What Is Medical Payments Coverage?
Medical Payments Coverage, commonly called MedPay, is an optional auto insurance add-on that pays for medical bills resulting from a car accident regardless of who was at fault. It pays promptly—often within weeks of treatment—without waiting for liability to be determined. It is one of the few insurance coverages that never requires you to prove fault to collect.
How MedPay Works in New Mexico
New Mexico does not mandate MedPay as a required coverage, but most standard auto insurance policies offer it as an optional endorsement. Common limits range from $1,000 to $25,000 per person per accident. MedPay in New Mexico typically covers:
- Emergency room and hospital bills from the accident
- Ambulance and emergency transport
- Surgery, follow-up care, and rehabilitation
- Dental injuries directly caused by the collision
- Coverage extends to the policyholder, all vehicle occupants, and the policyholder as a pedestrian
MedPay does not cover lost wages, pain and suffering, or long-term disability—those fall under the liability claim against the at-fault driver.
How It Affects Your Personal Injury Case
MedPay bridges the gap between the accident and the settlement. Liability claims can take months to years to resolve; MedPay gets your bills paid immediately so treatment doesn’t stop due to cost. If you ultimately recover a settlement from the at-fault driver, your insurer may assert a reimbursement claim for the MedPay it paid—though New Mexico’s made-whole principles may limit that claim if your total recovery doesn’t fully compensate you.
Example Scenario
Lucia is rear-ended in Santa Fe and goes to the ER. The at-fault driver’s insurer opens an investigation that will take months. Lucia’s own policy has $10,000 in MedPay. She files the MedPay claim and her ER bills ($7,200) are paid within three weeks. Her PI case against the at-fault driver settles six months later for $85,000. Her insurer seeks reimbursement of the $7,200 from the settlement.
Frequently Asked Questions
Does using MedPay affect my personal injury claim in New Mexico?
No. MedPay is a first-party benefit you paid for through your premiums. Using it does not reduce your claim against the at-fault driver, does not constitute an admission, and is not evidence in the PI case. The at-fault driver’s liability remains fully intact regardless of whether MedPay was used.
Can my insurer take back the MedPay from my settlement in New Mexico?
New Mexico’s made-whole doctrine may limit your insurer’s reimbursement right if your total damages exceed your total recovery. An attorney can negotiate the reimbursement amount, and in cases of significant under-recovery, the insurer may be required to reduce or waive the reimbursement claim.
Have questions about MedPay and your injury claim? Call El Gringo Law at (505) 207-5000 for a free case review.
