Appeals Court Upholds Anti-Stacking Rule for MedPay: Bousquet v. Commerce Insurance (AC 25-P-1008, Sept. 4, 2026)

Can your auto insurer deny medical-expense benefits because your health plan already paid the hospital? Yes, the Massachusetts Appeals Court said on September 4, 2026. The decision affirms a District Court judgment and validates policy language the Commissioner of Insurance approved in 2016.

Noellen Bousquet was hurt when another driver reversed on Interstate 395 and crashed into her car. She incurred more than $16,000 in medical bills. Her health insurer, Fallon Community Health Plan, paid those expenses after Commerce Insurance Company paid $2,000 in personal injury protection benefits. Bousquet settled with the tortfeasor and used part of the proceeds to satisfy Fallon’s statutory lien. She then sued Commerce for the $25,000 in optional medical-payments (MedPay) coverage she had purchased.

Commerce refused to pay. The 2016 standard Massachusetts automobile policy states that no MedPay payments will be made that duplicate payments under a health insurance policy. Bousquet argued the language conflicts with General Laws chapter 175, section 113C, which requires insurers to offer MedPay coverage of at least $5,000.

What the Statute Says

Chapter 175, section 113C, provides that insurers must offer MedPay as an option but says nothing about whether that coverage may be limited when other insurance applies. Bousquet claimed the silence proves the Legislature intended to allow duplicate recovery. The Appeals Court disagreed.

Writing for the panel, Justice Neyman explained that statutory silence often requires an agency to clarify issues necessarily implicated by the statute. The plain language of section 113C requires insurers to offer MedPay but does not prohibit the Commissioner from defining or limiting its scope. Without any indication that the Legislature intended to require duplicative recoveries, the decision about policy language fell within the Commissioner’s discretion as a policy matter.

The Golchin Blueprint

The 2016 policy revision grew directly out of the Supreme Judicial Court’s 2013 decision in Golchin v. Liberty Mutual Insurance Co. There, the SJC held that under the old policy an insured could recover both MedPay and health insurance benefits for the same expenses because the policy contained no exclusion or limitation for medical costs also covered by health insurance.

But the SJC left the door open. The court noted that insurers could petition the Division of Insurance to change the policy language to clarify that it does not require double recovery. The 2016 revision did exactly that, adding explicit language that no MedPay payments will be made that duplicate payments under a health insurance policy.

The Division of Insurance also issued a regulation in 2016 stating that MedPay benefits under a motor vehicle policy shall always be secondary to and in excess of any health benefit plan or PIP benefits. A notice on the Division’s website advises consumers to consider carefully whether to purchase MedPay coverage if they already have health insurance, warning that it may not be necessary.

The Limits of Agency Power

Bousquet argued that the new language renders MedPay coverage illusory, confiscatory, and worthless. The court rejected these labels as conclusory. Massachusetts public policy bars coverages that are unrealistically limited or so narrow as to have no substantial economic value. But the 2016 policy does not eliminate MedPay altogether; it only prohibits recovery where the insured has already received payment for the same medical expenses under another policy.

The court noted that not everyone is covered by health insurance or able to obtain promised benefits. In those situations, MedPay would still provide value. Because the limitation does not exceed the bounds recognized in prior case law, the Commissioner’s interpretation remains entitled to deference.

Coordination of Benefits

The decision turns on the structure of Massachusetts auto insurance. Part 2 of the standard policy provides up to $2,000 in PIP benefits for anyone, and additional PIP benefits for medical expenses that a health plan will not pay. Once an insured triggers the coordination requirement by using the first $2,000, further expenses must be submitted to the health plan first.

Bousquet followed this process. Commerce paid the initial $2,000. Fallon then paid the remaining bills. Under General Laws chapter 111, section 70A, Fallon asserted a lien in Bousquet’s tort action against the driver who caused the crash. When Bousquet settled that case, she reimbursed Fallon from the settlement proceeds. She argued she should not have to bear the cost twice by forgoing MedPay benefits she had purchased.

The court placed the burden on Bousquet to show that the 2016 policy language exceeded the statute’s authorization. She could not meet that burden. The statute’s silence on limitations, combined with the Commissioner’s broad regulatory authority over policy provisions and the Supreme Judicial Court’s guidance in Golchin, meant the new language was consistent with section 113C.

Practical Consequences

The ruling clarifies that Massachusetts drivers with health insurance will rarely recover MedPay benefits after an accident. The coverage retains value for the uninsured, for those whose health plans deny coverage, and for expenses health insurance does not cover. But for the typical insured motorist, MedPay now functions as excess coverage rather than a source of double recovery.

The decision may also affect premium calculations. If MedPay rarely pays out for insured drivers, actuarial risk is lower. Whether that translates to lower optional-coverage premiums remains to be seen. The court noted that when Bousquet renewed her policy, she was informed of the change to part 6 coverage.

The Appellate Division affirmed the District Court’s judgment after the parties agreed to submit the matter on the pleadings. No material facts were in dispute. The Appeals Court reviewed the question of statutory interpretation de novo and found no error. The judgment in favor of Commerce Insurance stands.

Read the full opinion: Bosquet v. Commerce Insurance Company (AC-25-P-1008, September 4, 2026).