Extended Medical Expense Benefits Coverage: What is it, and what does it cover?

Ever wonder what “Extended Medical Expense Benefits Coverage” on your personal auto insurance policy actually covers?  It is sometimes known as “med-pay.” Insurance regulations in New Jersey require auto insurers to include a minimum coverage of $1,000 and a maximum coverage of $10,000 in Extended Medical Expense Benefits Coverage on standard private passenger auto insurance policies in the state. So, in layman’s terms, each policy must offer $1,000 in that type of coverage, and that coverage can be increased up to $10,000.

For starters, you should always pick the maximum Extended Medical Expense Benefits Coverage limit of $10,000 instead of the minimum requirement of $1,000. The difference in policy premium is negligible. But what does this coverage actually provide? If you selected $10,000 in Extended Medical Expense Benefits Coverage, this benefits extension provides up to $10,000 in medical expenses or up to $10,000 in accidental death benefits if an insured person suffers injuries or death in an accident arising out of the ownership, maintenance, or use of either an insured automobile or a highway vehicle which is neither owned by the insured nor available to him or any family member for regular use.

The only exclusions from the definition of “highway vehicle” when used by a named insured or relative of the named insured are:

• farm tractors or other farm equipment designed for use principally off public roads, but only while such vehicles are in fact off public roads;
• vehicles operated on rails or crawler treads; and
• vehicles which are, at the time of the accident, located for use as a residence or premises.

Persons who are merely passengers or permissive users of the vehicle (as opposed to the named insured or a family member on the policy insuring the vehicle) are excluded in all the foregoing cases and also if the vehicle us a motorcycle or a vehicle being used as a public or livery conveyance.

Keep in mind that Extended Medical Expense Benefits are not available in any case where other Personal Injury Protection (PIP) coverage applies. Extended Medical Expense Benefits cannot duplicate benefits payable under workers compensation or Medicare. The key benefit of Extended Medical Expense Benefits Coverage is that, in some limited situations, it can provide some coverage for medical expenses incurred as a result of a vehicular accident even where PIP would not otherwise apply.

If you have any questions, please feel free to contact me or come in and meet with me here in my firms Marlton, New Jersey office for a free initial consultation. I will be happy to answer any of your auto insurance questions free of charge.

Stephen Di Stefano is an attorney in Stark & Starks Marlton, New Jersey office, specializing in Accident & Personal Injury Law. For more information, please contact Mr. Di Stefano.