MEDICAL PAYMENTS COVERAGE INSURING AGREEMENT. We will pay reasonable expenses incurred for necessary medical and funeral services because of "bodily injury":
MEDICAL PAYMENTS COVERAGE INSURING AGREEMENT. If you pay the premium for this coverage, we will pay the reasonable expenses incurred for necessary medical services received within three years from the date of a motor vehicle accident because of bodily injury:
1. sustained by an insured person; and
2. caused by that motor vehicle accident. We, or someone on our behalf, will determine:
1. whether the expenses for medical services are reasonable; and
2. whether the medical services are necessary. When used in this Part II:
MEDICAL PAYMENTS COVERAGE INSURING AGREEMENT. A. We will pay reasonable expenses incurred for necessary medical and funeral services because of "bodily injury":
1. Caused by an accident; and
2. Sustained by an "insured".
MEDICAL PAYMENTS COVERAGE INSURING AGREEMENT. If you pay the premium for this coverage, we will pay the reasonable expenses in- curred for necessary medical services received within three years from the date of an accident involving a watercraft or trailer because of bodily injury:
1. sustained by an insured person; and
MEDICAL PAYMENTS COVERAGE INSURING AGREEMENT. A. Subject to the limit of liability shown on the Declarations Page, if you pay us the premium for Medical Payments Coverage, we will pay medical expenses and funeral service expenses arising out of bodily injury:
1. Caused by an accident;
2. Sustained by an insured; and
3. Arising out of the ownership, maintenance or use of an auto. We will pay only those medical expenses and funeral service expenses incurred within three (3) years from the date of the accident.
B. We have the right to review the medical expenses to determine if they are reasonable and necessary for diagnosis and treatment of bodily injury. We may use independent sources of information selected by us to assist us in determining if any medical expense is reasonable and necessary. These sources may include, but are not limited to:
1. Physical exams paid for by us and performed by physicians we select;
2. Review of medical files;
3. Computer databases; or
4. Published sources of medical expense information.
C. We may refuse to pay for:
1. Any portion of a medical expense that is unreasonable because the fee for the service is greater than the usual and customary charge; and/or
2. Any medical expense because the service rendered is unnecessary for the treatment of the bodily injury sustained. If we refuse to pay for any portion of a medical expense because the fee is unreasonable or for any service because the service is unnecessary and the insured is sued for payment of this medical expense, we will defend the insured with an attorney of our choice. We will pay defense costs and any judgment against the insured up to our limit of liability for this coverage. The insured must cooperate with us in the defense of the lawsuit and attend depositions, hearings, or trials at our request. We will pay, upon written request by the insured:
1. Reasonable loss of earnings to an insured, up to $200 per day, that is incurred by an insured due to attendance at hearings, proceedings or trials at our request. The insured must provide us written proof of such loss; and
2. Other reasonable expenses the insured incurs at our request as a result of a lawsuit by a health care provider to recover medical expenses we refuse to pay because the fee is unreasonable or unnecessary.
D. We may refuse to pay for any medical services that are not provided and prescribed by a medical provider licensed by the state and acting within the scope of that license.
E. We will not pay for any portion of a medical expense that excee...
MEDICAL PAYMENTS COVERAGE INSURING AGREEMENT. A. Subject to the limit of liability shown in the Declarations, if you pay a premium for Medical Payments Coverage, we will pay reasonable expenses incurred for necessary medical and funeral services because of bodily injury:
1. Caused by an accident; and
2. Sustained by an insured. We will pay only those medical and funeral expenses incurred within 3 years from the date of the accident.
B. Insured as used in Part B means:
1. You or any family member:
a. while occupying a recreational vehicle; or
b. as a pedestrian when struck by a motor vehicle designed for use mainly on public roads or a trailer of any type.
2. Any other person while occupying your covered auto when your covered auto is being used within the scope of your permission.
