement with an at-fault driver.
    • If you don't have health insurance Medical Payment Coverage can pay for your medical bills even when you cause the accident.

What is the Claim Process of Medical Expenses Cover in Car Insurance?

1) Making a Claim:

If you/your family members (named in the Policy Schedule) met with any Accidental Bodily Injury that may result in a claim, then as a condition precedent to our liability:

  • You or someone claiming on behalf must inform us in writing immediately and in any event within 30 days
  • You must immediately consult a Doctor and follow the advice and treatment that he recommends
  • You must take reasonable steps to mitigate the consequence of Bodily injury
  • You must have yourself examined by our medical advisors if we ask for this
  • You or someone claiming on behalf must promptly give us documentation and other information. We ask for to verify the claim or our obligation to make payment for it
  • In the event of You/Your family members (named in the Policy Schedule) death, someone claiming on deceased’s behalf must inform us in writing immediately and send Us a copy of the post- mortem report within 30 days Note.
2) Claim Settlement:
  • You agree that we need only make payment when you or someone claiming on behalf has provided a claim to our satisfaction
  • We will make payment to you or to Your Nominee. If there is no Nominee, We will pay to your legal heir, executor or validly appointed legal representative as per succession certificate and any payment we make in this way will be a complete and final discharge of our liability to make payment

Does Car Insurance Cover Medical Expenses & Bills?

Yes, your car insurance will help cover your medical bills up to your policy’s maximums, but the extent depends on the type and amount of coverage you have. There are two types of auto coverage: liability only and full coverage. Each has different stipulations for coverage and may require different policy minimums and unique medical coverages.

What are the limits of medical payments coverage?

  • Your Medical expenses coverage limit is the maximum amount your insurer will pay per person per accident for a covered loss.
  • These limits often get discussed when first enrolling, and multiple options are typically available.
  • Selecting the right limit is important because any amount owed for medical bills over the coverage limit will be your responsibility to pay.
  • When choosing your coverage limit, consider the other health insurance plans you currently have.
  • Many health insurance providers typically require you to pay a deductible or co-insurance payment up to 20% for emergency care.
  • If you select medical payments coverage with a higher limit than your health insurance deductible, it can help cover your deductible and any remaining medical costs.

Top Companies That Offer Medical Expenses in Car Insurance Policy:

Companies Plan IDV Additional Covers & Discounts Premiums
TATA AIG 1 year comprehensive 1.62 lakh NCB Discount 4793 View Plans
National 1 year comprehensive 1.84 lakh NCB Discount 4267 View Plans
Royal Sundaram 1 year comprehensive 2.26 lakh 24x7 roadside assistance,  NCB Discount 5342 View Plans
HDFC ERGO 1 year comprehensive 2.40 lakh 24x7 Roadside Assistance,           Key replacement 5989 View Plans
Bajaj Allianz 1 year comprehensive 2.96 lakh 24x7 Roadside Assistance, Key replacement, NCB Discount, Commercial Discount 6234 View Plans

Conclusion: Medical expenses coverage can come in handy in the event that you're in a car accident and you or someone else in your vehicle sustains an injury. Even though it's optional in most of the states where it's available, it can be highly valuable in helping you pay for costly medical bills. This is especially true if you have a high-deductible health plan.

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