After a car accident with injuries in Georgia, if you have medical payments coverage on your car insurance policy, it will pay for medical bills up to the policy limit amount, usually $1,000, $5,000 or $10,000.00. This money is a godsend and it is very wise to carry the coverage. Invariably we get clients asking “Do I Need to Repay Car Insurance Medical Payments to My Insurance Company?”
The answer in Georgia is “usually, no.’ Georgia has passed legislation that says you do not need to repay medical payments insurance payments when you receive a settlement from the at fault driver’s insurance company unless you were “made whole” for all economic and non-economic damages by the settlement. Because most settlements are by definition a compromise, the injured party is almost never made whole.
Of all of the major insurance companies in the Atlanta and Georgia markets, two companies stand out for their persistence in pestering their insureds to repay them despite the made whole rule; USAA and Geico. Geico med pay recovery adjusters will literally call month after month regardless of how many times you explain that the settlement was not far in excess of the medical bills. The safest policy is to document your position in writing.
Here is a sample of a letter we wrote to USAA when they kept insisting on reimbursement for medical payments insurance:
USAA Casualty Insurance Company
Jane Doe
9800 Fredericksburg Road
San Antonio, TX 78288
RE: Reference # XXXXX
Client: John Doe
Dear Ms. Doe:
As USAA should be aware, Georgia protects its citizens from unfair contractual reimbursement claims pursuant to O.C.G.A. § 33-24-56, the “made whole” statute. In car accident cases where liability is uncertain, the Plaintiff is forced to accept less than the true value of their case. In this case $5,000.00 of the settlement was allocated to repayment of medical bills.
The settlement is long since over and O.C.G.A. § 33-24-56 overrides USAA’s contractual claims with regard to Med Pay coverage. USAA is not entitled to any reimbursement.
Please modify your records to reflect the firm’s new address when you have a chance.
Sincerely,
Christopher M. Simon