{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-2201.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-2201.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-2201.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-2201.html"}],"law_id":82480,"edition_id":1,"section_id":82480,"structure_id":13816,"section_number":"38.2-2201","catch_line":"Provisions for payment of medical expense and loss of income benefits; assignment of certain benefits","history":"1972, c. 859, \u00a7 38.1-380.1; 1973, c. 294; 1977, c. 112; 1982, c. 450; 1983, cc. 197, 370; 1986, c. 562; 1987, c. 429; 1989, c. 243; 1991, c. 4; 1996, c. 276; 1997, c. 503; 2013, c. 75; 2014, cc. 157, 417; 2015, cc. 502, 503.","full_text":"A\n\nUpon request of an insured, each insurer licensed in this Commonwealth issuing or delivering any policy or contract of bodily injury or property damage liability insurance covering liability arising from the ownership, maintenance or use of any motor vehicle shall provide on payment of the premium, as a minimum coverage (i) to persons occupying the insured motor vehicle; and (ii) to the named insured and, while resident of the named insured’s household, the spouse and relatives of the named insured while in or upon, entering or alighting from or through being struck by a motor vehicle while not occupying a motor vehicle, the following health care and disability benefits for each accident:1\n\nAll reasonable and necessary expenses for medical, chiropractic, hospital, dental, surgical, prosthetic and rehabilitation services, services provided by an emergency medical services vehicle as defined in § 32.1-111.1, and funeral expenses, resulting from the accident and incurred within three years after the date of the accident, up to $2,000 per person; however, if the insured does not elect to purchase such limit the insurer and insured may agree to any other limit;2\n\nIf the person is usually engaged in a remunerative occupation, an amount equal to the loss of income incurred after the date of the accident resulting from injuries received in the accident up to $100 per week during the period from the first workday lost as a result of the accident up to the date the person is able to return to his usual occupation. However, the period shall not extend beyond one year from the date of the accident; and3\n\nAn expense described in subdivision 1 shall be deemed to have been incurred:\n\t\t\t\ta. If the insured is directly responsible for payment of the expense;\n\t\t\t\tb. If the expense is paid by (i) a health care insurer pursuant to a negotiated contract with the health care provider or (ii) Medicaid or Medicare, where the actual payment with reference to the medical bill rendered by the provider is less than or equal to the provider’s usual and customary fee, in the amount of the actual payment as evidenced by an explanation of benefits, remittance advice, or similar documentation from the health care provider; however, if the insured is required to make a payment in addition to the actual payment by the health care insurer or Medicaid or Medicare, the amount shall be increased by the payment made by the insured; or\n\t\t\t\tc. If no medical bill is rendered or specific charge made by a health care provider to the insured, an insurer, or any other person, in the amount of the usual and customary fee charged in that community for the service rendered.B\n\nThe insured has the option of purchasing either or both of the coverages set forth in subdivisions A 1 and A 2. Either or both of the coverages, as well as any other medical expense or loss of income coverage under any policy of automobile liability insurance, shall be payable to the covered injured person or pursuant to an assignment of benefits in accordance with subsection D, notwithstanding the failure or refusal of the named insured or other person entitled to the coverage to give notice to the insurer of an accident as soon as practicable under the terms of the policy, except where the failure or refusal prejudices the insurer in establishing the validity of the claim.C\n\nIn any policy of personal automobile insurance in which the insured has purchased coverage under subsection A, every insurer providing such coverage arising from the ownership, maintenance or use of no more than four motor vehicles shall be liable to pay up to the maximum policy limit available on every motor vehicle insured under that coverage if the health care or disability expenses and costs mentioned in subsection A exceed the limits of coverage for any one motor vehicle so insured.D\n\nAny attempt to assign medical expense benefits shall be subject to the following:1\n\nAn assignment of medical expense benefits shall be valid only if:\n\t\t\t\ta. A copy of the AOB form, executed by the assignor and in compliance with the other requirements of subdivision D 1 and a copy of the notice complying with subdivision g if such notice is provided in a separate document pursuant to subdivision e, is provided to the motor vehicle insurer;\n\t\t\t\tb. The AOB form is (i) in writing, which includes any printed or electronic format, (ii) dated, and (iii) executed by the assignor;\n\t\t\t\tc. The AOB form includes a conspicuous statement that the assignor is not required to execute the AOB form;\n\t\t\t\td. If the AOB form includes a notice that complies with the provisions of subdivision g, the AOB form is signed, initialed, or otherwise marked by the assignor, at or near the notice provision, to acknowledge that the assignor has read, or had the opportunity to read, the notice;\n\t\t\t\te. If the AOB form does not include a notice that complies with the provisions of subdivision g, (i) the assignor is given a separate document, in any printed or electronic format, that is delivered to the assignor at the same time as the AOB form and that contains a notice that complies with the provisions of subdivision g; (ii) the AOB form includes a conspicuous statement that a notice regarding the assignment of medical expense benefits is provided in a separate document; and (iii) the AOB form is signed, initialed, or otherwise marked by the assignor at or near the statement described in clause (ii) to acknowledge that the assignor has read, or had the opportunity to read, the separate document containing the notice;\n\t\t\t\tf. The statements required by subdivision D 1 to be included in the AOB form or a separate document, including the notice prescribed by subdivision g, are in not less than eight-point type; and\n\t\t\t\tg. The assignor is provided, either in the AOB form or in a separate document, a notice that summarizes the effect of the assignment of medical expense benefits, which notice states the following:\n\t\t\t\t“Notice: automobile accident patients\n\t\t\t\tIf you have been in an automobile accident, you may be entitled to payment from your automobile insurance if you have medical expense benefits coverage. By signing this assignment of benefits form you are giving to your health care provider the right to receive some or all of that payment directly from your automobile insurance company.\n\t\t\t\tIf you have health insurance and your healthcare provider is in-network: as long as you provide information necessary to verify your health insurance coverage the healthcare provider may only bill the amount you owe for any copayment, coinsurance, or deductibles to your automobile insurance and you may be entitled to any remainder of your automobile insurance benefit.\n\t\t\t\tIf you do not provide information necessary to verify your health insurance coverage, do not have health insurance, or your healthcare provider is not in your health insurer’s provider network: your health care provider may bill their full charges to your automobile insurance.\n\t\t\t\tYou may want to consult your insurance agent or attorney before signing or initialing this form. You are not required to sign\/initial this form to receive care.”2\n\nUpon receipt of a copy of an AOB form that satisfies the requirements of subdivision D 1 and (i) an explanation of benefits or remittance advice or (ii) a bill, claim form, or documentation from the assignee advising that it has been represented to the assignee that the covered injured person does not have health insurance or is covered by a self-insured or self-funded employee welfare benefit plan subject to the Employee Retirement Income Security Act of 1974 which requires medical expense coverage to be primary, a motor vehicle insurer shall pay directly to the health care provider, from any medical expense benefits available to such person under a motor vehicle insurance policy:\n\t\t\t\ta. If the covered injured person is covered under a health care policy, the health care provider is an in-network provider, and the health care provider has submitted its claim to the health insurer for the health care services, the amount of any copayments, coinsurance, or deductibles owed by the injured covered person to the health care provider, as evidenced by an explanation of benefits, remittance advice, or similar documentation provided to the motor vehicle insurer; or\n\t\t\t\tb. If (i) the covered injured person is not covered under a health care policy, (ii) the covered injured person is covered by a self-insured or self-funded employee welfare benefit plan subject to the Employee Retirement Income Security Act of 1974 which requires medical expense coverage to be primary, or (iii) the health care provider is not an in-network provider, amounts to cover the cost of the health care services provided, in the amount of the usual and customary fee charged in that community for the health care services rendered;3\n\nA motor vehicle insurer shall in all respects be held harmless for making payments pursuant to subdivision D 2 to a health care provider in accordance with an assignment of benefits that satisfies