Most people have vehicle insurance. There are many types of coverages within the vehicle insurance policy available to purchase. One such coverage is known as Medical Payments or Med-Pay. This type of coverage essentially means that if you are in an automobile accident with a covered automobile and you were injured, your insurance company will pay for any and all necessary and reasonable medical expenses up to the coverage limit. There is also usually found a reimbursement provision within this coverage that states that should you receive money from a third party (usually the other party at fault for the accident), then your insurance company is entitled to reimbursement of the amount of medical payment they had paid out on your claim.
An issue has come up about whether the your insurance carrier is entitled be reimbursed if the amount that you received from the third party insurance company is insufficient to pay the entire value of your case. The California case law has held that unless you are “made whole”, your insurance company is not entitled to reimbursement. For example, lets assume you were involved in an accident and sustained injuries. You incurred medical expenses of $7,000.00 and you had insurance coverage with medical payments coverage of $5,000.00. Let’s further assume that the third party had a $15,000.00 liability policy. Your insurance company pays the $5,000.00 in med-pay and the third party insurance has paid you the policy limit of $15,000.00. Is your insurance company entitled to be reimbursed the $5,000.00? The answer depends upon the value of your case. If your value of your claim is worth at least $20,000.00, then your insurance company is not entitled to reimbursement since your claim in which to make you “whole” is the same or valued more than the total amount collected (i.e. med pay of $5,000.00 and $15,000.00 from the third party).