Zender: No-fault coverage that matters

James F. Zender

What kind of medical coverage do you have on your car insurance policy? Chances are you don’t know. Most drivers do not give it much thought until injured in an accident.

As the political debate about no-fault insurance continues, your auto insurance company would love to shift the cost of providing necessary medical care to your regular health insurance company, but this is not in your best interest.

From my position as a psychologist specializing in treating patients seriously injured in auto accidents, I can say Michigan got it right with its no-fault automobile insurance act in 1973, which provides for all necessary care for people injured in auto accidents.

The one question all drivers should ask now, beforebeing in an auto accident causing physical or psychological injuries, is: “Do you have ‘full medical coverage’ on your policy?” If not, your auto insurance could add trauma to trauma, because if you are seriously injured, medical bills can run into the thousands, hundreds of thousands or even millions of dollars.

When you purchase your next policy, your auto insurance company may encourage you to purchase what is called “coordinated benefits.” On the surface, coordinated benefits sounds smart. Who doesn’t want to be coordinated?

But this is one instance where you do not want to be coordinated.

With uncoordinated coverage or full medical coverage, your auto insurance is the primary insurer in the event of injury, that is 100 percent responsible for paying your medical bills.

There are a number of reasons you want full medical coverage on your auto insurance plan:

■ The complexity of getting things paid more than doubles when two insurance companies are involved. Often insurance companies will point the finger at each other saying the other is responsible for paying the bills. Payments can be delayed, and your credit can suffer. I know of one case where an individual was covered by five different insurance companies, and none of them paid until after lengthy litigation.

■ Coordinated benefits often limit which providers can treat you. Some of the best providers for auto accident injuries may be out of network or may not accept your regular medical insurance, and you would never be able to receive the highly specialized care you need unless you can afford to pay out of pocket.

■ Coordinated benefits create twice the work, at rates that could be significantly less, for the provider. Some providers may not want to get involved in your case, or their ability to deliver optimal care could ultimately be affected.

If your regular health insurance has a lifetime maximum payout and you are catastrophically injured, you could burn through that coverage. But, if you have full medical on your auto policy, your own health insurance coverage is preserved.

Full medical coverage on your auto insurance policy will cost you a little more but it could mean the difference between getting the high quality care you need, in some cases for the rest of your life, and going bankrupt trying to pay for the extended care you or your loved ones may need. Michigan’s current law works in your best interest, if you make the right choices to protect yourself.

James Zender is a Mount Clemens clinical and forensic psychologist with more 30 years of trauma experience.