the requirements of subdivision D 1;4\n\nA covered injured person shall not be required to assign to any person any medical expense benefits he may have under this section, including any assignment of the proceeds of such coverages;5\n\nAn assignment of medical expense benefits shall be void and unenforceable as against public policy if the assignment does not comply with the requirements of subdivision D 1;6\n\nMedical expense benefits may not be reduced because of any benefits paid, payable, or provided by any insurance contract providing hospital, medical, surgical, and similar or related benefits, or any subscription contract or health services plan delivered or issued for delivery or providing for the payment of benefits to or on behalf of persons residing in or employed in the Commonwealth, except as authorized by this section; and7\n\nNothing in this section shall prohibit the payment of medical expense benefits due to the covered injured person directly to any state or federal assistance program that has provided medical benefits to such injured person when the injury arose out of the ownership, maintenance, or use of any motor vehicle.E\n\nAs used in subsection D:\n\t\t\t“AOB form” means the document or instrument that contains a provision by which the assignor assigns medical expense benefits, including any assignment of the proceeds of such coverages, to an assignee. The AOB form may be a separate instrument or included in another instrument, including a consent form or a form assigning other benefits.\n\t\t\t“Assignee” means the health care provider to which the assignor is assigning medical expense benefits, including any assignment of the proceeds of such coverages.\n\t\t\t“Assignor” means the covered injured person or a person authorized to consent on the covered injured person’s behalf.\n\t\t\t“Health care policy” means any health care plan, subscription contract, evidence of coverage, certificate, health services plan, medical or hospital services plan, accident and sickness insurance policy or certificate, or other similar certificate, policy, contract, or arrangement, and any endorsement or rider thereto, offered, arranged, issued, or administered by a health insurer to an individual or a group contract holder to cover all or a portion of the cost of individuals, or their eligible dependents, receiving covered health care services. Health care policy includes coverages issued pursuant to (i) Chapter 28 (§ 2.2-2800 et seq.) of Title 2.2 (state employees); (ii) § 2.2-1204 (local choice); (iii) 5 U.S.C. § 8901 et seq. (federal employees); and (iv) an employee welfare benefit plan as defined in 29 U.S.C. § 1002(1) of the Employee Retirement Income Security Act of 1974 that is self-insured or self-funded. Health care policy does not include (a) coverages issued pursuant to Title XVIII of the Social Security Act, 42 U.S.C. § 1395 et seq. (Medicare); Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq. (Medicaid), or Title XXI of the Social Security Act, 42 U.S.C. § 1397aa et seq. (CHIP); or Chapter 55 of Title 10 of the United States Code, 10 U.S.C. § 1071 et seq. (TRICARE); (b) subscription contracts for one or more dental or optometric services plans that are subject to Chapter 45 (§ 38.2-4500 et seq.); (c) insurance policies that provide coverage, singly or in combination, for death, dismemberment, disability, or hospital and medical care caused by or necessitated as a result of accident or specified kinds of accidents, including student accident, sports accident, blanket accident, specific accident, and accidental death and dismemberment policies; (d) credit life insurance and credit accident and sickness insurance issued pursuant to Chapter 37.1 (§ 38.2-3717 et seq.) of Title 38.2; (e) insurance policies that provide payments when an insured is disabled or unable to work because of illness, disease, or injury, including incidental benefits; (f) long-term care insurance as defined in § 38.2-5200; (g) plans providing only limited health care services under § 38.2-4300 unless offered by endorsement or rider to a group health benefit plan; (h) TRICARE supplement, Medicare supplement, and workers’ compensation coverages; or (i) medical expense coverage issued pursuant to this section.\n\t\t\t“Health care provider” has the same meaning that is ascribed to that term in § 8.01-581.1.\n\t\t\t“Health care services” means items or services furnished to any individual for the purpose of preventing, alleviating, curing, or healing human illness, injury, or physical disability.\n\t\t\t“Health insurer” means any entity that is the issuer or sponsor of a health care policy.\n\t\t\t“In-network provider” means a health care provider that is employed by or has entered into a provider agreement with the health insurer that has issued the health care policy, under which applicable agreement the health care provider has agreed to provide health care services to covered patients.\n\t\t\t“Medical expense benefits” means the benefits of coverages described in subdivision A 1, including any assignment of the proceeds of such coverages.\n\t\t\t“Motor vehicle insurer” means the insurer issuing or delivering a policy or contract covering liability arising from the ownership, maintenance, or use of any motor vehicle that provides coverage for medical expense benefits.\n\t\t\t“Person authorized to consent on the covered injured person’s behalf” means any person authorized by law to consent on behalf of the covered injured person incapable of making an informed decision or, in the case of a minor child, the parent or parents having custody of the child or the child’s legal guardian or as otherwise provided by law.\n\t\t\t“Provider agreement” means a contract, agreement, or arrangement between a health care provider and a health insurer, or a health insurer’s network, provider panel, intermediary, or representative, under which the health care provider has agreed to provide health care services to patients with coverage under a health care policy issued by the health insurer and to accept payment from the health insurer for the health care services provided.","order_by":null,"text":{"0":{"id":295508,"text":"Upon request of an insured, each insurer licensed in this Commonwealth issuing or delivering any policy or contract of bodily injury or property damage liability insurance covering liability arising from the ownership, maintenance or use of any motor vehicle shall provide on payment of the premium, as a minimum coverage (i) to persons occupying the insured motor vehicle; and (ii) to the named insured and, while resident of the named insured’s household, the spouse and relatives of the named insured while in or upon, entering or alighting from or through being struck by a motor vehicle while not occupying a motor vehicle, the following health care and disability benefits for each accident:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":295509,"text":"All reasonable and necessary expenses for medical, chiropractic, hospital, dental, surgical, prosthetic and rehabilitation services, services provided by an emergency medical services vehicle as defined in § 32.1-111.1, and funeral expenses, resulting from the accident and incurred within three years after the date of the accident, up to $2,000 per person; however, if the insured does not elect to purchase such limit the insurer and insured may agree to any other limit;","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":295510,"text":"If the person is usually engaged in a remunerative occupation, an amount equal to the loss of income incurred after the date of the accident resulting from injuries received in the accident up to $100 per week during the period from the first workday lost as a result of the accident up to the date the person is able to return to his usual occupation. However, the period shall not extend beyond one year from the date of the accident; and","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"A3"},"3":{"id":295511,"text":"An expense described in subdivision 1 shall be deemed to have been incurred:\n\t\t\t\ta. If the insured is directly responsible for payment of the expense;\n\t\t\t\tb. If the expense is paid by (i) a health care insurer pursuant to a negotiated contract with the health care provider or (ii) Medicaid or Medicare, where the actual payment with reference to the medical bill rendered by the provider is less than or equal to the provider’s usual and customary fee, in the amount of the actual payment as evidenced by an explanation of benefits, remittance advice, or similar documentation from the health care provider; however, if the insured is required to make a payment in addition to the actual payment by the health care insurer or Medicaid or Medicare, the amount shall be increased by the payment made by the insured; or\n\t\t\t\tc. If no medical bill is rendered or specific charge made by a health care provider to the insured, an insurer, or any other person, in the amount of the usual and customary fee charged in that community for the service rendered.","type":"section","prefixes":["A","3"],"prefix":"3","entire_prefix":"A3","prefix_anchor":"A3","level":2,"prior_prefix":"A2","next_prefix":"B"},"4":{"id":295512,"text":"The insured has the option of purchasing either or both of the coverages set forth in subdivisions A 1 and A 2. Either or both of the coverages, as well as any other medical expense or loss of income coverage under any policy of automobile liability insurance, shall be payable to the covered injured person or pursuant to an assignment of benefits in accordance with subsection D, notwithstanding the failure or refusal of the named insured or other person entitled to the coverage to give notice to the insurer of an accident as soon as practicable under the terms of the policy, except where the failure or refusal prejudices the insurer in establishing the validity of the claim.