again medpay is not subrgatible but it can be subrogated against.

Message Author
ampm-bookmark
delicious-small Add to delicious
yahoomyweb-small Add to YahooMyWeb
blinklist-small Add to BlinkList
PostPosted: Sat Mar 15, 2008 1:06 pm   Post subject:   

Thanks for that info Dasfuk, we (of course) had no idea...



Quote:
Ouch, that hurt!
well maybe you know how you make others feel just a tiny bit now Mike...but I'm sure that comment was meant sarcastically but a girl can hope can't she...
Quote:
I can't help you on the personal injury stuff or helping you calculate loss of income
I disagree Mike, I think you could (on the proving loss of income) just how would you go about proving (lets say) loss of income if your entire shop were shut down for two weeks....lets take two scenrios, one right after a hail storm (yikes can't believe i even said the 'h' word) and another lets say in the middle of January, no big ice storms just normal mid january MO weather (not like this year!)....what would you come up with to attempt to prove your loss of income? Would no doubt be a daunting task...but think it may prove valueable information (and pertain to the thread)...

Quote:
It sounds like the person or persons who were trained as expert negotiators resorted to taking the low road along with him.
I whole heartedly agree, and think most would...course all we have to go on is Johnny's take on the conversation...but certainly agree from his discription, you bet cha!



Quote:
My attorney has informed me that he carries 200,000 in med pay so that if he can not work, he can pay his staff and cover medical treatments so as to not use his health and accident coverage who might place a lein on a personal injury settlement subrogated against the other insurer


You are correct in that medpay is not subrogatable in our state however you are incorrect in that he can pay his staff etc..with the medpay, (well i guess he can but then he's not paying his medical bills) medpay in our state covers ONLY medical/funeral bills/ treatment...NOT loss of wage etc...From the MO-A-20.5-A policy:
Quote:
We will pay the reasonable charges for necessary good and services for treatment of bodily injury sustaind by an insured, if such bodily injury directly results from an accident that arises out of the use of an auto...(within three years fo the accident date-treatment must be discovered and treatment started, within one year of the accident date).




From the Missouri Dept of Ins website:

Quote:
Medical Payments

Coverage, available in various liability insurance policies, in which the insurer agrees to reimburse the insured and others, without regard to the insured's liability, for medical or funeral expenses as the result of bodily injury or death by accident under specified conditions.


Although medpay is not subrogatible, meaning your carrier going to someone else for repayment...your health carrier CAN subrogate your medpay coverage (if you use your health care) and/or the bodily injury settlement (if there is one) from the third party carrier..If it is a self funded program (which I think most are aren't they?)
Quote:
Only self-funded health benefit plans are allowed to subrogate in Missouri.
Of course we are talking about your basic auto policy, either you misunderstood your attorney (re:paying his staff) or he is not talking about a private auto policy...also our state allows 'double dipping' meaning you can feasible collect on the same medical bill three times...say you have 1k in medical bills from a not at fault accident....Your carrier under medpay (which cannot generate a rate increase incidently), the 'at fault' carrier will also pay you the bill (generally not till the end when you settle it is lumped in with your settlement) and your health carrier...most health carriers now though are quick to file a lein, (subro either medpay/bi carriers, they can't collect it twice but will generally file the lein with both making certain they are reimbursed)...again medpay is not subrgatible but it can be subrogated against...(or lein filed against any medpay payment)..



Quote:
This information is the type that is not afforded to policy holders because agents and insurers would prefer you use the other companies funds and not theirs, and they would not have to spend funds litigating or subrogating for any losses paid to the insured vehicle owner.
Just couldn't get thru that post without some kind of negative remark could you? pity...If the insured has medpay coverage it is in their policy...Mike in our state, it is required when a claim is reported that the adjuster advise the insured of ALL COVERAGES THAT COULD APPLY TO THE LOSS...so there went that crack...right out the window....the adjuster not only does not keep this information from you they can't! and DON'T...



