After an auto accident in Virginia, there are several claims that you might be making.  You probably have a property damage claim against the other driver’s insurance company.  You might have a personal injury claim against the other driver’s insurance company as well.  And, if you have the proper coverage, you may have a claim for Medical Expense Payments (MedPay) benefits under your own insurance policy.  We’ve discussed MedPay claims here and here.  Frankly, your MedPay claim should be one of the easier things to figure out and get paid.

One insurance company is turning up over and over as a bad actor in handling MedPay cases: USAA.

MedPay is a provision on your own auto insurance policy that pays your medical bills if you have no health insurance or no coverage for a certain modality.  If you do have health coverage, MedPay reimburses you for your co-pays and also makes a payment to you for the amount that your health insurance company pays.  Virginia Code 38.2-2201 provides the rules for these payments and they are fairly straightforward.

All that is required of someone who is hurt in an auto accident is that they provide their MedPay carrier with medical bills and records for the treatment and, if you have health insurance, that you provide the figures for co-pays and insurance payment.  We are finding that over and over again USAA is requiring all sorts of information before issuing a payment.  We have seen payment denials seeking:

  • Taxpayer ID of the physician
  • Physical location of the physicians office
  • CPT and ICD-10 codes

Even more egregious, this information often appears in the body of the bill or records somewhere, but the adjuster has simply overlooked it.  We believe that this is all part of a tactic for USAA to hold on for more money and to make the claims process so difficult that you simply walk away from your $1,000 in coverage.

Attorneys at Marks & Glass have sued USAA at least a dozen times in the last year (2016) alleging that these denials are arbitrary and made in a bad faith violation of Virginia Code 8.01-66.1.  In several of those cases, USAA has reimbursed our client for the filing fee and paid a portion of the attorney’s fee spent in recovering money that they should have paid much earlier.  In every single one of those cases, USAA has made a full payment to our client of the MedPay funds. (State Bar disclaimer: this is not a guarantee of particular results in your case)

Has USAA unreasonably denied your Medical Expense Benefits claim?  We uncontested handle MedPay cases as a courtesy to our clients and don’t charge any fee.  If USAA has denied your claim, we may be able to help.

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