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A3","next_prefix":"C"},"5":{"id":295513,"text":"In any policy of personal automobile insurance in which the insured has purchased coverage under subsection A, every insurer providing such coverage arising from the ownership, maintenance or use of no more than four motor vehicles shall be liable to pay up to the maximum policy limit available on every motor vehicle insured under that coverage if the health care or disability expenses and costs mentioned in subsection A exceed the limits of coverage for any one motor vehicle so insured.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"6":{"id":295514,"text":"Any attempt to assign medical expense benefits shall be subject to the following:","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"D1"},"7":{"id":295515,"text":"An assignment of medical expense benefits shall be valid only if:\n\t\t\t\ta. A copy of the AOB form, executed by the assignor and in compliance with the other requirements of subdivision D 1 and a copy of the notice complying with subdivision g if such notice is provided in a separate document pursuant to subdivision e, is provided to the motor vehicle insurer;\n\t\t\t\tb. The AOB form is (i) in writing, which includes any printed or electronic format, (ii) dated, and (iii) executed by the assignor;\n\t\t\t\tc. The AOB form includes a conspicuous statement that the assignor is not required to execute the AOB form;\n\t\t\t\td. If the AOB form includes a notice that complies with the provisions of subdivision g, the AOB form is signed, initialed, or otherwise marked by the assignor, at or near the notice provision, to acknowledge that the assignor has read, or had the opportunity to read, the notice;\n\t\t\t\te. If the AOB form does not include a notice that complies with the provisions of subdivision g, (i) the assignor is given a separate document, in any printed or electronic format, that is delivered to the assignor at the same time as the AOB form and that contains a notice that complies with the provisions of subdivision g; (ii) the AOB form includes a conspicuous statement that a notice regarding the assignment of medical expense benefits is provided in a separate document; and (iii) the AOB form is signed, initialed, or otherwise marked by the assignor at or near the statement described in clause (ii) to acknowledge that the assignor has read, or had the opportunity to read, the separate document containing the notice;\n\t\t\t\tf. The statements required by subdivision D 1 to be included in the AOB form or a separate document, including the notice prescribed by subdivision g, are in not less than eight-point type; and\n\t\t\t\tg. The assignor is provided, either in the AOB form or in a separate document, a notice that summarizes the effect of the assignment of medical expense benefits, which notice states the following:\n\t\t\t\t“Notice: automobile accident patients\n\t\t\t\tIf you have been in an automobile accident, you may be entitled to payment from your automobile insurance if you have medical expense benefits coverage. By signing this assignment of benefits form you are giving to your health care provider the right to receive some or all of that payment directly from your automobile insurance company.\n\t\t\t\tIf you have health insurance and your healthcare provider is in-network: as long as you provide information necessary to verify your health insurance coverage the healthcare provider may only bill the amount you owe for any copayment, coinsurance, or deductibles to your automobile insurance and you may be entitled to any remainder of your automobile insurance benefit.\n\t\t\t\tIf you do not provide information necessary to verify your health insurance coverage, do not have health insurance, or your healthcare provider is not in your health insurer’s provider network: your health care provider may bill their full charges to your automobile insurance.\n\t\t\t\tYou may want to consult your insurance agent or attorney before signing or initialing this form. You are not required to sign\/initial this form to receive care.”","type":"section","prefixes":["D","1"],"prefix":"1","entire_prefix":"D1","prefix_anchor":"D1","level":2,"prior_prefix":"D","next_prefix":"D2"},"8":{"id":295516,"text":"Upon receipt of a copy of an AOB form that satisfies the requirements of subdivision D 1 and (i) an explanation of benefits or remittance advice or (ii) a bill, claim form, or documentation from the assignee advising that it has been represented to the assignee that the covered injured person does not have health insurance or is covered by a self-insured or self-funded employee welfare benefit plan subject to the Employee Retirement Income Security Act of 1974 which requires medical expense coverage to be primary, a motor vehicle insurer shall pay directly to the health care provider, from any medical expense benefits available to such person under a motor vehicle insurance policy:\n\t\t\t\ta. If the covered injured person is covered under a health care policy, the health care provider is an in-network provider, and the health care provider has submitted its claim to the health insurer for the health care services, the amount of any copayments, coinsurance, or deductibles owed by the injured covered person to the health care provider, as evidenced by an explanation of benefits, remittance advice, or similar documentation provided to the motor vehicle insurer; or\n\t\t\t\tb. If (i) the covered injured person is not covered under a health care policy, (ii) the covered injured person is covered by a self-insured or self-funded employee welfare benefit plan subject to the Employee Retirement Income Security Act of 1974 which requires medical expense coverage to be primary, or (iii) the health care provider is not an in-network provider, amounts to cover the cost of the health care services provided, in the amount of the usual and customary fee charged in that community for the health care services rendered;","type":"section","prefixes":["D","2"],"prefix":"2","entire_prefix":"D2","prefix_anchor":"D2","level":2,"prior_prefix":"D1","next_prefix":"D3"},"9":{"id":295517,"text":"A motor vehicle insurer shall in all respects be held harmless for making payments pursuant to subdivision D 2 to a health care provider in accordance with an assignment of benefits that satisfies the requirements of subdivision D 1;","type":"section","prefixes":["D","3"],"prefix":"3","entire_prefix":"D3","prefix_anchor":"D3","level":2,"prior_prefix":"D2","next_prefix":"D4"},"10":{"id":295518,"text":"A covered injured person shall not be required to assign to any person any medical expense benefits he may have under this section, including any assignment of the proceeds of such coverages;","type":"section","prefixes":["D","4"],"prefix":"4","entire_prefix":"D4","prefix_anchor":"D4","level":2,"prior_prefix":"D3","next_prefix":"D5"},"11":{"id":295519,"text":"An assignment of medical expense benefits shall be void and unenforceable as against public policy if the assignment does not comply with the requirements of subdivision D 1;","type":"section","prefixes":["D","5"],"prefix":"5","entire_prefix":"D5","prefix_anchor":"D5","level":2,"prior_prefix":"D4","next_prefix":"D6"},"12":{"id":295520,"text":"Medical expense benefits may not be reduced because of any benefits paid, payable, or provided by any insurance contract providing hospital, medical, surgical, and similar or related benefits, or any subscription contract or health services plan delivered or issued for delivery or providing for the payment of benefits to or on behalf of persons residing in or employed in the Commonwealth, except as authorized by this section; and","type":"section","prefixes":["D","6"],"prefix":"6","entire_prefix":"D6","prefix_anchor":"D6","level":2,"prior_prefix":"D5","next_prefix":"D7"},"13":{"id":295521,"text":"Nothing in this section shall prohibit the payment of medical expense benefits due to the covered injured person directly to any state or federal assistance program that has provided medical benefits to such injured person when the injury arose out of the ownership, maintenance, or use of any motor vehicle.","type":"section","prefixes":["D","7"],"prefix":"7","entire_prefix":"D7","prefix_anchor":"D7","level":2,"prior_prefix":"D6","next_prefix":"E"},"14":{"id":295522,"text":"As used in subsection D:\n\t\t\t“AOB form” means the document or instrument that contains a provision by which the assignor assigns medical expense benefits, including any assignment of the proceeds of such coverages, to an assignee. The AOB form may be a separate instrument or included in another instrument, including a consent form or a form assigning other benefits.\n\t\t\t“Assignee” means the health care provider to which the assignor is assigning medical expense benefits, including any assignment of the proceeds of such coverages.\n\t\t\t“Assignor” means the covered injured person or a person authorized to consent on the covered injured person’s behalf.