Virginia Medical Expense Benefits on Car Insurance: What Med Pay and Income Loss Coverage Pay and How Claims Work

Virginia medical expense benefits are optional coverage you can add to an auto liability policy. If you ask for them and pay the premium, they pay reasonable and necessary medical and funeral expenses from a car accident up to the limit you chose, for expenses incurred within three years of the crash, under Virginia Code § 38.2-2201 (opens in a new tab). A companion income loss benefit pays up to $100 a week to a person who usually works for pay, for up to one year. Both pay regardless of who caused the accident, according to the Virginia SCC Auto Insurance Guide (opens in a new tab). Virginia has no automatic no-fault PIP, so your declarations page is where you confirm whether you have this coverage and at what limit.

Are medical expense benefits required in Virginia?

No. Virginia insurers that write motor vehicle liability policies must provide medical expense and income loss benefits when the insured asks for them and pays the premium, and you may buy either one, both, or neither, under § 38.2-2201 (opens in a new tab). That makes them an add-on, not one of the state's legal minimums.

What Virginia does require is liability insurance on a registered vehicle. Liability coverage pays for injuries and property damage you or a permitted driver cause to other people, and it has to stay active as long as the vehicle is registered, according to the Virginia DMV's financial responsibility page (opens in a new tab). Our guide to Virginia car insurance requirements covers those minimums. Medical expense benefits sit beside that liability coverage and pay for your own side of the accident.

Is Virginia a no-fault state?

Virginia is not a no-fault state. Its required auto coverage is built around liability, so the driver who caused a crash is responsible for the other people's losses, and an injured person can bring a liability claim against that driver. States such as New York require no-fault insurance that pays your own medical bills first; Virginia does not.

The confusion comes from the way medical expense benefits pay. They are first-party benefits, meaning they come from your own policy, and they pay regardless of who caused the accident, according to the SCC Auto Insurance Guide (opens in a new tab). That works much like personal injury protection, but only if you chose to buy it. If you have read about PIP in other states, our article on whether personal injury protection is worth it explains how that coverage works where it is required.

Who does the coverage protect?

The coverage reaches more people than the policyholder. Under § 38.2-2201 (opens in a new tab), it applies to:

• Anyone occupying the insured vehicle.
• The named insured.
• The named insured's spouse and relatives who live in the same household, while in or on a vehicle, getting in or out of one, or when struck by a motor vehicle while not in one.

In practice, a carpool mate, a friend or a neighbor's child hurt while riding in your car can be covered, according to the SCC Auto Insurance Guide (opens in a new tab). You and family members in your household can also be covered if a car hits you while you are walking or while you are riding in someone else's vehicle. A passenger who is not related to you is covered as an occupant of your car, so ask your agent how the policy treats people outside your household in other situations.

What medical expenses are covered, and what limits apply?

The benefit pays reasonable and necessary expenses for medical, chiropractic, hospital, dental, surgical, prosthetic, rehabilitation, emergency medical services and funeral costs, under § 38.2-2201 (opens in a new tab). The expenses have to be incurred within three years after the accident, and the policy limit caps the total.

The statute sets the benefit at up to $2,000 per person, unless you do not elect that limit and you and the insurer agree on a different one. That is why the number on your declarations page matters more than any figure you see quoted elsewhere. Look for the medical expense line and the limit shown for each vehicle.

A personal policy that covers no more than four vehicles has one more rule. If the qualifying expenses go over the limit for one vehicle, the insurer can be liable up to the maximum available limit on each covered vehicle, under the same section. Ask your agent how that applies to your policy before you rely on it.

What does income loss coverage pay?

Income loss coverage pays a person who is usually engaged in a remunerative occupation, meaning someone who works for pay, for income lost because of injuries from the crash. The amount is up to $100 per week. Payments start with the first workday missed and stop when the person can return to their usual occupation, and they cannot continue past one year from the accident date, under § 38.2-2201 (opens in a new tab).

The statute does not set a separate formula for different jobs. Before you file, ask the insurer what proof it needs for your employment, your earnings, the days you missed and the date you went back to work. Self-employed readers should ask this question early, since their records look different from a pay stub.

How does it work with health insurance?

Having health insurance does not cancel your auto benefit. Virginia law bars an insurer from reducing medical expense benefits because you have other health benefits, except as § 38.2-2201 (opens in a new tab) allows.

The two coverages work in a set order when you use an in-network provider. The provider submits the claim to your health insurer first. The health plan then sends an explanation of benefits, or EOB, the statement that shows what it paid and what you still owe. With a valid assignment and that EOB or similar documentation, the auto insurer pays your eligible copayments, coinsurance and deductibles directly to the provider, according to the SCC's P&C Common Problems 2025 (opens in a new tab). Any remaining benefits are paid under the statute and your coverage.

If you have no health insurance or you see an out-of-network provider, payment may be based on the usual and customary fee in the community, subject to your coverage and the required documents. Keep every EOB you receive, because the auto insurer uses it to work out what you still owe.

Medical expense benefits are also separate from a claim against the driver who caused the crash. Under § 38.2-2209 (opens in a new tab), an insurer paying motor vehicle medical benefits has no right of subrogation, which means it cannot step into your shoes to recover what it paid from the at-fault driver. Your own possible liability claim against that driver is a different matter, and its outcome depends on the facts of the crash.

Do you have to sign an assignment of benefits?

