Resource Library

Medical Payments Coverage

Date: April 2020

MCIT offers medical payments coverage on a discretionary basis to injured parties who are not members’ employees with the intent of averting a time-consuming and potentially expensive litigation to prove negligence. The coverage is typically used to reimburse the injured party for medical expenses, which may include health insurance deductibles and co-pays.

MCIT investigates each reported incident and discusses the applicability of coverage with the member. These payments are made regardless of fault in consultation with the member.

Members generally recognize and appreciate that this coverage may prevent a more severe claim. The coverage has a $2,500 limit per person, and MCIT waives the deductible on this line of coverage.

The medical payments coverage applies to actual medical expenses, including first aid; necessary medical, surgical, X-ray or dental services; and ambulance, hospital and professional nursing services incurred within one year of the incident. Coverage can also extend to authorized volunteers injured while performing their duties on behalf of the member.

Medical payments coverage does not apply to injuries sustained by:

  • anyone who is a “covered party” under the member’s MCIT Coverage Document, including employees and the member’s elected or appointed officials, with the exception of authorized volunteers as noted previously.
  • persons hired to do work on the member’s premises or anyone, whether an employee or not, if benefits for the injury are payable or must be provided under workers’ compensation.
  • someone injured on the premises in an area he or she normally occupies (e.g., a tenant or employees of an organization who leases space in the member’s building).
  • a person confined to the member’s jail or correctional facility.
  • a person taking part in athletic activities.
  • students and children participating in youth activities conducted by a covered party.

Excluded parties are generally covered elsewhere. Examples:

  • A member’s employees are covered by workers’ compensation.
  • An independent contractor should be covered by his or her own workers’ compensation policy.
  • Students can be covered by a separate medical/accident policy purchased by the member.

MCIT encourages members to report all claims for damages, as well as any incident that might result in a claim through the online member portal. For questions regarding coverage, members are encouraged to contact their risk management consultant toll-free at 1.866.547.6516.

The information contained in this document is intended for general information purposes only and does not constitute legal or coverage advice on any specific matter.