Denial of Medical Payment Insurance Benefits

Every state in the country, including Montana, requires that drivers carry a minimum amount of auto liability insurance to protect others against the negligence of those operating motor vehicles.  Unfortunately, the minimum liability insurance limits imposed by state legislatures are never high enough to adequately compensate the victims of auto accidents who are seriously injured as a result of another driver’s negligence.

 In Montana, the minimum liability insurance limits are $25,000 per person and $50,000 per accident.  In 2015, the Montana legislature increased the mandatory minimum amount of property damage coverage from $10,000 to $20,000.  This legislative change, which went into effect for policies issued or renewed on or after January 1, 2016, was long overdue.  

In order to protect themselves against the negligence of those who carry the minimum liability insurance limits, many drivers wisely elect to purchase medical payments insurance coverage which provides for the payment of an injured party’s medical bills up to a certain amount regardless of who is at fault for causing the accident.  Unlike liability insurance, medical payments insurance is elective coverage not mandated by the legislature.  There is no limit on the amount of medical payments insurance you can purchase, but the vast majority of insurance policies provide coverage in the amount of $1,000, $5,000 or $10,000 per person.  It is often possible to stack these policies if a separate premium was paid for each vehicle owned.

Although most auto insurers sell medical payments insurance coverage, at least one insurer, United Services Auto Association (USAA), has a track record of wrongfully denying and delaying claims for medical payments benefits in Montana.  Over the past decade, USAA has been hit with a barrage of lawsuits around the country stemming from its wrongful denial of claims for medical payments benefits.  Recently, a judge in the Thirteenth Judicial District Court in Montana certified a class action lawsuit against USAA based on the plaintiffs’ claims that USAA wrongfully delayed and/or denied medical payments benefits to at least 154 Montana residents.

Similarly, in Florida, a chiropractic clinic recently filed its own class action against USAA alleging that USAA breached its insurance contracts by using an alternative method for calculating reimbursements. Much like the class action that was certified in Montana, the Florida suit takes aim at USAA’s wrongful denial of medical payments benefits.  

In Montana, when an insurer such as USAA wrongfully denies a claim for medical payments benefits, the insured is entitled to file suit against the insurer and seek his attorney’s fees.  Although it is in the discretion of the Court as to whether to award fees, Montana case law has firmly established that the insured is entitled to recover attorney’s fees when an insurer forces the insured to initiate legal action in order to obtain the full benefit of his insurance contract.  The fact that insurers like USAA know they will be responsible for paying attorney’s fees helps level the playing field for auto accident victims who have had their medical payments insurance benefits wrongfully denied by insurers looking to increase their bottom line.  

The attorneys at Hoyt & Blewett PLLC specialize in pursuing all types of insurance claims on behalf of individuals injured in auto accidents, including those victims who have had their medical payment insurance benefits wrongfully denied.  In the event you are involved in an auto accident, know that our firm will work diligently to ensure that when you pay a premium for medical payments insurance coverage, the insurer honors its contractual obligation to pay you the benefits to which you are entitled.  

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