\n\t\t\t“Health care policy” means any health care plan, subscription contract, evidence of coverage, certificate, health services plan, medical or hospital services plan, accident and sickness insurance policy or certificate, or other similar certificate, policy, contract, or arrangement, and any endorsement or rider thereto, offered, arranged, issued, or administered by a health insurer to an individual or a group contract holder to cover all or a portion of the cost of individuals, or their eligible dependents, receiving covered health care services. Health care policy includes coverages issued pursuant to (i) Chapter 28 (§ 2.2-2800 et seq.) of Title 2.2 (state employees); (ii) § 2.2-1204 (local choice); (iii) 5 U.S.C. § 8901 et seq. (federal employees); and (iv) an employee welfare benefit plan as defined in 29 U.S.C. § 1002(1) of the Employee Retirement Income Security Act of 1974 that is self-insured or self-funded. Health care policy does not include (a) coverages issued pursuant to Title XVIII of the Social Security Act, 42 U.S.C. § 1395 et seq. (Medicare); Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq. (Medicaid), or Title XXI of the Social Security Act, 42 U.S.C. § 1397aa et seq. (CHIP); or Chapter 55 of Title 10 of the United States Code, 10 U.S.C. § 1071 et seq. (TRICARE); (b) subscription contracts for one or more dental or optometric services plans that are subject to Chapter 45 (§ 38.2-4500 et seq.); (c) insurance policies that provide coverage, singly or in combination, for death, dismemberment, disability, or hospital and medical care caused by or necessitated as a result of accident or specified kinds of accidents, including student accident, sports accident, blanket accident, specific accident, and accidental death and dismemberment policies; (d) credit life insurance and credit accident and sickness insurance issued pursuant to Chapter 37.1 (§ 38.2-3717 et seq.) of Title 38.2; (e) insurance policies that provide payments when an insured is disabled or unable to work because of illness, disease, or injury, including incidental benefits; (f) long-term care insurance as defined in § 38.2-5200; (g) plans providing only limited health care services under § 38.2-4300 unless offered by endorsement or rider to a group health benefit plan; (h) TRICARE supplement, Medicare supplement, and workers’ compensation coverages; or (i) medical expense coverage issued pursuant to this section.\n\t\t\t“Health care provider” has the same meaning that is ascribed to that term in § 8.01-581.1.\n\t\t\t“Health care services” means items or services furnished to any individual for the purpose of preventing, alleviating, curing, or healing human illness, injury, or physical disability.\n\t\t\t“Health insurer” means any entity that is the issuer or sponsor of a health care policy.\n\t\t\t“In-network provider” means a health care provider that is employed by or has entered into a provider agreement with the health insurer that has issued the health care policy, under which applicable agreement the health care provider has agreed to provide health care services to covered patients.\n\t\t\t“Medical expense benefits” means the benefits of coverages described in subdivision A 1, including any assignment of the proceeds of such coverages.\n\t\t\t“Motor vehicle insurer” means the insurer issuing or delivering a policy or contract covering liability arising from the ownership, maintenance, or use of any motor vehicle that provides coverage for medical expense benefits.\n\t\t\t“Person authorized to consent on the covered injured person’s behalf” means any person authorized by law to consent on behalf of the covered injured person incapable of making an informed decision or, in the case of a minor child, the parent or parents having custody of the child or the child’s legal guardian or as otherwise provided by law.\n\t\t\t“Provider agreement” means a contract, agreement, or arrangement between a health care provider and a health insurer, or a health insurer’s network, provider panel, intermediary, or representative, under which the health care provider has agreed to provide health care services to patients with coverage under a health care policy issued by the health insurer and to accept payment from the health insurer for the health care services provided.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D7"}},"ancestry":[{"id":13816,"edition_id":1,"name":"Liability Insurance Policies","identifier":"22","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:45:57","date_modified":"2026-06-26 03:45:57","permalink":{"id":213545,"object_type":"structure","relational_id":13816,"identifier":"22","token":"38.2\/22","url":"\/38.2\/22\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":76505,"structure_id":13816,"section_number":"38.2-2200","catch_line":"Required provisions as to insolvency or bankruptcy, and as to when action maintained against insurer","url":"\/38.2-2200\/","token":"38.2\/22\/38.2-2200","metadata":false},{"id":82480,"structure_id":13816,"section_number":"38.2-2201","catch_line":"Provisions for payment of medical expense and loss of income benefits; assignment of certain benefits","url":"\/38.2-2201\/","token":"38.2\/22\/38.2-2201","metadata":false},{"id":75263,"structure_id":13816,"section_number":"38.2-2202","catch_line":"Required notice of optional coverage available","url":"\/38.2-2202\/","token":"38.2\/22\/38.2-2202","metadata":false},{"id":85859,"structure_id":13816,"section_number":"38.2-2203","catch_line":"Policy providing for reimbursement for services that may be performed by certain practitioners other than physicians","url":"\/38.2-2203\/","token":"38.2\/22\/38.2-2203","metadata":false},{"id":70028,"structure_id":13816,"section_number":"38.2-2204","catch_line":"Liability insurance on motor vehicles, aircraft, and watercraft; standard provisions; \"omnibus clause.\"","url":"\/38.2-2204\/","token":"38.2\/22\/38.2-2204","metadata":false},{"id":56297,"structure_id":13816,"section_number":"38.2-2205","catch_line":"Liability insurance on motor vehicles; standard provisions; applicability of other valid and collectible insurance","url":"\/38.2-2205\/","token":"38.2\/22\/38.2-2205","metadata":false},{"id":80304,"structure_id":13816,"section_number":"38.2-2205.1","catch_line":"Suspension of liability coverage at insured's request","url":"\/38.2-2205.1\/","token":"38.2\/22\/38.2-2205.1","metadata":false},{"id":76965,"structure_id":13816,"section_number":"38.2-2206","catch_line":"Uninsured motorist insurance coverage","url":"\/38.2-2206\/","token":"38.2\/22\/38.2-2206","metadata":false},{"id":62972,"structure_id":13816,"section_number":"38.2-2207","catch_line":"No policy to exclude coverage to employee","url":"\/38.2-2207\/","token":"38.2\/22\/38.2-2207","metadata":false},{"id":80121,"structure_id":13816,"section_number":"38.2-2208","catch_line":"Notices of cancellation of or refusal to renew motor vehicle insurance policies","url":"\/38.2-2208\/","token":"38.2\/22\/38.2-2208","metadata":false},{"id":76452,"structure_id":13816,"section_number":"38.2-2209","catch_line":"Motor vehicle liability medical benefit insurer not to retain right of subrogation to recover from third party","url":"\/38.2-2209\/","token":"38.2\/22\/38.2-2209","metadata":false},{"id":75993,"structure_id":13816,"section_number":"38.2-2210","catch_line":"Warning concerning cancellation to appear on application for motor vehicle liability insurance; reason for cancellation or nonrenewal required on application","url":"\/38.2-2210\/","token":"38.2\/22\/38.2-2210","metadata":false},{"id":61927,"structure_id":13816,"section_number":"38.2-2211","catch_line":"Motor vehicle liability insurer not to receive credit for other medical expense insurance","url":"\/38.2-2211\/","token":"38.2\/22\/38.2-2211","metadata":false},{"id":80817,"structure_id":13816,"section_number":"38.2-2212","catch_line":"Grounds and procedure for cancellation of or refusal to renew motor vehicle insurance policies; review by Commissioner","url":"\/38.2-2212\/","token":"38.2\/22\/38.2-2212","metadata":false},{"id":71236,"structure_id":13816,"section_number":"38.2-2212.1","catch_line":"Powers of Commission; replacement policies","url":"\/38.2-2212.1\/","token":"38.2\/22\/38.2-2212.1","metadata":false},{"id":57322,"structure_id":13816,"section_number":"38.2-2213","catch_line":"Discrimination in issuance of motor vehicle insurance","url":"\/38.2-2213\/","token":"38.2\/22\/38.2-2213","metadata":false},{"id":55969,"structure_id":13816,"section_number":"38.2-2213.1","catch_line":"Certain action prohibited when motor vehicle owner fails to allow access to recorded data from recording device","url":"\/38.2-2213.1\/","token":"38.2\/22\/38.2-2213.1","metadata":false},{"id":72056,"structure_id":13816,"section_number":"38.2-2214","catch_line":"Statement defining rate classifications to be provided by insurer to insured","url":"\/38.2-2214\/","token":"38.2\/22\/38.2-2214","metadata":false},{"id":56175,"structure_id":13816,"section_number":"38.2-2215","catch_line":"Failure to issue or failure to renew motor vehicle liability insurance on the basis of a motor vehicle's age prohibited","url":"\/38.2-2215\/","token":"38.2\/22\/38.2-2215","metadata":false},{"id":77698,"structure_id":13816,"section_number":"38.2-2216","catch_line":"Medical benefit offset against liability or uninsured motorist coverage prohibited","url":"\/38.2-2216\/","token":"38.2\/22\/38.2-2216","metadata":false},{"id":66919,"structure_id":13816,"section_number":"38.2-2217","catch_line":"Reduction in rates for certain persons who attend mature driver motor vehicle crash prevention courses and driver improvement clinics","url":"\/38.2-2217\/","token":"38.2\/22\/38.2-2217","metadata":false},{"id":62782,"structure_id":13816,"section_number":"38.2-2217.1","catch_line":"Insurers required to renew motor vehicle liability coverage for vanpools; exceptions","url":"\/38.2-2217.1\/","token":"38.2\/22\/38.2-2217.1","metadata":false},{"id":75945,"structure_id":13816,"section_number":"38.2-2218","catch_line":"Adoption of standard forms for motor vehicle insurance","url":"\/38.2-2218\/","token":"38.2\/22\/38.2-2218","metadata":false},{"id":65638,"structure_id":13816,"section_number":"38.2-2219","catch_line":"Hearing on objections to the form","url":"\/38.2-2219\/","token":"38.2\/22\/38.2-2219","metadata":false},{"id":68775,"structure_id":13816,"section_number":"38.2-2220","catch_line":"Use of form after adoption","url":"\/38.2-2220\/","token":"38.2\/22\/38.2-2220","metadata":false},{"id":77162,"structure_id":13816,"section_number":"38.2-2221","catch_line":"Amendment of standard