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6.3 Part B Medical Payments

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Arkansas Property & Casualty Insurance State

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1 Standalone Coverage Map

Standalone Coverage Map

2 Introduction: Arkansas Property & Casualty Insurance Exam Overview

Arkansas Property & Casualty Exam Overview

3 National Portion: Insurance Fundamentals

1.1 Risk, Hazards, Perils, and the Law of Large Numbers 1.2 Insurable Interest, Indemnity, and Other Insurance Principles 1.3 Insurance Contract Law and Elements 1.4 Policy Structure: Declarations, Insuring Agreement, Conditions, Exclusions 1.5 Parties, Agents vs. Brokers, and Authority

4 National Portion: Property Insurance Concepts

2.1 Causes of Loss / Named-Peril vs. Open-Peril 2.2 Valuation: ACV, Replacement Cost, and Functional Value 2.3 Coinsurance and the Coinsurance Formula 2.4 Deductibles, Limits, and Loss Settlement 2.5 Common Property Policy Conditions and Clauses

5 National Portion: Dwelling Policies (DP)

3.1 Dwelling Policy Forms DP-1, DP-2, DP-3 3.2 Dwelling Coverages A-E and Other Coverages 3.3 Dwelling Perils, Conditions, and Endorsements 3.4 Mobile Home and Specialized Dwelling Coverage

6 National Portion: Homeowners Policies - Forms & Section I

4.1 Homeowners Forms HO-2 through HO-8 and Eligibility 4.2 Section I Coverages A-D and Additional Coverages 4.3 Section I Perils Insured Against and Exclusions 4.4 Replacement Cost vs. ACV and Loss Settlement in Homeowners

7 National Portion: Homeowners Policies - Section II & Endorsements

5.1 Section II Coverages E (Liability) and F (Medical Payments) 5.2 Homeowners Conditions and Duties After Loss 5.3 Common Homeowners Endorsements (scheduled property, water backup, ordinance or law)

8 National Portion: Personal Auto Policy - Liability & Injury

6.1 Personal Auto Policy Structure and Eligibility 6.2 Part A Liability and Supplementary Payments 6.3 Part B Medical Payments 6.4 Part C Uninsured/Underinsured Motorists

9 National Portion: Personal Auto Policy - Physical Damage & Duties

7.1 Part D: Coverage for Damage to Your Auto 7.2 Exclusions and Part E: Duties After an Accident 7.3 Part F: General Provisions, Endorsements, and No-Fault Concepts

10 National Portion: Liability Insurance Concepts

8.1 Negligence, Torts, and Legal Liability 8.2 Defenses, Damages, and Vicarious Liability 8.3 Occurrence vs. Claims-Made Triggers 8.4 Bodily Injury, Property Damage, and Personal/Advertising Injury

11 National Portion: Commercial Property Insurance

9.1 Commercial Package Policy Structure and Common Policy Conditions 9.2 Building and Personal Property Coverage Form (BPP) 9.3 Causes of Loss Forms (Basic, Broad, Special) 9.4 Business Income and Extra Expense 9.5 Commercial Property Endorsements and the BOP

12 National Portion: Commercial General Liability - Coverages

10.1 CGL Coverage A: Bodily Injury and Property Damage Liability 10.2 CGL Coverage B: Personal and Advertising Injury, Coverage C: Medical Payments 10.3 Who Is an Insured and Supplementary Payments

13 National Portion: Commercial General Liability - Limits, Triggers & Exclusions

11.1 CGL Limits of Insurance and Aggregates 11.2 Occurrence vs. Claims-Made CGL and Retroactive Dates 11.3 Key CGL Exclusions and Endorsements

14 National Portion: Commercial Auto Insurance

12.1 Business Auto Coverage Form and Covered Auto Symbols 12.2 Commercial Auto Liability and Physical Damage 12.3 Motor Carrier / Trucking and MCS-90 12.4 Garage Coverage Form and Garagekeepers 12.5 Commercial Auto Endorsements

15 National Portion: Workers Compensation

13.1 Workers Compensation Statutory Background and Benefits 13.2 Part One (Workers Comp) and Part Two (Employers Liability) 13.3 Premium Basis, Experience Modification, and Classification 13.4 Other States, USL&H, and Federal Acts 13.5 Workers Comp Exclusions and Endorsements

16 National Portion: Other Commercial Lines - BOP, Crime & Marine

14.1 Businessowners Policy (BOP) in Depth 14.2 Crime and Fidelity Coverage 14.3 Inland Marine and Nationwide Marine Definition 14.4 Ocean Marine Coverages (Hull, Cargo, Freight, P&I)

17 National Portion: Other Commercial Lines - Specialty & Professional

15.1 Farm and Agricultural Coverage 15.2 Commercial Umbrella and Excess Liability 15.3 Professional Liability and Errors & Omissions 15.4 Directors & Officers and Employment Practices Liability

18 National Portion: Other Commercial Lines - Surety, Flood & Specialty

16.1 Surety and Fidelity Bonds 16.2 National Flood Insurance Program (NFIP) 16.3 Cyber, Aviation, and Other Specialty Lines

19 National Portion: Insurance Regulation & Market Conduct

17.1 State Regulation, Licensing, and the McCarran-Ferguson Act 17.2 Rates, Forms, Solvency, and Guaranty Associations 17.3 Producer Authority, Fiduciary Duty, and Company Operations