I don't understand how you are going to collect your loss of wages, and your bi settlement with having zero communication with the other carrier?
Quote:
The only time I would have spoke to the at fault insurer would have been to give them my mailing address, fax, or email.
If you have a med pay claim (and another insured party is at fault) then you also have a bi claim..and maybe some loss of wage, but certainly some pain and suffering and the aforementioned medical bills...how you gonna' get that without talking to anyone? Or are you saying that you are just automatically getting an attorney to handle this (let's say) 100 dollar doctor visit?


_________________

"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr.
Lori
Forum Expert
Leave a quick message

Lori
Forum Expert

Joined: 10 Sep 2007
Posts: 8080

Location: Missouri
287.93 Dollars($)

PostPosted: Sat Mar 15, 2008 3:18 pm   Post subject: briefly  

The med pay discussion occurred in the mid nineties. It is possible at that time, one might have been able to use med pay for the loss of income, I don't know, only was advised by the attorney at that time. Court cases change policies and they are revised when possible to close loop holes. I don't doubt that you can no longer collect loss of income.



My point was that, I would rather deal with my own insurance company whom with I maintain excellent coverage so that I won't be in a position to have to negotiate in a panic situation or from a position of disadvantage in knowledge from possibly an adversarial company adjuster.



People do not read their policies and agents are not available oftentimes to discuss options with them. I routinely speak to consumers that do not know they are entitled to use their med pay coverage because they were not advised. People on the other end of a discompassionate 800 line are not always helpful either when taking claims information.



Just as I was able to stack three uninsured motorist coverage policies in the mid nineties to settle a claim with my own insurer, that too has possibly been changed. No one told me about that til I attended a personal injury seminar.





There are states that allow uninsured motorist coverage for property damage where as my state does not. I would suggest that it is important for posters to mention their residence to best know how to help them by parties that reside or work in those specific areas.



I think most all claims should be handled or at the least followed up by letter and if you record conversations, those should be accessible to both parties upon request. We speak about things that make most people's eyes glaze over and their brain shut down. It is imperitive that people communicate in writing to avoid confusion and misrepresentation on either part.



_________________

If you can't find the time to do it right, how will you ever find the time to do it over.
MikeoftheOzarks
Senior member
Leave a quick message



Joined: 10 Feb 2008
Posts: 605

Location: in the missouri ozarks
193.97 Dollars($)

PostPosted: Sat Mar 15, 2008 11:43 pm   Post subject:   

Quote:
The med pay discussion occurred in the mid nineties. It is possible at that time, one might have been able to use med pay for the loss of income, I don't know, only was advised by the attorney at that time. Court cases change policies and they are revised when possible to close loop holes. I don't doubt that you can no longer collect loss of income
All I know is that I went to work in a claims office in 1986 and ever since then you could not get loss of wage under your med pay coverage...(in our state).
Quote:
My point was that, I would rather deal with my own insurance company whom with I maintain excellent coverage so that I won't be in a position to have to negotiate in a panic situation or from a position of disadvantage in knowledge from possibly an adversarial company adjuster
alright then I understand and agree with that..
Quote:
Just as I was able to stack three uninsured motorist coverage policies in the mid nineties to settle a claim with my own insurer, that too has possibly been changed. No one told me about that til I attended a personal injury seminar
Yes, Missouri allows stacking, some states do some don't we do...If you were in an active UM claim and all your policys were with the same company, then the adjuster should've made you aware of this, not to do so would be bad faith.



Quote:
There are states that allow uninsured motorist coverage for property damage where as my state does not.
Well Mike, sorry to tell ya' but again you are wrong/incorrect...first of all they don't ''allow'' it. They sell it, it's called UMPD (uninsured motorist property damage) and Missouri does sell it..(some states do not offer it, again since I have been at this they have offered it) It generally carries a 200 or 250 deductible I can't remember for sure on that..if you want to buy it call you agent..he'd be happy to sell it to you..most people that carry collision coverage do not buy it...because it's the same thing...(well meaning collision coverage also covers physical damage to the insured vehicle caused by an uninsured motorist)...
Quote:
I would suggest that it is important for posters to mention their residence to best know how to help them by parties that reside or work in those specific areas
Absolutely, we ask OP's when it applies....(and it generally does) to please supply their states...
Quote:
I think most all claims should be handled or at the least followed up by letter
saying what?
Quote:
if you record conversations, those should be accessible to both parties upon request
for what?