form","url":"\/38.2-2221\/","token":"38.2\/22\/38.2-2221","metadata":false},{"id":68996,"structure_id":13816,"section_number":"38.2-2222","catch_line":"Withdrawal of form","url":"\/38.2-2222\/","token":"38.2\/22\/38.2-2222","metadata":false},{"id":73915,"structure_id":13816,"section_number":"38.2-2223","catch_line":"Variations of, or additions to, form","url":"\/38.2-2223\/","token":"38.2\/22\/38.2-2223","metadata":false},{"id":67966,"structure_id":13816,"section_number":"38.2-2224","catch_line":"Commission to establish guidelines for filing readable motor vehicle insurance policy forms","url":"\/38.2-2224\/","token":"38.2\/22\/38.2-2224","metadata":false},{"id":70751,"structure_id":13816,"section_number":"38.2-2225","catch_line":"Sending copies of orders to companies affected","url":"\/38.2-2225\/","token":"38.2\/22\/38.2-2225","metadata":false},{"id":79233,"structure_id":13816,"section_number":"38.2-2226","catch_line":"Insurer to give notice to claimant of intention to rely on certain defenses and of execution of nonwaiver of rights agreement","url":"\/38.2-2226\/","token":"38.2\/22\/38.2-2226","metadata":false},{"id":64295,"structure_id":13816,"section_number":"38.2-2226.1","catch_line":"Insurer to give notice of settlement of claim","url":"\/38.2-2226.1\/","token":"38.2\/22\/38.2-2226.1","metadata":false},{"id":75189,"structure_id":13816,"section_number":"38.2-2227","catch_line":"Aircraft liability policy not to deny coverage for violation of federal or civil regulations, etc.; permitted exclusions or conditions","url":"\/38.2-2227\/","token":"38.2\/22\/38.2-2227","metadata":false},{"id":54902,"structure_id":13816,"section_number":"38.2-2228","catch_line":"Repealed","url":"\/38.2-2228\/","token":"38.2\/22\/38.2-2228","metadata":false},{"id":54970,"structure_id":13816,"section_number":"38.2-2228.2","catch_line":"Certain medical malpractice claims to be reported to the Commission","url":"\/38.2-2228.2\/","token":"38.2\/22\/38.2-2228.2","metadata":false},{"id":76107,"structure_id":13816,"section_number":"38.2-2229","catch_line":"Claims-made liability insurance","url":"\/38.2-2229\/","token":"38.2\/22\/38.2-2229","metadata":false},{"id":71578,"structure_id":13816,"section_number":"38.2-2230","catch_line":"Mandatory offer of rental reimbursement coverage","url":"\/38.2-2230\/","token":"38.2\/22\/38.2-2230","metadata":false},{"id":81873,"structure_id":13816,"section_number":"38.2-2231","catch_line":"Physical damage arbitration between insurers; alternate forums","url":"\/38.2-2231\/","token":"38.2\/22\/38.2-2231","metadata":false},{"id":54821,"structure_id":13816,"section_number":"38.2-2232","catch_line":"Liability insurance on private pleasure watercraft; optional coverage","url":"\/38.2-2232\/","token":"38.2\/22\/38.2-2232","metadata":false},{"id":69145,"structure_id":13816,"section_number":"38.2-2233","catch_line":"Installment payments of motor vehicle insurance","url":"\/38.2-2233\/","token":"38.2\/22\/38.2-2233","metadata":false},{"id":83935,"structure_id":13816,"section_number":"38.2-2234","catch_line":"Insurance credit score disclosure; use of credit information","url":"\/38.2-2234\/","token":"38.2\/22\/38.2-2234","metadata":false}],"previous_section":{"id":76505,"structure_id":13816,"section_number":"38.2-2200","catch_line":"Required provisions as to insolvency or bankruptcy, and as to when action maintained against insurer","url":"\/38.2-2200\/","token":"38.2\/22\/38.2-2200","metadata":false},"next_section":{"id":75263,"structure_id":13816,"section_number":"38.2-2202","catch_line":"Required notice of optional coverage available","url":"\/38.2-2202\/","token":"38.2\/22\/38.2-2202","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-2201\/","history_text":"

This law was first created in 1972. The record of its establishment is cataloged in chapter 859 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1972 \u201cActs\u201d aren\u2019t available online. It has been modified 13 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1973, chapter 294; in 1977, chapter 112; in 1982, chapter 450; in 1983, chapters 197 and 370; in 1986, chapter 562; in 1987, chapter 429; in 1989, chapter 243; in 1991, chapter 4; in 1996, chapter 276<\/a>; in 1997, chapter 503<\/a>; in 2013, chapter 75<\/a>; in 2014, chapters 157<\/a> and 417<\/a>; in 2015, chapters 502<\/a> and 503<\/a>.<\/p>","references":[{"id":66976,"section_number":"38.2-124","catch_line":"Motor vehicle","order_by":null,"url":"\/38.2-124\/"},{"id":71560,"section_number":"8.01-27.5","catch_line":"Duty of in-network providers to submit claims to health insurers; liability of covered patients for unbilled health care services","order_by":null,"url":"\/8.01-27.5\/"},{"id":62732,"section_number":"8.01-413.01","catch_line":"Authenticity and reasonableness of medical bills; presumption","order_by":null,"url":"\/8.01-413.01\/"}],"refers_to":[{"id":64954,"section_number":"2.2-1204","catch_line":"Health insurance program for employees of local governments, local officers, teachers, etc.; definitions","order_by":null,"url":"\/2.2-1204\/"},{"id":68109,"section_number":"2.2-2800","catch_line":"Disability to hold state office","order_by":null,"url":"\/2.2-2800\/"},{"id":74269,"section_number":"32.1-111.1","catch_line":"Definitions","order_by":null,"url":"\/32.1-111.1\/"},{"id":78738,"section_number":"38.2-3717","catch_line":"Scope","order_by":null,"url":"\/38.2-3717\/"},{"id":72005,"section_number":"38.2-4300","catch_line":"Definitions","order_by":null,"url":"\/38.2-4300\/"},{"id":59325,"section_number":"38.2-4500","catch_line":"Applicability of chapter","order_by":null,"url":"\/38.2-4500\/"},{"id":81666,"section_number":"38.2-5200","catch_line":"Definitions","order_by":null,"url":"\/38.2-5200\/"},{"id":79489,"section_number":"8.01-581.1","catch_line":"Definitions","order_by":null,"url":"\/8.01-581.1\/"}],"permalink":{"id":213551,"object_type":"law","relational_id":82480,"identifier":"38.2-2201","token":"38.2\/22\/38.2-2201","url":"\/38.2-2201\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-2201\/","token":"38.2\/22\/38.2-2201","dublin_core":{"Title":"Provisions for payment of medical expense and loss of income benefits; assignment of certain benefits","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-2201","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Upon request of an insured, each insurer<\/span> licensed in this Commonwealth issuing or delivering any policy or contract<\/span> of bodily injury or property damage liability insurance<\/span> covering liability arising from the ownership, maintenance or use of any motor vehicle shall provide on payment of the premium, as a minimum coverage (i) to persons<\/span> occupying the insured motor vehicle; and (ii) to the named insured and, while resident of the named insured’s household, the spouse and relatives of the named insured while in or upon, entering or alighting from or through being struck by a motor vehicle while not occupying a motor vehicle, the following health care and disability benefits for each accident: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> All reasonable and necessary expenses for medical, chiropractic, hospital, dental, surgical, prosthetic and rehabilitation services, services provided by an emergency medical services vehicle as defined in § 32.1-111.1<\/a>, and funeral expenses, resulting from the accident and incurred within three years after the date of the accident, up to $2,000 per person<\/span>; however, if the insured does not elect to purchase such limit the insurer<\/span> and insured may agree to any other limit; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> If the person<\/span> is usually engaged in a remunerative occupation, an amount equal to the loss of income incurred after the date of the accident resulting from injuries received in the accident up to $100 per week during the period from the first workday lost as a result of the accident up to the date the person<\/span> is able to return to his usual occupation. However, the period shall not extend beyond one year from the date of the accident; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> An expense described in subdivision 1 shall be deemed to have been incurred:\n\t\t\t\ta. If the insured is directly responsible for payment of the expense;\n\t\t\t\tb. If the expense is paid by (i) a health care insurer<\/span> pursuant to a negotiated contract<\/span> with the health care provider or (ii) Medicaid or Medicare<\/span>, where the actual payment with reference to the medical bill rendered by the provider is less than or equal to the provider’s usual and customary fee, in the amount of the actual payment as evidenced by an explanation of benefits, remittance advice, or similar documentation from the health care provider; however, if the insured is required to make a payment in addition to the actual payment by the health care insurer<\/span> or Medicaid or Medicare<\/span>, the amount shall be increased by the payment made by the insured; or\n\t\t\t\tc. If no medical bill is rendered or specific charge made by a health care provider to the insured, an insurer<\/span>, or any other person<\/span>, in the amount of the usual and customary fee charged in that community for the service rendered. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The insured has the option of purchasing either or both of the coverages set forth in subdivisions A 1 and A 2. Either or both of the coverages, as well as any other medical expense or loss of income coverage under any policy of automobile liability insurance<\/span>, shall be payable to the covered injured person<\/span> or pursuant to an assignment of benefits in accordance with subsection D, notwithstanding the failure or refusal of the named insured or other person<\/span> entitled to the coverage to give notice to the insurer<\/span> of an accident as soon as practicable under the terms of the policy, except where the failure or refusal prejudices the insurer<\/span> in establishing the validity of the claim. