Our insured was out hunting with a friend and accidentally shot himself in the leg. The friend put him in the friend's car and was taking him to the hospital when the vehicle ran off the road. This, of course, delayed getting the insured to the hospital for treatment. Now, the insured has an attorney who is demanding the medical payments limit of $5,000 under the insured's auto med pay coverage. The lawyer alleges that the auto accident caused additional injury to the insured.

The auto med pay insuring agreement does apply to expenses for bodily injury caused by an accident, and our insured is an insured while occupying a motor vehicle. We don't see any exclusions that would apply, so would the med pay coverage be due in this instance?

Minnesota Subscriber

The med pay coverage would apply to the injuries, if any, suffered by the insured while he was in the friend's vehicle. Med pay applies to an accident, but it has to be an auto accident since it applies to an insured who is the named insured while occupying a motor vehicle. In other words, if the injuries to the insured that arose due to the insured being in the auto accident can be separated from the gunshot injury, then the med pay would apply to those specific injuries. The gun shot injury is not covered by the auto med pay. The covered expenses have to be reasonable and for necessary medical services.

And note, your insured is also an insured under the friend's auto med pay coverage (assuming that the friend has such coverage) since he was a person occupying that covered auto. This means that there is other applicable auto med pay insurance, and since the vehicle being used by the insured was one that he did not own, the coverage under your policy is excess over any other collectible auto insurance providing med pay coverage.

This premium content is locked for FC&S Coverage Interpretation Subscribers

Enjoy unlimited access to the trusted solution for successful interpretation and analyses of complex insurance policies.

  • Quality content from industry experts with over 60 years insurance experience, combined
  • Customizable alerts of changes in relevant policies and trends
  • Search and navigate Q&As to find answers to your specific questions
  • Filter by article, discussion, analysis and more to find the exact information you’re looking for
  • Continually updated to bring you the latest reports, trending topics, and coverage analysis