She Bought $25,000 of Crash Medical Coverage and Collected Nothing. Her Health Plan Paid First.

If you carry health insurance and you’re also paying for Medical Payments coverage on your car policy, go look at what that second line actually buys you.

A Massachusetts appeals court ruled on September 4 that your auto insurer doesn’t have to pay it on bills your health plan already covered. The driver who brought the case had bought $25,000 of the stuff. She collected none of it.

Noellen Bousquet was hurt in a crash. Her Commerce Insurance policy carried personal injury protection, the no-fault coverage that pays your own medical bills regardless of who caused the wreck, plus an optional $25,000 of Medical Payments stacked on top. Commerce paid her $2,000 under PIP. Her health plan, Fallon Community Health Plan, covered the rest and put a lien of $13,429.62 on her case.

Then she asked Commerce for the MedPay. Commerce said no, and pointed at a sentence added to the state’s standard auto policy back in 2016: no payment under that part that would duplicate a payment for the same injury under a health insurance policy.

She argued that sentence hollows out a coverage the legislature ordered insurers to sell. State law requires every auto insurer in Massachusetts to offer at least $5,000 of Medical Payments. That’s a strange kind of offer if the fine print can cancel it.

The court sided with the insurer. The nonduplication clause doesn’t erase the coverage, it stops you collecting the same dollar twice.

Here is what nobody put in a press release. The state’s own Division of Insurance already tells buyers to think carefully about MedPay if they have health insurance, because the extra coverage may not be necessary. Consumer guidance just became case law.

What’s MedPay still good for, then?

The part your health plan doesn’t pay. Your deductible. Your copays. Care your plan denies. The bills of a passenger riding in your car with no coverage of their own. That’s a real exposure and it’s worth insuring.

It isn’t worth insuring to $25,000. If your health plan carries a $1,500 deductible, your actual gap tops out somewhere around $1,500 plus copays, and a $25,000 limit is a ceiling you can’t reach. You’re paying for altitude you’ll never use.

Flip to a high-deductible plan with a $7,000 out-of-pocket maximum and the math changes completely. Same coverage, different value. Your call, and it’s a real call. Just make it after you know which one you are.

Pull your declarations page this week. Find the Medical Payments line, write down the limit and what it costs you, then read the exclusion printed under it. Call your agent and ask one question: what’s the premium difference between the minimum limit and the one I’m carrying?

Then set your health plan’s deductible next to that number. If the limit is ten times your real gap, move the money into bodily injury and uninsured motorist limits, where one bad crash genuinely can blow past what you bought. Price the swap with our insurance estimator and compare carriers on our best auto insurance page and the auto insurance hub.

One more number for Massachusetts drivers. PIP caps out at $8,000 per person, but if you have health insurance it pays only the first $2,000 of your medical bills before your health plan takes over. Commerce paid Bousquet exactly that and not a dollar more. The policy worked the way it was written. She just didn’t find out until somebody else had already paid the bills.

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