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> In any policy of personal automobile insurance<\/span> in which the insured has purchased coverage under subsection A, every insurer<\/span> providing such coverage arising from the ownership, maintenance or use of no more than four motor vehicles shall be liable to pay up to the maximum policy limit available on every motor vehicle insured under that coverage if the health care or disability expenses and costs mentioned in subsection A exceed the limits of coverage for any one motor vehicle so insured. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> Any attempt to assign medical expense benefits<\/span> shall be subject to the following: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> An assignment of medical expense benefits<\/span> shall be valid only if:\n\t\t\t\ta. A copy of the AOB form<\/span>, executed by the assignor<\/span> and in compliance with the other requirements of subdivision D 1 and a copy of the notice complying with subdivision g if such notice is provided in a separate document pursuant to subdivision e, is provided to the motor vehicle insurer<\/span>;\n\t\t\t\tb. The AOB form<\/span> is (i) in writing, which includes any printed or electronic format, (ii) dated, and (iii) executed by the assignor<\/span>;\n\t\t\t\tc. The AOB form<\/span> includes a conspicuous statement that the assignor<\/span> is not required to execute the AOB form<\/span>;\n\t\t\t\td. If the AOB form<\/span> includes a notice that complies with the provisions of subdivision g, the AOB form<\/span> is signed, initialed, or otherwise marked by the assignor<\/span>, at or near the notice provision, to acknowledge that the assignor<\/span> has read, or had the opportunity to read, the notice;\n\t\t\t\te. If the AOB form<\/span> does not include a notice that complies with the provisions of subdivision g, (i) the assignor<\/span> is given a separate document, in any printed or electronic format, that is delivered to the assignor<\/span> at the same time as the AOB form<\/span> and that contains a notice that complies with the provisions of subdivision g; (ii) the AOB form<\/span> includes a conspicuous statement that a notice regarding the assignment of medical expense benefits<\/span> is provided in a separate document; and (iii) the AOB form<\/span> is signed, initialed, or otherwise marked by the assignor<\/span> at or near the statement described in clause (ii) to acknowledge that the assignor<\/span> has read, or had the opportunity to read, the separate document containing the notice;\n\t\t\t\tf. The statements required by subdivision D 1 to be included in the AOB form<\/span> or a separate document, including the notice prescribed by subdivision g, are in not less than eight-point type; and\n\t\t\t\tg. The assignor<\/span> is provided, either in the AOB form<\/span> or in a separate document, a notice that summarizes the effect of the assignment of medical expense benefits<\/span>, which notice states<\/span> the following:\n\t\t\t\t“Notice: automobile accident patients\n\t\t\t\tIf you have been in an automobile accident, you may be entitled to payment from your automobile insurance if you have medical expense benefits<\/span> coverage. By signing this assignment of benefits form you are giving to your health care provider the right to receive some or all of that payment directly from your automobile insurance company<\/span>.\n\t\t\t\tIf you have health insurance and your healthcare provider is in-network: as long as you provide information necessary to verify your health insurance coverage the healthcare provider may only bill the amount you owe for any copayment, coinsurance, or deductibles to your automobile insurance and you may be entitled to any remainder of your automobile insurance benefit.\n\t\t\t\tIf you do not provide information necessary to verify your health insurance coverage, do not have health insurance, or your healthcare provider is not in your health insurer<\/span>’s provider network: your health care provider may bill their full charges to your automobile insurance.\n\t\t\t\tYou may want to consult your insurance agent or attorney before signing or initialing this form. You are not required to sign\/initial this form to receive care.” <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Upon receipt of a copy of an AOB form<\/span> that satisfies the requirements of subdivision D 1 and (i) an explanation of benefits or remittance advice or (ii) a bill, claim form, or documentation from the assignee<\/span> advising that it has been represented to the assignee<\/span> that the covered injured person<\/span> does not have health insurance or is covered by a self-insured or self-funded employee welfare benefit plan subject to the Employee Retirement Income Security Act of 1974 which requires medical expense coverage to be primary, a motor vehicle insurer<\/span> shall pay directly to the health care provider, from any medical expense benefits<\/span> available to such person<\/span> under a motor vehicle insurance policy:\n\t\t\t\ta. If the covered injured person<\/span> is covered under a health care policy<\/span>, the health care provider is an in-network provider<\/span>, and the health care provider has submitted its claim to the health insurer<\/span> for the health care services<\/span>, the amount of any copayments, coinsurance, or deductibles owed by the injured covered person<\/span> to the health care provider, as evidenced by an explanation of benefits, remittance advice, or similar documentation provided to the motor vehicle insurer<\/span>; or\n\t\t\t\tb. If (i) the covered injured person<\/span> is not covered under a health care policy<\/span>, (ii) the covered injured person<\/span> is covered by a self-insured or self-funded employee welfare benefit plan subject to the Employee Retirement Income Security Act of 1974 which requires medical expense coverage to be primary, or (iii) the health care provider is not an in-network provider<\/span>, amounts to cover the cost of the health care services<\/span> provided, in the amount of the usual and customary fee charged in that community for the health care services<\/span> rendered; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> A motor vehicle insurer<\/span> shall in all respects be held harmless for making payments pursuant to subdivision D 2 to a health care provider in accordance with an assignment of benefits that satisfies the requirements of subdivision D 1; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> A covered injured person<\/span> shall not be required to assign to any person<\/span> any medical expense benefits<\/span> he may have under this section, including any assignment of the proceeds of such coverages; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> An assignment of medical expense benefits<\/span> shall be void and unenforceable as against public policy if the assignment does not comply with the requirements of subdivision D 1; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> Medical expense benefits<\/span> may not be reduced because of any benefits paid, payable, or provided by any insurance contract<\/span> providing hospital, medical, surgical, and similar or related benefits, or any subscription contract<\/span> or health services plan<\/span> delivered or issued for delivery or providing for the payment of benefits to or on behalf of persons<\/span> residing in or employed in the Commonwealth, except as authorized by this section; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> Nothing in this section shall prohibit the payment of medical expense benefits<\/span> due to the covered injured person<\/span> directly to any state<\/span> or federal assistance program that has provided medical benefits to such injured person<\/span> when the injury arose out of the ownership, maintenance, or use of any motor vehicle. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> As used in subsection D:\n\t\t\t“AOB form<\/span>” means the document or instrument that contains a provision by which the assignor<\/span> assigns medical expense benefits<\/span>, including any assignment of the proceeds of such coverages, to an assignee<\/span>. The AOB form<\/span> may be a separate instrument or included in another instrument, including a consent form or a form assigning other benefits.\n\t\t\t“Assignee<\/span>” means the health care provider to which the assignor<\/span> is assigning medical expense benefits<\/span>, including any assignment of the proceeds of such coverages.\n\t\t\t“Assignor<\/span>” means the covered injured person<\/span> or a person<\/span> authorized to consent on the covered injured person<\/span>’s behalf.