A standard homeowners insurance policy provides more than just coverage from home damage or theft. It also comes with medical payments coverage, or Coverage F in the liability section of your home insurance policy, to help pay for small medical expenses in the event that a neighbor, guest, or any nonresident is hurt while on your property.
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Medical payments to others coverage basically functions as a "gesture of goodwill" to the injured party as a means to prevent lawsuits and subsequent high-dollar amount liability claims.
Since you can usually only purchase up to $5,000 in coverage, most insurers are fairly lenient when it comes to what types of situations and medical expenses it will cover. Additionally, it's a "no-fault" coverage, which means that neither you or the injured party need to prove negligence when you file a claim.
What is medical payments to others coverage?
Medical payments coverage is a type of liability coverage that's included on standard home insurance policies. Also called Coverage F, this coverage helps pay for minor medical bills when a guest is injured on your property. In some cases, it will cover injuries off of your property as well.
In most cases, you have the option of choosing anywhere between $1,000 and $5,000 in coverage per occurrence (the event that led to the injury) — though some insurers may offer up to $10,000 per occurrence. If injury costs from an occurrence happen to exceed the Coverage F limit of liability in your policy, you or the injured guest will have to pay for the remaining amount either out of pocket or with whatever supplemental options are available to you.
While medical payments coverage limits are fairly minimal, this coverage can play a big role in preventing an accidental injury or injuries from escalating into a lawsuit.
For example, say a partygoer sustains a bad knee injury after slipping and falling in your home, landing them in the hospital and putting them out of work for several weeks. While you're not necessarily at fault, you (and your insurer) may still be responsible for everything from medical expenses to lost wages to legal fees in the event that the partygoer files a lawsuit and the court determines that you were negligent. By offering to cover their hospital bills via medical payments to others coverage, they may think twice before suing.
What does medical payments insurance cover?
Medical payments to others coverage helps pay for “necessary” medical expenses that occur within three years from the date of the incident, according to the Insurance Services Office (ISO). [1]
In most cases, insurers will reimburse you for the following medical expenses under Coverage F:
Health insurance deductibles and copays
Doctor or hospital visits
Medical, dental, or surgical procedures
X-rays or prosthetics
Ambulance and emergency technician fees
Professional nursing services
Funeral services
Keep in mind that this coverage doesn’t cover injuries to family or friends who are permanent residents of the home. The one exception to this is when the resident is an employee of the household, like a groundskeeper or housekeeper.
Does medical payments insurance cover injuries away from the home?
Yes, under the following circ*mstances, medical payments to others coverage may help pay for injuries to people that occur away from your home.
The injury was caused by a condition in your home. For example, if your home has mold growth or physically ill residents and the guest gets sick after leaving the premises.
The injury was caused by you. For instance, if you accidentally hit a tennis ball into a stranger’s nose while you're practicing at a public park.
The injury was caused by a household employee. Like if one of your housekeepers accidentally drops a heavy package of yours on someone’s foot and injures them while at the post office.
The injury was caused by one of your pets. For example, if your dog bites or attacks someone while you're out for a walk.
What is not covered by medical payments insurance?
Medical payments to others coverage won't cover injuries that occur under any of the following circ*mstances:
The injury was expected or intentional
The injury happened due to business that took place at your house
The injury happened because of failure to render professional services
The house where the injury occurred isn’t insured
War
Communicable disease
Corporal punishment or physical or mental abuse
Controlled substances
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What’s the difference between medical payments to others and personal liability coverage?
While both medical payments coverage and personal liability coverage reimburse you for medical expenses if a guest is physically injured on your property, there are a few key differences between the two.
Medical payments to others coverage | Personal liability coverage | |
|---|---|---|
Coverage limits | $1,000 to $5,000 | $100,000 to $500,000 |
Does it matter who is at fault? | No | Yes |
Types of injuries covered | Minor injuries with inexpensive medical bills | Major injuries with steep medical bills |
Covers property damage | No | Yes |
Cover legal bills | No | Yes |
Take a deeper look at how medical payments to others coverage and personal liability coverage differ below.
Medical payments coverage is meant for low-risk injuries
When a guest is injured on your property, medical payments coverage is meant for minor injuries a guest might sustain, regardless of who is at fault. Meanwhile, liability insurance protects you from expensive litigation and steep medical bills in the event that you’re found legally responsible for damages.
Let’s take a look at an example
If a guest were to sue you after getting bitten by your dog, either of you could file a claim for the injury and those medical expenses would be paid for through your liability coverage.
But a lower-risk injury, like a guest who falls ill after eating your homemade quiche, could be covered by your medical payments coverage (even if they knew an ingredient was present in the dish that they shouldn’t have eaten).
Medical payments coverage won’t pay for property damage
Medical payments coverage doesn’t pay for damage you cause to someone else’s property, but liability insurance will.
Let's take a look at an example
If you accidentally pitch a baseball through your neighbor’s window, your liability coverage would pay for the costs to repair the window, but medical payments coverage won’t cover that repair.
Medical payments coverage has lower limits than liability coverage
Medical payments to others coverage limits typically fall within the $1,000 to $5,000 range, while your liability coverage limit is typically set between $100,000 and $500,000 —if not higher.
How much medical payments to others coverage should I have?
Since medical payments coverage often deters injured parties from pursuing expensive legal action against you, experts recommend going with the highest coverage limit offered by your insurance company. While most standard insurers cap coverage at $5,000, some specialty carriers like Chubb offer as much as $25,000 in medical payments to others coverage.
If you’re worried about the cost, consider that the liability section of your policy generally provides the biggest bang for your buck. So going with the maximum coverage amount really isn’t going to cost you that much more than if you opted for the minimum.
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