No way should you give the claimant the insured's state or visa versa.....
Quote:
We speak about things that make most people's eyes glaze over and their brain shut down.
LaughingWink
Quote:
It is imperitive that people communicate in writing to avoid confusion and misrepresentation on either part.
I totally agree! Wow Mike that's like two or three things in one thread that we agree on! WinkRolling Eyes


_________________

"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr.
Lori
Forum Expert
Leave a quick message

Lori
Forum Expert

Joined: 10 Sep 2007
Posts: 8080

Location: Missouri
287.93 Dollars($)

PostPosted: Sun Mar 16, 2008 5:42 am   Post subject:   

I've always recommended my insured's use their PIP or med pay. In Texas, you can have one or the other, which I generally push PIP for the loss of income coverage.



Several times, I've had insured's scared to file a claim on their own policy because they felt it was the other person's fault and they should not have to use their own insurance. Knowing how health insurance companies will generally try to subro against my insured's PIP, I strongly urge my insured to use it before the health carrier does.

MBTexas
Member
Leave a quick message

MBTexas

Joined: 11 Mar 2008
Posts: 93

Location: Magnolia, TX
6.93 Dollars($)

PostPosted: Sun Mar 16, 2008 12:16 pm   Post subject:   

Yes, PIP (in all states I've been exposed to) will pay loss of wage....you are a good agent MB, and I'm certain you (nor any agent or adjuster I know) hides any coverage from your clients...some insured's though have the strong opinion that they, 'by golly didn't do anything wrong and don't want to use their coverage period!' .... and I get that...



_________________

"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr.
Lori
Forum Expert
Leave a quick message

Lori
Forum Expert

Joined: 10 Sep 2007
Posts: 8080

Location: Missouri
287.93 Dollars($)

PostPosted: Sun Mar 16, 2008 4:40 pm   Post subject:   

A couple of questions.



[1] When I'm harmed by another and submit a claim against my policy:



a. Will I need to pay a Deductible?



b. Will my covered losses/damage I be bound (limited) by the terms of my contract of insurance? (rental, loss of use, income, etc.)



c. Since I'm filing a claim, against my insurer what effect will it have on my good standing (no claims in 20+ years) with my insurer?



-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-



[2] When I'm harmed by another and submit a claim against the at fault party:



a. Will I need to pay a Deductible?



b. Will my covered losses/damage I be bound (limited) by the terms of my contract of insurance? (rental, loss of use, income, etc.)



c. Since I'm 'Not' filing a claim against my insurer, what effect will it have on my good standing (no claims in 20+ years) with my insurer?



FK,

FK
Senior member
Leave a quick message

FK

Joined: 10 Feb 2008
Posts: 290

Location: Pa.
41.08 Dollars($)

PostPosted: Sun Mar 16, 2008 6:18 pm   Post subject:   

Quote:
[1] When I'm harmed by another and submit a claim against my policy:



a. Will I need to pay a Deductible?
depends what coverage you are talking about medpay/pip =no you will not...even collision about half the collision claims I'm handling now the claimant carrier has 'fronted' the deductible to the insured, as my company is also fronting to them, if the insured still wishes to use their collision coverage rather than the PD coverage of the other company...



Quote:
b. Will my covered losses/damage I be bound (limited) by the terms of my contract of insurance? (rental, loss of use, income, etc.)
Collision/Comp coverage are typcially ACV coverages so the limit is the value...rental has a limit, if you collect loss of wage yes you have a limit (PIP)...However what you are missing is you can collect med pay AND a BI settlement from the other carrier...not one or the other...but you are intitled to both...



Quote:
c. Since I'm filing a claim, against my insurer what effect will it have on my good standing (no claims in 20+ years) with my insurer?
Most states will not allow a rate increase for not at fault losses, there is a thead here that I can find (for MO) anyway that I posted from the fair claims practices act of this state...you would have to check your state, to see, but it is my understanding that there is no such thing any longer (in other words a claim has to be an 'at fault' loss to generate a rate increase, not losses in general or 'cwp' (closed without payment) losses)..



Why did you post that twice?