\n\t\t\t“Health care policy<\/span>” means any health care plan, subscription contract<\/span>, evidence<\/span> of coverage, certificate, health services plan<\/span>, medical or hospital services plan, accident and sickness insurance policy or certificate, or other similar certificate, policy, contract<\/span>, or arrangement, and any endorsement or rider thereto, offered, arranged, issued, or administered by a health insurer<\/span> to an individual or a group contract<\/span> holder to cover all or a portion of the cost of individuals, or their eligible dependents, receiving covered health care services<\/span>. Health care policy<\/span> includes coverages issued pursuant to (i) Chapter 28 (§ 2.2-2800<\/a> et seq.) of Title 2.2 (state<\/span> employees); (ii) § 2.2-1204<\/a> (local choice); (iii) 5 U.S.C. § 8901 et seq. (federal employees); and (iv) an employee welfare benefit plan as defined in 29 U.S.C. § 1002(1) of the Employee Retirement Income Security Act of 1974 that is self-insured or self-funded. Health care policy<\/span> does not include (a) coverages issued pursuant to Title XVIII of the Social Security Act, 42 U.S.C. § 1395 et seq. (Medicare<\/span>); Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq. (Medicaid), or Title XXI of the Social Security Act, 42 U.S.C. § 1397aa et seq. (CHIP); or Chapter 55 of Title 10 of the United States<\/span> Code, 10 U.S.C. § 1071 et seq. (TRICARE); (b) subscription contracts<\/span> for one or more dental or optometric services plans that are subject to Chapter 45 (§ 38.2-4500<\/a> et seq.); (c) insurance policies<\/span> that provide coverage, singly or in combination, for death, dismemberment, disability, or hospital and medical care caused by or necessitated as a result of accident or specified kinds of accidents, including student accident, sports accident, blanket accident, specific accident, and accidental death and dismemberment policies; (d) credit life insurance and credit accident and sickness insurance issued pursuant to Chapter 37.1 (§ 38.2-3717<\/a> et seq.) of Title 38.2; (e) insurance policies<\/span> that provide payments when an insured is disabled or unable to work because of illness, disease, or injury, including incidental benefits; (f) long-term care insurance as defined in § 38.2-5200<\/a>; (g) plans providing only limited health care services<\/span> under § 38.2-4300<\/a> unless offered by endorsement or rider to a group health benefit plan; (h) TRICARE supplement, Medicare<\/span> supplement, and workers’ compensation coverages; or (i) medical expense coverage issued pursuant to this section.\n\t\t\t“Health care provider” has the same meaning that is ascribed to that term in § 8.01-581.1<\/a>.\n\t\t\t“Health care services<\/span>” means items or services furnished to any individual for the purpose of preventing, alleviating, curing, or healing human illness, injury, or physical disability.\n\t\t\t“Health insurer<\/span>” means any entity that is the issuer or sponsor of a health care policy<\/span>.\n\t\t\t“In-network provider<\/span>” means a health care provider that is employed by or has entered into a provider agreement<\/span> with the health insurer<\/span> that has issued the health care policy<\/span>, under which applicable agreement the health care provider has agreed to provide health care services<\/span> to covered patients.\n\t\t\t“Medical expense benefits<\/span>” means the benefits of coverages described in subdivision A 1, including any assignment of the proceeds of such coverages.\n\t\t\t“Motor vehicle insurer<\/span>” means the insurer issuing or delivering a policy or contract<\/span> covering liability arising from the ownership, maintenance, or use of any motor vehicle that provides coverage for medical expense benefits<\/span>.\n\t\t\t“Person<\/span> authorized to consent on the covered injured person<\/span>’s behalf” means any person<\/span> authorized by law<\/span> to consent on behalf of the covered injured person<\/span> incapable of making an informed decision or, in the case of a minor<\/span> child, the parent or parents having custody<\/span> of the child or the child’s legal guardian or as otherwise provided by law<\/span>.\n\t\t\t“Provider agreement<\/span>” means a contract<\/span>, agreement, or arrangement between a health care provider and a health insurer<\/span>, or a health insurer<\/span>’s network, provider panel<\/span>, intermediary, or representative, under which the health care provider has agreed to provide health care services<\/span> to patients with coverage under a health care policy<\/span> issued by the health insurer<\/span> and to accept payment from the health insurer<\/span> for the health care services<\/span> provided. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nPROVISIONS FOR PAYMENT OF MEDICAL EXPENSE AND LOSS OF INCOME BENEFITS;\nASSIGNMENT OF CERTAIN BENEFITS (\u00a7 38.2-2201)\n\nA. Upon request of an insured, each insurer licensed in this Commonwealth\nissuing or delivering any policy or contract of bodily injury or property damage\nliability insurance covering liability arising from the ownership, maintenance\nor use of any motor vehicle shall provide on payment of the premium, as a\nminimum coverage (i) to persons occupying the insured motor vehicle; and (ii) to\nthe named insured and, while resident of the named insured’s household,\nthe spouse and relatives of the named insured while in or upon, entering or\nalighting from or through being struck by a motor vehicle while not occupying a\nmotor vehicle, the following health care and disability benefits for each\naccident:\n\n 1. All reasonable and necessary expenses for medical, chiropractic, hospital,\n dental, surgical, prosthetic and rehabilitation services, services provided by\n an emergency medical services vehicle as defined in § 32.1-111.1, and\n funeral expenses, resulting from the accident and incurred within three years\n after the date of the accident, up to $2,000 per person; however, if the\n insured does not elect to purchase such limit the insurer and insured may\n agree to any other limit;\n\n 2. If the person is usually engaged in a remunerative occupation, an amount\n equal to the loss of income incurred after the date of the accident resulting\n from injuries received in the accident up to $100 per week during the period\n from the first workday lost as a result of the accident up to the date the\n person is able to return to his usual occupation. However, the period shall\n not extend beyond one year from the date of the accident; and\n\n 3. An expense described in subdivision 1 shall be deemed to have been\n incurred:\n \t\t\t\ta. If the insured is directly responsible for payment of the expense;\n \t\t\t\tb. If the expense is paid by (i) a health care insurer pursuant to a\n negotiated contract with the health care provider or (ii) Medicaid or\n Medicare, where the actual payment with reference to the medical bill rendered\n by the provider is less than or equal to the provider’s usual and\n customary fee, in the amount of the actual payment as evidenced by an\n explanation of benefits, remittance advice, or similar documentation from the\n health care provider; however, if the insured is required to make a payment in\n addition to the actual payment by the health care insurer or Medicaid or\n Medicare, the amount shall be increased by the payment made by the insured; or\n \t\t\t\tc. If no medical bill is rendered or specific charge made by a health care\n provider to the insured, an insurer, or any other person, in the amount of the\n usual and customary fee charged in that community for the service rendered.\n\nB. The insured has the option of purchasing either or both of the coverages set\nforth in subdivisions A 1 and A 2. Either or both of the coverages, as well as\nany other medical expense or loss of income coverage under any policy of\nautomobile liability insurance, shall be payable to the covered injured person\nor pursuant to an assignment of benefits in accordance with subsection D,\nnotwithstanding the failure or refusal of the named insured or other person\nentitled to the coverage to give notice to the insurer of an accident as soon as\npracticable under the terms of the policy, except where the failure or refusal\nprejudices the insurer in establishing the validity of the claim.\n\nC. In any policy of personal automobile insurance in which the insured has\npurchased coverage under subsection A, every insurer providing such coverage\narising from the ownership, maintenance or use of no more than four motor\nvehicles shall be liable to pay up to the maximum policy limit available on\nevery motor vehicle insured under that coverage if the health care or disability\nexpenses and costs mentioned in subsection A exceed the limits of coverage for\nany one motor vehicle so insured.\n\nD. Any attempt to assign medical expense benefits shall be subject to the\nfollowing:\n\n 1. An assignment of medical expense benefits shall be valid only if:\n \t\t\t\ta. A copy of the AOB form, executed by the assignor and in compliance with\n the other requirements of subdivision D 1 and a copy of the notice complying\n with subdivision g if such notice is provided in a separate document pursuant\n to subdivision e, is provided to the motor vehicle insurer;\n \t\t\t\tb. The AOB form is (i) in writing, which includes any printed or\n electronic format, (ii) dated, and (iii) executed by the assignor;\n \t\t\t\tc. The AOB form includes a conspicuous statement that the assignor is not\n required to execute the AOB form;\n \t\t\t\td. If the AOB form includes a notice that complies with the provisions of\n subdivision g, the AOB form is signed, initialed, or otherwise marked by the\n assignor, at or near the notice provision, to acknowledge that the assignor\n has read, or had the opportunity to read, the notice;\n \t\t\t\te. If the AOB form does not include a notice that complies with the\n provisions of subdivision g, (i) the assignor is given a separate document, in\n any printed or electronic format, that is delivered to the assignor at the\n same time as the AOB form and that contains a notice that complies with the\n provisions of subdivision g; (ii) the AOB form includes a conspicuous\n statement that a notice regarding the assignment of medical expense benefits\n is provided in a separate document; and (iii) the AOB form is signed,\n initialed, or otherwise marked by the assignor at or near the statement\n described in clause (ii) to acknowledge that the assignor has read, or had the\n opportunity to read, the separate document containing the notice;\n \t\t\t\tf. The statements required by subdivision D 1 to be included in the AOB\n form or a separate document, including the notice prescribed by subdivision g,\n are in not less than eight-point type; and\n \t\t\t\tg. The assignor is provided, either in the AOB form or in a separate\n document, a notice that summarizes the effect of the assignment of medical\n expense benefits, which notice states the following:\n \t\t\t\t“Notice: automobile accident patients\n \t\t\t\tIf you have been in an automobile accident, you may be entitled to payment\n from your automobile insurance if you have medical expense benefits coverage.