Dear Tax Talk,
I am getting a settlement check this week for an auto accident. I have to pay my insurance company back for its medical payments, and it covers some additional visits for medical care. The rest of the $10,000 is permanent body and emotional damage, and physical stress. Do I have to put this on my taxes? Do I have to show proof to the IRS of the payment to the insurance company?
— Cindy

Dear Cindy,
I am sorry to hear about your accident and hope you are doing well. Settlement proceeds may or may not be deductible, depending on all the facts and circumstances in each case. In your situation, the settlement payment consists of multiple elements that have been allocated. Generally, the IRS will not question an allocation if it is consistent with the substance of the settled claims.

You do not have to include the settlement proceeds that need to be repaid to the insurance company. The amounts received for personal physical injury or physical sickness are not included in income if you did not take an itemized deduction for medical expenses and received a tax benefit. But, you must include in income that portion of the settlement that is for medical expenses you deducted in any prior year(s) to the extent the deduction(s) provided a tax benefit.

The settlement proceeds for emotional distress or mental anguish originating from a personal physical injury or physical sickness are treated the same as proceeds for personal injury or physical sickness. But, if the proceeds for emotional distress or mental anguish do not originate from a personal physical injury or physical sickness, then you must include them in your income. If that is the case, you will then be able to deduct amounts paid for medical expenses attributable to the emotional distress or mental anguish.

You should keep a record of the payment that you make to the insurance company. You do not need to submit it with your return, but you need to have it available should the IRS have any questions on your tax return.

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