Short Answer

In North Carolina, submit a complete MedPay “proof of loss” package to your own auto insurer: the crash report, itemized medical bills, related medical records, and receipts—plus your policy/claim number and a signed HIPAA release or provider assignment if you want direct payment. MedPay pays reasonable, necessary accident-related medical expenses up to your policy limit, regardless of fault. Policies require prompt notice and proof; delays happen when bills are not itemized or records are missing.

Understanding the Problem

You are in North Carolina and want to know exactly what to send your auto insurer so your Medical Payments (MedPay) benefits are approved and paid without delay. You have MedPay coverage, were rear-ended, and received ER care followed by two months of chiropractic treatment. The goal is a clear checklist so your insurer has what it needs to verify coverage, causation, necessity, and amount—without repeated back-and-forth.

Apply the Law

Under North Carolina law, MedPay is first-party auto insurance that pays reasonable and necessary medical expenses caused by a covered auto accident, up to the policy limit, regardless of fault. Claims are presented to your own insurer’s claims department, not to a court. You must give prompt notice and submit adequate proof of loss (the documentation that shows what happened, what treatment you had, and how much is owed). If a claim is wrongfully denied, contract-law deadlines apply.

Key Requirements

• Covered person and covered accident: You were an insured under the policy and injured in a motor-vehicle accident covered by that policy.
• Causation: The medical treatment relates to injuries from that accident (insurers look for the crash report and provider notes tying treatment to the crash).
• Reasonable and necessary medical expenses: Send itemized bills and records so the insurer can evaluate necessity, dates of service, and CPT/diagnosis codes.
• Proof and timing: Provide prompt notice and complete proof of loss; many policies require expenses be incurred and submitted within a stated period.
• Policy limits and payee: Payment is capped by your MedPay limit; you may request payment to you or directly to providers with an assignment/authorization.

What the Statutes Say

• N.C. Gen. Stat. § 1-52 (Three-year limit for contract actions) - Deadline to sue on a denied MedPay claim is generally three years from breach.
• N.C. Gen. Stat. § 58-63-15(11) (Unfair claim settlement practices) - Insurers must handle claims fairly; this guides claim handling standards.

Analysis

Apply the Rule to the Facts: You have MedPay, a rear-end collision, ER care, and two months of chiropractic treatment. To show causation and necessity, send the crash report, ER records, and chiropractic notes, plus itemized bills for each provider. Include your claim/policy number and a signed HIPAA release or provider assignment if you want direct payment. Submit promptly so the insurer can process within the policy’s time window.

Process & Timing

1. Who files: You (or your attorney). Where: Your auto insurer’s MedPay/claims department in North Carolina (online portal, email, or mail per your policy). What: A complete “proof of loss” package: claim/policy number; crash report; your statement with date/time/location; ER records and itemized bill (UB-04/CMS-1500); chiropractic records and itemized statements; imaging reports and bills; prescriptions and receipts; over-the-counter and medical supply receipts if covered; Explanation of Benefits (if health insurance paid any portion); mileage/transport receipts if your policy covers them; signed HIPAA release or provider assignment for direct pay. When: Give prompt notice and submit documentation as it becomes available; many policies set a window (often 1–3 years) for incurring and submitting expenses.
2. Insurer review: Adjuster verifies coverage, accident-related causation, necessity, and amounts. If anything is missing (most commonly itemized bills or records), they will request it. Turnaround typically improves when all bills are itemized and records match the billed dates.
3. Payment: The insurer issues payment up to your MedPay limit, either to you or directly to providers if you requested it. You receive an explanation showing what was paid and remaining limits, if any.

Exceptions & Pitfalls

• Missing itemization: Balance statements are not enough—send itemized bills and the matching medical records.
• Gaps in care or long delays: Adjusters scrutinize long gaps; include provider notes explaining any delay.
• Relying on providers to send records: Clinics often take weeks; request your own records and submit them together.
• Using EOBs as “bills”: An EOB shows what health insurance processed; you still need the provider’s itemized bill.
• Privacy concerns: If you prefer not to sign a broad authorization, gather the specific records yourself and send only what is accident-related.
• Policy-specific limits: Some policies exclude certain items (e.g., non-prescription supplies). Check your declarations and MedPay endorsement.
• Coordination with liability claim: MedPay is separate first-party coverage; it generally does not reduce your bodily injury claim against the at-fault driver.

Talk to a Personal Injury Attorney

If you’re dealing with a MedPay claim and want to avoid delays, our firm has experienced attorneys who can help you understand your options and timelines. Reach out today. Call (919) 341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.