\n By signing this assignment of benefits form you are giving to your health care\n provider the right to receive some or all of that payment directly from your\n automobile insurance company.\n \t\t\t\tIf you have health insurance and your healthcare provider is in-network:\n as long as you provide information necessary to verify your health insurance\n coverage the healthcare provider may only bill the amount you owe for any\n copayment, coinsurance, or deductibles to your automobile insurance and you\n may be entitled to any remainder of your automobile insurance benefit.\n \t\t\t\tIf you do not provide information necessary to verify your health\n insurance coverage, do not have health insurance, or your healthcare provider\n is not in your health insurer’s provider network: your health care\n provider may bill their full charges to your automobile insurance.\n \t\t\t\tYou may want to consult your insurance agent or attorney before signing or\n initialing this form. You are not required to sign\/initial this form to\n receive care.”\n\n 2. Upon receipt of a copy of an AOB form that satisfies the requirements of\n subdivision D 1 and (i) an explanation of benefits or remittance advice or\n (ii) a bill, claim form, or documentation from the assignee advising that it\n has been represented to the assignee that the covered injured person does not\n have health insurance or is covered by a self-insured or self-funded employee\n welfare benefit plan subject to the Employee Retirement Income Security Act of\n 1974 which requires medical expense coverage to be primary, a motor vehicle\n insurer shall pay directly to the health care provider, from any medical\n expense benefits available to such person under a motor vehicle insurance\n policy:\n \t\t\t\ta. If the covered injured person is covered under a health care policy,\n the health care provider is an in-network provider, and the health care\n provider has submitted its claim to the health insurer for the health care\n services, the amount of any copayments, coinsurance, or deductibles owed by\n the injured covered person to the health care provider, as evidenced by an\n explanation of benefits, remittance advice, or similar documentation provided\n to the motor vehicle insurer; or\n \t\t\t\tb. If (i) the covered injured person is not covered under a health care\n policy, (ii) the covered injured person is covered by a self-insured or\n self-funded employee welfare benefit plan subject to the Employee Retirement\n Income Security Act of 1974 which requires medical expense coverage to be\n primary, or (iii) the health care provider is not an in-network provider,\n amounts to cover the cost of the health care services provided, in the amount\n of the usual and customary fee charged in that community for the health care\n services rendered;\n\n 3. A motor vehicle insurer shall in all respects be held harmless for making\n payments pursuant to subdivision D 2 to a health care provider in accordance\n with an assignment of benefits that satisfies the requirements of subdivision\n D 1;\n\n 4. A covered injured person shall not be required to assign to any person any\n medical expense benefits he may have under this section, including any\n assignment of the proceeds of such coverages;\n\n 5. An assignment of medical expense benefits shall be void and unenforceable\n as against public policy if the assignment does not comply with the\n requirements of subdivision D 1;\n\n 6. Medical expense benefits may not be reduced because of any benefits paid,\n payable, or provided by any insurance contract providing hospital, medical,\n surgical, and similar or related benefits, or any subscription contract or\n health services plan delivered or issued for delivery or providing for the\n payment of benefits to or on behalf of persons residing in or employed in the\n Commonwealth, except as authorized by this section; and\n\n 7. Nothing in this section shall prohibit the payment of medical expense\n benefits due to the covered injured person directly to any state or federal\n assistance program that has provided medical benefits to such injured person\n when the injury arose out of the ownership, maintenance, or use of any motor\n vehicle.\n\nE. As used in subsection D:\n\t\t\t“AOB form” means the document or instrument that contains a\nprovision by which the assignor assigns medical expense benefits, including any\nassignment of the proceeds of such coverages, to an assignee. The AOB form may\nbe a separate instrument or included in another instrument, including a consent\nform or a form assigning other benefits.\n\t\t\t“Assignee” means the health care provider to which the assignor\nis assigning medical expense benefits, including any assignment of the proceeds\nof such coverages.\n\t\t\t“Assignor” means the covered injured person or a person\nauthorized to consent on the covered injured person’s behalf.\n\t\t\t“Health care policy” means any health care plan, subscription\ncontract, evidence of coverage, certificate, health services plan, medical or\nhospital services plan, accident and sickness insurance policy or certificate,\nor other similar certificate, policy, contract, or arrangement, and any\nendorsement or rider thereto, offered, arranged, issued, or administered by a\nhealth insurer to an individual or a group contract holder to cover all or a\nportion of the cost of individuals, or their eligible dependents, receiving\ncovered health care services. Health care policy includes coverages issued\npursuant to (i) Chapter 28 (§ 2.2-2800 et seq.) of Title 2.2 (state\nemployees); (ii) § 2.2-1204 (local choice); (iii) 5 U.S.C. § 8901 et\nseq. (federal employees); and (iv) an employee welfare benefit plan as defined\nin 29 U.S.C. § 1002(1) of the Employee Retirement Income Security Act of\n1974 that is self-insured or self-funded. Health care policy does not include\n(a) coverages issued pursuant to Title XVIII of the Social Security Act, 42\nU.S.C. § 1395 et seq. (Medicare); Title XIX of the Social Security Act, 42\nU.S.C. § 1396 et seq. (Medicaid), or Title XXI of the Social Security Act,\n42 U.S.C. § 1397aa et seq. (CHIP); or Chapter 55 of Title 10 of the United\nStates Code, 10 U.S.C. § 1071 et seq. (TRICARE); (b) subscription contracts\nfor one or more dental or optometric services plans that are subject to Chapter\n45 (§ 38.2-4500 et seq.); (c) insurance policies that provide coverage,\nsingly or in combination, for death, dismemberment, disability, or hospital and\nmedical care caused by or necessitated as a result of accident or specified\nkinds of accidents, including student accident, sports accident, blanket\naccident, specific accident, and accidental death and dismemberment policies;\n(d) credit life insurance and credit accident and sickness insurance issued\npursuant to Chapter 37.1 (§ 38.2-3717 et seq.) of Title 38.2; (e) insurance\npolicies that provide payments when an insured is disabled or unable to work\nbecause of illness, disease, or injury, including incidental benefits; (f)\nlong-term care insurance as defined in § 38.2-5200; (g) plans providing\nonly limited health care services under § 38.2-4300 unless offered by\nendorsement or rider to a group health benefit plan; (h) TRICARE supplement,\nMedicare supplement, and workers’ compensation coverages; or (i) medical\nexpense coverage issued pursuant to this section.\n\t\t\t“Health care provider” has the same meaning that is ascribed to\nthat term in § 8.01-581.1.\n\t\t\t“Health care services” means items or services furnished to any\nindividual for the purpose of preventing, alleviating, curing, or healing human\nillness, injury, or physical disability.\n\t\t\t“Health insurer” means any entity that is the issuer or sponsor\nof a health care policy.\n\t\t\t“In-network provider” means a health care provider that is\nemployed by or has entered into a provider agreement with the health insurer\nthat has issued the health care policy, under which applicable agreement the\nhealth care provider has agreed to provide health care services to covered\npatients.\n\t\t\t“Medical expense benefits” means the benefits of coverages\ndescribed in subdivision A 1, including any assignment of the proceeds of such\ncoverages.\n\t\t\t“Motor vehicle insurer” means the insurer issuing or delivering a\npolicy or contract covering liability arising from the ownership, maintenance,\nor use of any motor vehicle that provides coverage for medical expense benefits.\n\t\t\t“Person authorized to consent on the covered injured person’s\nbehalf” means any person authorized by law to consent on behalf of the\ncovered injured person incapable of making an informed decision or, in the case\nof a minor child, the parent or parents having custody of the child or the\nchild’s legal guardian or as otherwise provided by law.\n\t\t\t“Provider agreement” means a contract, agreement, or arrangement\nbetween a health care provider and a health insurer, or a health insurer’s\nnetwork, provider panel, intermediary, or representative, under which the health\ncare provider has agreed to provide health care services to patients with\ncoverage under a health care policy issued by the health insurer and to accept\npayment from the health insurer for the health care services provided.\n\nHISTORY: 1972, c. 859, \u00a7 38.1-380.1; 1973, c. 294; 1977, c. 112; 1982, c. 450;\n1983, cc. 197, 370; 1986, c. 562; 1987, c. 429; 1989, c. 243; 1991, c. 4; 1996,\nc. 276; 1997, c. 503; 2013, c. 75; 2014, cc. 157, 417; 2015, cc. 502, 503.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}