Since her condition is directly related to the accident, we believe that these bills should be covered by the PAP.

What do you think?

Illinois Subscriber

The insuring agreement in the medical payments section of the personal auto policy (PAP) promises to pay “reasonable expenses incurred for necessary medical and funeral services because of 'bodily injury.'” The bodily injury must be sustained by an insured and caused by an accident.

The policy defines “bodily injury” as “bodily harm, sickness or disease, including death that results.” Post-traumatic stress disorder is a psychological injury. It certainly may have physical manifestations, but it is a psychological injury.

Some states have defined bodily injury to include psychological injury. If Illinois has done so, then your client may be able to collect under her medical payments coverage. As it stands now, we believe the insurer is correct to deny the claim.

In reviewing the amendatory endorsements, it appears that only two states, Colorado and Kansas, specify psychological injuries as covered under medical payments—and those are no-fault states that include such coverage within personal injury protection (PIP).