Med Pay Dilemma

February 9, 2015

We have a NYS personal auto policy for our insured. His child's finger was injured when the door of a rental car was closed onto her finger. The rental car company won't pay for the medical bills unless there is no other coverage. Our insurer is denying the claim because our insured is divorced and while he has joint custody, the child lives with the mother most of the time. The mother refuses to put the claim into her insurance. The former husband is the one that rented the car and had custody of the child at the time of the injury.

Can our insurer deny the claim if there is joint custody? Can the rental company deny the claim if our insurer won't pay and the mother refuses to submit a claim to her auto insurance carrier?

New York Subscriber

Med pay coverage is for an insured that is injured because of an accident. The child is not an insured under the father's policy under the circumstances you note since the child is not a family member as defined since the child does not reside with the father. So, if the auto policy is a standard one, the child is not eligible for med pay. The mother's policy would consider the child an insured for med pay but since she won't put the claim in for whatever reason, that course of action is out.

What you might consider is liability coverage under the father's auto policy. If he is legally responsible for injury to the child, he has coverage under the liability section of the PAP as an insured under the PAP for the use of any auto.

As for the rental company, you would have to check the rental agreement to see if the company has any responsibility to pay.

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