20 National Portion: Ethics & Unfair Trade Practices

18.1 Unfair Trade Practices and Unfair Claims Settlement 18.2 Producer Ethics, Errors & Omissions Exposure, and Fiduciary Conduct 18.3 Privacy, Fraud, and Consumer Protection

21 Chapter 1: Arkansas P&C Insurance Regulation & Licensing

1.1 Arkansas Insurance Department 1.2 Arkansas P&C Producer Licensing Requirements 1.3 Arkansas Producer Responsibilities

22 Chapter 2: Arkansas Property Insurance

2.1 Arkansas Homeowners Insurance 2.2 Arkansas Commercial Property Insurance

23 Chapter 3: Arkansas Casualty & Auto Insurance

3.1 Arkansas Auto Insurance Requirements 3.2 Arkansas Liability Insurance 3.3 Arkansas Workers' Compensation Insurance

24 Chapter 4: Arkansas Ethics & Professional Conduct

4.1 Ethical Practices and Consumer Protection

6.3 Part B Medical Payments

Key Takeaways Explain This Topic AI

Part B pays reasonable medical and funeral expenses from an auto accident regardless of fault (first-party, no-fault), for expenses incurred within three years.

Limits apply per person, per accident (commonly $1,000-$10,000), and do not stack across multiple injured occupants.

You and family members are covered as occupants of any auto and as pedestrians; other persons are covered only while occupying your covered auto.

Med Pay is generally excess over other auto medical coverage on non-owned vehicles and may carry subrogation rights against duplicated liability recoveries.

Exclusions include fewer-than-four-wheel vehicles, livery use, regular-use non-covered autos, vehicles used as residences, racing, war/nuclear, and workers-compensation-eligible injuries.

Last updated: June 2026

Part B - Medical Payments Coverage

Part B pays reasonable and necessary medical and funeral expenses incurred because of bodily injury caused by an auto accident , and it pays regardless of fault . It is a first-party coverage - it pays the insured and certain occupants without anyone having to be proven negligent. Expenses must be incurred within three years of the accident.

Because Part B is no-fault, it provides fast, small-dollar medical reimbursement that supplements the insured's health plan and avoids waiting for a liability determination. Typical written limits are modest - $1,000 to $10,000 per person , applied per person, per accident (not a single shared limit).

Who Is an Insured Under Part B

The Part B definition of "insured" splits into two groups:

You or any family member while occupying (in, upon, getting in/out of) any auto , or when struck as a pedestrian by any motor vehicle designed for use on public roads (this pedestrian coverage follows the person, not the car).

Any other person while occupying your covered auto - guest passengers in your insured vehicle are covered, but only while in your covered auto, not when they are pedestrians or in other vehicles.

This person-vs.-vehicle distinction is a classic exam item: a family member is covered as a pedestrian or in any auto; a non-family passenger is covered only inside your covered auto .

Coordination With Other Coverage and Subrogation

Med Pay can overlap with health insurance, Part C, and the at-fault driver's Part A liability. Standard rules:

Med Pay is generally excess over other auto medical coverage on a vehicle the insured does not own.

If the insured collects under both Med Pay and a liability settlement, the insurer may have subrogation/reimbursement rights for amounts duplicated, depending on state law.

Med Pay does not require the insured to prove fault, which is why it pays quickly.

Worked example. An insured passenger incurs $7,500 in medical bills. The PAP carries $5,000 Med Pay per person . Part B pays its $5,000 limit; the remaining $2,500 must be pursued through health insurance or the at-fault party's liability coverage. Med Pay does not stack across multiple injured persons - each injured insured has a separate $5,000 limit.

Med Pay vs. PIP (No-Fault States)

Med Pay is easy to confuse with Personal Injury Protection (PIP) , the broader first-party benefit required in no-fault states. Both pay regardless of fault, but they differ in scope:

  • Feature Part B Med Pay PIP (No-Fault)
  • Medical/funeral expense Yes Yes
  • Lost wages No Yes (usually a percentage, capped)
  • Essential-services / replacement-services No Yes
  • Survivor / death benefits Funeral only Yes
  • Right to sue the at-fault party Unrestricted Limited by a verbal or monetary threshold

In add-on and traditional-fault states the PAP offers Med Pay ; in no-fault states the PIP endorsement replaces or supplements it. Exam questions often hinge on the fact that only PIP pays lost wages and replacement services - Med Pay is strictly medical and funeral. The no-fault "threshold" (verbal injury description or a dollar amount of medical bills) is what an injured person must exceed before retaining the right to sue in tort.

Part B Exclusions (Traps)

  • Excluded Situation Note
  • Injury while occupying a vehicle with fewer than four wheels e.g., motorcycle
  • Injury while the covered auto is used to carry persons/property for a fee car pools excepted

Injury while occupying a vehicle (other than your covered auto) furnished for regular use named insured & family

  • Injury while occupying a vehicle used as a residence or premises parked living quarters
  • Injury arising out of war, nuclear hazard, or racing speed-contest exclusion
  • Injury while using a vehicle without a reasonable belief of entitlement mirrors Part A

Note that Part B is not workers compensation: injuries that should be covered by workers compensation are excluded to avoid duplication.