Guides
Medical payments to others (Coverage F) explained
Coverage F pays a guest's small medical bills after an injury at your home, no fault required, up to a per-person limit. Who qualifies and how a claim works.
Coverage F, medical payments to others, pays the reasonable medical bills of a guest who is hurt at your home, or hurt elsewhere by you, a household pet or your activities, whether or not you were at fault. The limit is small and applies per person per accident; the amount appears on your declarations page, and ISO-based policies commonly start at $1,000. It never pays for you or the people who live with you. Think of it as a goodwill coverage that settles small injuries quickly, before they turn into liability claims.
This guide follows the ISO HO-3 (form HO 00 03 05 11, the May 2011 edition). Your insurer's own form and your state's amendatory endorsements control, so read the Section II pages of your policy.
What Coverage F pays
The form pays "necessary medical expenses" that are incurred or medically ascertained within three years of the accident. It defines medical expenses as reasonable charges for medical, surgical, x-ray, dental, ambulance, hospital, professional nursing, prosthetic devices and funeral services. The limit is the most the insurer pays for all medical expense for one person from one accident, so three guests hurt in the same fall each have their own limit.
Two features set it apart from liability coverage. Nobody has to prove you were negligent, and the form says that payment under this coverage is not an admission of liability by you or the insurer. A guest with a sprained wrist from your wet deck gets the ER bill paid without anyone arguing about whose fault it was. Also, the insurer cannot recover Coverage F payments from anyone else through subrogation, which the form expressly rules out.
Who is covered and who is not
The form has a short list of situations where Coverage F applies to a person who is not an insured:
- someone on the insured location with your permission;
- someone off the location whose injury arises out of a condition on the property or the ways immediately adjoining it, such as your sidewalk;
- someone injured by the activities of an insured, such as a child hit by a ball in the neighbor's yard;
- someone injured by a residence employee in the course of the job; and
- someone injured by an animal owned by or in the care of an insured, which is how Coverage F applies to a dog bite on a walk (see dog bites, breed lists and homeowners liability).
| Person | Covered by Coverage F? |
|---|---|
| Guest or neighbor injured on your property | Yes, if on the insured location with permission |
| Contractor, delivery driver or other worker injured on the job | Generally no, because the form excludes anyone eligible for workers' compensation benefits |
| Passerby bitten by your dog on the street | Yes, the animal rule applies off the premises |
| You, your spouse, your kids, relatives living with you | No, the form excludes you and regular household residents |
| A roommate or other person who regularly lives on the property | No |
| Housekeeper or nanny hurt on the job | Usually no, because workers' compensation benefits take over; see household employees and workers' comp |
| A guest hurt during a business you run from home | Generally excluded by the business exclusion |
| An injury you or a family member caused on purpose | Excluded as expected or intended |
The Section II exclusions that apply to Coverage E also apply to Coverage F, including those for motor vehicles, watercraft, business activity and professional services; Liability exclusions: what Coverage E won't pay lists them. The first-aid expense coverage in the same section is separate: the policy pays what you spend on first aid to others at the time of the injury, and it does so in addition to the limit.
Coverage F compared with Coverage E
| Coverage F, medical payments | Coverage E, personal liability | |
|---|---|---|
| Triggered by | Injury and medical bills | A claim or suit alleging you are legally liable |
| Fault required | No | Yes, legal liability |
| Limit applies | Per person, per accident | Per occurrence, shared by all insureds and claimants |
| Pays | Medical expenses only | Damages, plus a defense |
| Typical size | Small, often starting at $1,000 | Chosen by you, commonly $100,000 and up |
Coverage F does not stop someone from later suing. If the injury is serious, treat the medical payments as the first step and expect Coverage E to be involved, as described in what happens when someone sues you after an injury at your home. The premises liability rules decide who owes what once a lawsuit starts, and slip and fall on your property: how liability works covers the injuries that most often lead to claims.
What to do when a guest is hurt
- Get help first. Call 911 for anything serious. Offer first aid. The policy treats your first-aid expenses for others as covered.
- Record the facts. Write down names, contact details, witnesses and what happened, and photograph the spot before it is changed.
- Do not promise to pay. The policy's duties after an occurrence say an insured must not voluntarily make payments or assume obligations except for first aid at the time of the injury. If you pay the ER bill yourself, you may not get that money back.
- Report it. Give written notice to your insurer or agent as soon as is practical, with the policy number, the time and place, and the claimants and witnesses.
- Let the injured person file the medical claim. The form puts the burden on the injured person or someone acting for them to give written proof of claim and authorize the insurer to obtain medical records. The insurer can require a physical exam by a doctor of its choosing.
- Keep talking only to your insurer. If the injured person's lawyer contacts you, forward any demand or summons immediately and do not discuss fault.
How often it gets used
Medical payments claims are rare. In 2019 through 2023, III, citing ISO data, reports about 0.03 claims per 100 house-years for its combined "medical payments and other" category, and that category was 0.4% of homeowners losses in 2023. Rare is not the same as unimportant: for the household that has one, the claim is often a neighbor's child or a close friend.
Choosing a limit
The NAIC's consumer guide says you choose the medical payments limit, and the California Department of Insurance describes $1,000 as the usual minimum on a renters policy. The cost of a higher figure tends to be modest, because claims are infrequent, but get a quote. A single ambulance ride and emergency visit can use up a $1,000 limit, so households that host often, have a pool or keep a dog may reasonably want a higher number. Ask your agent for a quote at several levels.
Coverage F is no substitute for an adequate liability limit. It exists to handle small bills, not to pay for a long recovery.
A related coverage: damage to property of others
The same section includes a companion coverage: the form pays up to $1,000 per occurrence, at replacement cost, for damage to other people's property caused by an insured, even if you are not legally liable. It does not pay for intentional damage by an insured aged 13 or older, for property you own or that belongs to a tenant or household resident, or for damage tied to a business or to motor vehicles, watercraft and aircraft. It is the property-side equivalent of Coverage F, and it, too, is exempt from subrogation. A neighbor's broken window from a stray baseball is the classic fit.
Key takeaways
- Coverage F pays a guest's reasonable medical bills regardless of fault, up to a per-person limit that commonly begins at $1,000; check your declarations page for yours.
- It never covers you or regular residents of your household, and business activities and several other situations are excluded.
- Payment is not an admission of liability and does not bar a later lawsuit, so serious injuries usually bring in Coverage E.
- Do not pay a guest's bills yourself and expect reimbursement; report the incident to your insurer in writing as soon as practical.
- A modest increase in the limit often costs little. Ask for quotes, especially if you host often or own a pool or dog.