What is medical payments coverage?

Medical payments coverage pays for small-dollar medical bills if a guest is injured at your home — regardless of who’s at fault.

Pat Howard 1600Jennifer Gimbel

By

Pat Howard

Pat Howard

Managing Editor & Licensed Home Insurance Expert

Pat Howard is a managing editor and licensed home insurance expert at Policygenius, where he specializes in homeowners insurance. His work and expertise has been featured in MarketWatch, Real Simple, Fox Business, VentureBeat, This Old House, Investopedia, Fatherly, Lifehacker, Better Homes & Garden, Property Casualty 360, and elsewhere.

&Jennifer Gimbel

Jennifer Gimbel

Senior Managing Editor & Home Insurance Expert

Jennifer Gimbel is a senior managing editor and home insurance expert at Policygenius, where she oversees our homeowners insurance coverage. Previously, she was the managing editor at Finder.com and a content strategist at Babble.com.

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A standard homeowners insurance policy covers more than just damage to your home and belongings. It also includes medical payments to others coverage, which pays for minor medical bills if someone’s hurt while at your home — whether you’re to blame or not.

Key takeaways

  • Medical payments to others coverage reimburses you for minor medical expenses if a guest is injured on your property — regardless of who’s at fault.

  • It’s designed to prevent a minor injury from escalating into a lawsuit.

  • You can typically get up to $5,000 in medical payments coverage, though some insurers offer as much as $25,000 in protection.

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What is medical payments to others coverage?

Medical payments to others coverage is a type of liability coverage included in every standard home insurance policy. Also called Coverage F, medical payments coverage pays for inexpensive medical bills when a guest is injured on your property (or off your property in some cases).

Medical payments coverage limits are typically set between $1,000 and $5,000. That means if you have $5,000 in coverage and a houseguest’s injuries exceed that amount, the difference needs to be paid for out of pocket.

Although this type of coverage is fairly limited and only intended for minor physical injuries, medical payments coverage can potentially prevent an injury from escalating into a lawsuit. An injured guest may think twice about suing you if you offer to cover their hospital bills through your medical payments to others coverage.

What does medical payments to others cover?

Medical payments to others pays for “necessary” medical expenses that occur within three years from the date of the incident, according to the Insurance Services Office (ISO). [1]  

If deemed necessary by your insurer, the following expenses are typically reimbursed by Coverage F:

  • Health insurance deductibles and copays

  • Doctor or hospital visits

  • Medical, dental, or surgical procedures

  • X-rays or prosthetics 

  • Ambulance and emergency technician fees

  • Professional nursing services

  • Funeral services

Keep in mind that medical payments to others doesn’t cover injuries to family or friends who are permanent residents of the home. The one exception is if the resident is an employee of the household, like a groundskeeper or housekeeper. In that case, if they’re injured while working at your home, they’ll be covered under your medical payments coverage.

Health

Does medical payments to others cover injuries away from the home?

Yes, medical payments to others will also cover injuries to people away from your home in the following situations:

  • The injury occurred due to a condition at your home — like if your home had mold and a guest got sick after leaving your house.

  • The injury was accidentally caused by you — like if you accidentally knock a tennis ball into a stranger’s nose while you’re practicing at the park.

  • The injury was caused by a household employee — like if your housekeeper drops a heavy box on someone’s foot when they’re at the post office mailing it for you.

  • The injury was caused by a pet you own — like if your dog bites someone while out for a walk.

What is excluded from medical payments to others coverage?

Medical payments to others coverage doesn't cover injuries that happen under any of the following circumstance:

  • The injury was expected or intentional

  • The injury happened due to business that took place at your house* 

  • The injury happened because of failure to render professional services

  • The house where the injury occurred isn’t insured

  • War

  • Communicable disease

  • Corporal punishment or physical or mental abuse

  • Controlled substances

The one exception is if the “business” that took place at your house is related to renting out your home occasionally (like Airbnb-ing a room) or your home is approved to be used as a part-time office, school, studio, or private garage.

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What’s the difference between medical payments coverage and personal liability coverage?

While both medical payments coverage and personal liability coverage reimburse you for medical expenses if a guest is physically injured on your property, there are a few key differences between the two.

Medical payments to others coverage

Personal liability coverage

Coverage limits

$1,000 to $5,000

$100,000 to $500,000

Does it matter who is at fault?

No

Yes

Types of injuries covered

Minor injuries with inexpensive medical bills

Major injuries with steep medical bills

Covers property damage

No

Yes

Cover legal bills

No

Yes

Take a deeper look at how medical payments to others coverage and personal liability coverage differ below.

Medical payments coverage is meant for low-risk injuries

When a guest is injured on your property, medical payments coverage is meant for minor injuries guests might sustain, regardless of who is at fault. Meanwhile, liability insurance protects you from expensive litigation and steep medical bills in the event that you’re found legally responsible for damages.

Let’s take a look at an example

If a guest were to sue you after getting bitten by your dog, either of you could file a claim for the injury and those medical expenses would be paid for through your liability coverage. 

But a lower-risk injury, like a guest who falls ill after eating your homemade quiche, could be covered by your medical payments coverage (even if they knew an ingredient was present in the dish that they shouldn’t have eaten).

Medical payments coverage won’t pay for property damage

Medical payments coverage doesn’t pay for damage you cause to someone else’s property, but liability insurance will. 

Let's take a look at an example

If you accidentally pitch a baseball through your neighbor’s window, your liability coverage would pay for the costs to repair the window, but medical payments coverage won’t cover that repair.

Medical payments coverage has lower limits than liability coverage

Medical payments to others coverage limits typically fall within the $1,000 to $5,000 range, while your liability coverage limit is typically set between $100,000 and $500,000 — if not higher.

How much medical payments to others coverage should I have?

Since medical payments coverage often deters injured parties from pursuing expensive legal action against you, experts recommend going with the highest coverage limit offered by your insurance company. While most standard insurers cap coverage at $5,000, some specialty carriers like Chubb offer as much as $25,000 in medical payments to others coverage.

If you’re worried about the cost, consider that the liability section of your policy (which includes personal liability coverage and medical payments to others coverage) generally provides the biggest bang for your buck. So going with the maximum coverage amount really isn’t going to cost you that much more than if you opted for the minimum.

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References

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Policygenius uses external sources, including government data, industry studies, and reputable news organizations to supplement proprietary marketplace data and internal expertise. Learn more about how we use and vet external sources as part of our

editorial standards.
  1. Insurance Services Office

    . "

    Homeowners 3 - Special Form

    ." Accessed August 23, 2022.

Authors

Managing Editor & Licensed Home Insurance Expert

Pat Howard

Managing Editor & Licensed Home Insurance Expert

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Pat Howard is a managing editor and licensed home insurance expert at Policygenius, where he specializes in homeowners insurance. His work and expertise has been featured in MarketWatch, Real Simple, Fox Business, VentureBeat, This Old House, Investopedia, Fatherly, Lifehacker, Better Homes & Garden, Property Casualty 360, and elsewhere.

Senior Managing Editor & Home Insurance Expert

Jennifer Gimbel

Senior Managing Editor & Home Insurance Expert

gray linkedin icon link

Jennifer Gimbel is a senior managing editor and home insurance expert at Policygenius, where she oversees our homeowners insurance coverage. Previously, she was the managing editor at Finder.com and a content strategist at Babble.com.

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