No. An assignment of benefits is a form that lets the auto insurer pay your medical provider directly, and you are not required to sign one, under § 38.2-2201 (opens in a new tab). The assignment has to be in writing and dated, and it has to include a notice that signing it is optional, according to the SCC's P&C Common Problems 2025 (opens in a new tab).

Signing one changes who receives the money. With a valid assignment and the required documents, the insurer can pay the provider instead of you. Read the form before you sign it at a front desk, and ask the provider what happens to any balance the auto benefit does not cover.

How do you file a medical expense benefits claim?

Tell your insurer about the accident promptly. After it gets notice, the insurer should send you the forms it needs; fill them out correctly and completely and keep copies, according to the SCC Auto Insurance Guide (opens in a new tab). For the broader steps after a crash, see how to file a car insurance claim.

A complete claim file usually holds:

• Your policy number and declarations page.
• The accident date, location, vehicles and people involved.
• Police or incident information when you have it.
• The names of your medical providers and their bills.
• Explanations of benefits or remittance advice from your health plan.
• An assignment of benefits form, only if you choose to sign one.
• Proof of income loss, time missed from work and your return-to-work date.
• Copies of every form and letter you send or receive.

If the insurer pays only part of a bill or denies it, ask for the reason in writing.

What if the insurer delays or denies the claim?

An insurer should acknowledge your claim report within ten working days, according to the SCC Auto Insurance Guide (opens in a new tab). There is no single deadline for settling every claim, because claims differ.

Virginia law does set standards for how insurers handle claims. Under § 38.2-510 (opens in a new tab), it is an unfair claim settlement practice, when done often enough to show a general business practice, to fail to acknowledge and act reasonably promptly on claim communications, to fail to investigate reasonably, to fail to affirm or deny coverage within a reasonable time after you complete your proof of loss, or to fail to give a reasonable explanation for a denial or a reduced offer.

Start with the agent or insurer and ask for an explanation. Keep copies of the policy, claim forms, bills, EOBs, letters, denial notices and payment records. If the problem is still unresolved, you can file through the Virginia SCC's insurance complaint page (opens in a new tab). The SCC's Bureau of Insurance can contact the company or agent, review the response for compliance with Virginia law and the policy, and explain what it found. It cannot act as your lawyer, decide who was negligent, put a dollar value on an injury claim, or force a payment the policy does not provide.

What happens if your auto insurance lapses?

A lapse puts more than your medical expense benefits at risk. Virginia requires liability insurance to stay active as long as the vehicle is registered. If a registered vehicle is uninsured, the consequences can include suspension, a $600 non-compliance fee, filing an SR-22 certificate for three years and a possible reinstatement fee, according to the Virginia DMV (opens in a new tab). The option to pay a fee instead of buying insurance ended July 1, 2024; our article on the Virginia uninsured motor vehicle fee explains the change.

If you change insurers or drop a vehicle, ask for the new declarations page or endorsement in writing and check the effective date, the vehicles listed and the medical expense and income loss limits before you count on them.

Questions to ask your agent

• Does this policy include medical expense benefits, income loss benefits, or both?
• What limit appears for each vehicle?
• Does the policy cover passengers who are not household members?
• Does it cover household members hit as pedestrians or while riding in another vehicle?
• Which medical and funeral expenses qualify?
• What proof do you need for lost income?
• How does this coverage work with my health insurance, and does my provider need to bill the health plan first?
• What EOB or remittance documents do you need, and can my provider be paid directly?
• What forms do I complete after an accident, and how do I report a claim?
• Does the policy apply to personal use, business use, or both?
• What happens to these benefits if the policy is changed, canceled or lapses?

You can check an agent or agency through the SCC Bureau of Insurance Producer Search Engine (opens in a new tab) or the Virginia insurance license lookup (opens in a new tab). Riskado's directory lists insurance agencies across the US, including Virginia, by city and by category.

Frequently asked questions

Does medical expense coverage pay if I caused the accident?

Yes. The benefits pay regardless of who caused the accident, according to the SCC Auto Insurance Guide (opens in a new tab). The policy limit and the covered expense list still apply.

Can I use medical expense benefits and still claim against the at-fault driver?

They are separate. Your medical expense benefits come from your own policy, while a liability claim against the at-fault driver rests on that driver's responsibility for the crash. The insurer that paid your medical benefits has no right of subrogation to recover that money from a third party under § 38.2-2209 (opens in a new tab).

Does income loss coverage pay every injured person?

No. It pays a person who is usually engaged in a remunerative occupation, up to $100 a week, under § 38.2-2201 (opens in a new tab). Payments end when the person can return to the usual job or one year after the accident, whichever comes first.

What should I do if I already paid a medical bill myself?

Send the insurer the itemized bill, your proof of payment and any EOB from your health plan, and keep copies. Ask the insurer how it reimburses expenses you paid directly and what else it needs from you.

Can the SCC make my insurer pay?

The SCC can contact the insurer, review its response against Virginia law and your policy, and explain its findings, according to its complaint page (opens in a new tab). It cannot decide negligence, value an injury claim or force a payment outside the policy.

Check your declarations page before you need it

Medical expense benefits help only if they are on the policy at a limit that fits your household. Find the medical expense and income loss lines on your declarations page, note the limit for each vehicle, and keep your health plan card and EOBs together so a claim can move quickly. If you want to compare what Virginia drivers pay for the full policy, see the average cost of car insurance in Virginia.