Insurance Policy Exclusions to Medical Payments Coverage

When you and your passengers suffer injuries in a one-car accident, “medical payments coverage” will be your savior. While liability coverage deals with damage you cause to other motorists and their property, and collision and “other-than-collision” (also known as “comprehensive”) coverages deal with damage to your own car, medical payments coverage will keep you out of the poorhouse if you rack up huge medical bills.

The cost of a 2002 Impala to replace your damaged one is insignificant compared to the bill you will get for a broken back - and that’s why medical payments coverage is so important. But medical payments coverage is not all-inclusive - just as with other coverages, it has its own standard exclusions that savvy car insurance consumers need to be aware of.

The Purpose of the Exclusions

The car insurance business is heavily regulated, and in this (rare) case, the government is truly on the consumer’s side. Regulators do not allow car insurance companies to put frivolous exclusions in policy contracts just to avoid paying valid claims, so instead, medical payments exclusions generally have to meet one of three criteria: 1) Avoiding conflict and/or duplication with other, more suitable forms of insurance; 2) Eliminating risks more hazardous than those considered in the calculation of car insurance rates; and 3) Avoiding uninsurable hazards, such as war and terrorism.

But just because the government is on your side does not mean you have no responsibility to be aware of your exclusions. Pull out your standard insurance agreement and make sure that your coverage is in line with what is discussed here.
Excluded Vehicles

Medical payments coverage does not extend to bodily injuries sustained while occupying a vehicle with fewer than four wheels - i.e. a motorcycle. Separate insurance policies must be purchased for motorcycle coverage, since motorcycles present significantly more risk than regular cars, (just ask Ben Roethlisberger).

Secondly, injuries sustained while your automobile is being used as a “public conveyance” - i.e. an unregistered taxi service - are excluded. It is important to note that an exception must be made, by law, for “share-the-expense” carpool lanes. Even if you don’t know your passenger in this case, you (and he or she) are covered.

Duplicate Coverage

Injuries sustained during hours of employment, wherein you are driving as part of your job, are excluded since this should be covered by your employer’s insurance (and/or Workers’ Compensation).

Far-Fetched Exclusions

In addition to excluding coverage for damages sustained while drag racing or in the commission of illegal acts (i.e. bank robbery), there are also standard exclusions for “discharge of a nuclear weapon (even if accidental),” nuclear reaction, radiation, or radioactive contamination. The war doesn’t have to get nuclear either, as other standard language clearly spells out that damages caused by or as a consequence of war, civil war (specifically), insurrection, rebellion or revolution are also excluded. The revolution may be televised, but it won’t be covered by your car insurance.

Some of these exclusions are downright silly, but they illustrate the importance of fully understanding your car insurance policy. Imagine the shock of someone filing a claim after his car was damaged by the accidental discharge of a nuclear weapon, only to find out such damages weren’t covered - Kim Jung Il, this means you!

As always, it is important to be aware of your coverages and their exclusions. Review your policy, and once you know what you’ve got, take a little time to shop around. You may not be able to find an agent who will insure you against a second civil war, but you should be able to lower your car insurance rates, possibly while enhancing your coverage. Good luck!