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Many of us have purchased automobile insurance policies that contain "medical payments" coverage, which pays medical bills we incur to treat an injury sustained in an automobile accident, which sounds like a good idea. It used to be that, if you also had health insurance, you could submit your medical bills to your health insurer and then use your auto "medical payments" coverage to pay for the things that your health insurer would not cover.

That has all changed for a couple of reasons. First, as we all know, most health insurance companies require the doctor or hospital to agree to accept a reduced payment for the medical care they provided, which, understandably, does not make the hospital or doctor very happy. Additionally, most health insurance policies now state that, if your are injured in an automobile accident and you have "medical payments" coverage in your automobile insurance policy, your medical bills have to be paid by your "medical payments" coverage, and the health insurance will only kick in after your auto "medical payments" coverage is all used up.

Although this insurance provision appeared to conflict with R.C. 1751.60, which required doctors and hospitals to seek payment only from the heath insurance company, the Ohio Supreme Court, in King v. ProMedica Health System, Inc., recently held that doctors and hospitals do not have to submit their bills to your health insurance insurer for payment at the reduced amount, and may instead seek payment in full from your auto "medical payments" coverage. Your health insurance company does this because it relieves it of the responsibility to pay your medical bills and shifts it to your auto insurer, and the doctors and hospitals do this because they may be able to get a larger payment from your auto "medical payments" coverage than from your health insurance company. You, on the other hand, get no benefit for having purchased and paid for the "medical payments" coverage because that coverage is used up paying bills that would otherwise have been paid by your health insurer. The net result is that if you have health insurance, and also pay for auto "medical payments" coverage, you may be paying your auto insurer to cover things that are already covered by your health insurance. So, you may want to discuss this issue with your auto insurance agent and health insurance company to see if you are unnecessarily paying for "medical payments" coverage.  If you have been injured in an motor vehicle collision, you may also want to consult with experienced Ohio attorneys to determine how to best maximize the available insurance coverages.

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