Medical Payment Coverage in Homeowners Insurance Policies: How Does it Work?

In every standard homeowner’s insurance policy, there is a section called medical payment insurance. This can be found under the section of your homeowners policy called Coverage F.

Medical payment insurance is meant to help cover the medical expenses that arise due to minor injuries that occur to guests of your home. The coverage applies no matter who is at fault. Let’s say, for example, that a guest slips and falls on your wet floor. It does not matter if you warned them or if they were reckless, you will still be covered.

The injury does not always have to occur inside of your home either. If perhaps, your dog bit someone in the park, medical payment coverage can cover that too.

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How Medical Payment Coverage Works

When a guest of your home is injured within your home (or outside of it), you can file a claim with your insurance provider and be reimbursed for the medical expenses.

In most standard homeowners policies, the limit of coverage is between $1,000 and $5,000. This means that if the medical bills exceed this amount, the rest will have to be paid out of pocket. If you wish, you can purchase additional coverage up to $25,000 for a slightly higher fee.

The coverage only applies to guests of the home, not permanent residents. So if you are a landlord, your tenant is not covered under Coverage F. But the one exception to this rule is if someone is employed by the household and also happens to live there, such as a groundskeeper or housekeeper.

What Medical Bills are Covered

The medical expenses must be deemed as both reasonable and necessary. They may include:

Visits to the ER
Surgeries
Physical Therapy
X-rays
Dental Work
Ambulance Rides
Hospital Stays
Professional Nursing
Prosthetic Devices
Funeral Services

Depending on the situation, your medical payment insurance may not cover all of your guest’s expenses. But the coverage extended is very helpful to guests because they may not have medical insurance, and to homeowners because it reduces the likelihood of being sued.

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What is Not Covered Under Medical Payment Insurance

Medical payment insurance is intended to help with the costs of smaller, accidental injuries that occur in your home. This means that the following circumstances will prevent medical payment insurance from extending coverage to you:

Injury occurs to you as the homeowner, or permanent resident
Injury was expected or intentional
Arises out of a connection with business conducted at a separate location with its own insurance
Arises from failure to render professional services
Arises out of connection to war
Arises out of a communicable disease
Injury occurs from a from corporal punishment, mental abuse, or physical abuse
Controlled substances were involved in the occurrence of the injury

Medical Payment Insurance vs Liability Insurance

Medical payment insurance should not be confused with liability insurance. Though both are parts of your homeowners policy, and both have the capacity to reimburse medical bills, they are not the same. Liability insurance is meant for situations in which the homeowner is at fault. This insurance covers not just medical bills but also litigation and property damage. They have a much higher limit, which tends to be between $100 thousand and $500 thousand. Medical payment insurance on the other hand:

Is meant for low-risk injuries
Does not cover litigation or property damage
Has a lower limit
Does not require that the homeowner be at fault

Medical payment insurance comes in handy in those smaller situations and can prevent them from getting to the point where liability insurance would have to step in.

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Margaret Huntley Margaret Huntley is a creative writing and philosophy student at Western University. She has been working as a freelance writer for over two years and has written about everything from insurance, to poker, to health and wellness for international businesses.