_________________

"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr.
Lori
Forum Expert
Leave a quick message

Lori
Forum Expert

Joined: 10 Sep 2007
Posts: 8080

Location: Missouri
287.93 Dollars($)

PostPosted: Mon Mar 17, 2008 4:41 pm   Post subject:   

Quote:
[1] When I'm harmed by another and submit a claim against my policy:



a. Will I need to pay a Deductible?





As stated by Lori, deductibles are dependent on the coverage being used. Uninsured/Underinsured Motorist usually has a set deductible, which is $250 in Texas. If the company successfully subrogates, you are reimbursed the deductible, same with comp/collision.



Quote:
b. Will my covered losses/damage I be bound (limited) by the terms of my contract of insurance? (rental, loss of use, income, etc.)




On your own policy, yes. Rental would only be provided to you, in this case, if you purchased the coverage.



Always purchase rental coverage. I have seen 3rd party claims result in the claimant having to pay for their own rental car and be reimbursed by the carrier once the claim was closed. They were out hundreds of dollars because the carrier did not want to provide them with a car while they worked on closing the claim.



Another situation happened with a customer that was out of state. They had an accident, car was in the shop for a week and they had no transportation. They had strongly refused to purchase rental because they were retired and had 2 cars, therefore having "no need" for rental coverage.



Loss of use/income is provided through PIP, no deductible, up to PIP limits.



You are bound to your contract when using your own policy but generally the experience is much smoother.



Quote:
c. Since I'm filing a claim, against my insurer what effect will it have on my good standing (no claims in 20+ years) with my insurer?




A not-at-fault accident cannot be surcharged. Your carrier will also try and subrogate against the other parties company and be refunded the money they have paid out to you.



Quote:
[2] When I'm harmed by another and submit a claim against the at fault party:



a. Will I need to pay a Deductible?




No. Liability has no deductible, just limits.



Quote:
b. Will my covered losses/damage I be bound (limited) by the terms of my contract of insurance? (rental, loss of use, income, etc.)





No, the other party's liability coverage is to pay these. As I mentioned above, some companies handle it differently but you are to be indemnified for your loss, by the other party's company.



Quote:
c. Since I'm 'Not' filing a claim against my insurer, what effect will it have on my good standing (no claims in 20+ years) with my insurer?




Same as above. If filed and paid on the other party's policy, chances are your company may never even know about the claim.
MBTexas
Member
Leave a quick message

MBTexas

Joined: 11 Mar 2008
Posts: 93

Location: Magnolia, TX
6.93 Dollars($)

PostPosted: Tue Mar 18, 2008 2:54 pm   Post subject:   

Based on your responses to (b) one would think placing a claim against the at-fault party would allow the consumer a more complete recovery.



No betterment deductions,



Full cost of Rental car regardless if one has rental coverage on their own policy,



Diminished Value,



And likely a lot of other financial benefits than I can't imagine. (but likely a Lawyer could)



FK,

FK
Senior member
Leave a quick message

FK

Joined: 10 Feb 2008
Posts: 290

Location: Pa.
41.08 Dollars($)

PostPosted: Wed Mar 19, 2008 10:22 am   Post subject:   

Quote:
No betterment deductions,
Who said no 'betterment'? That isn't the case, no coverage deductible...but a claimant can and is many times charged betterment same as an insured....
Quote:
Full cost of Rental car regardless if one has rental coverage on their own policy,
true
Quote:
Diminished Value,
true, possible anyway unless in a state that prohibits it from third party claims, but I'm unaware of more than one or two that do...(prohibit or only in certain circumstances or criteria)...
Quote:
And likely a lot of other financial benefits than I can't imagine. (but likely a Lawyer could)
probably so!


_________________

"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr.
Lori
Forum Expert
Leave a quick message

Lori
Forum Expert

Joined: 10 Sep 2007
Posts: 8080

Location: Missouri
287.93 Dollars($)

Quick Reply
Your Name
Subject
Message body
All times are GMT
 Previous  1, 2
Page 2 of 2


Get a Quote
Ask Community Experts

flash plugin

Quick Links

Must See

Community

Hot topics in forums

Latest in blogs

AmPmInsure on Facebook



Page loaded in 0.310 seconds.