What Coverage Questions Usually Mean
In North Carolina injury cases, “MedPay” and “bodily injury liability” are two different paths that can exist at the same time. MedPay is generally a no-fault benefit meant to help pay medical bills quickly (subject to the policy’s terms and limits). A bodily injury liability claim is a claim that another person or entity is legally responsible for the injuries and related losses.
Common Potential Sources of Payment (High-Level)
- At-fault party liability coverage (if applicable): This is where you claim the full range of injury-related damages caused by negligence.
- Medical payments coverage / similar benefits (if relevant): This often applies regardless of fault, but it is commonly limited to medical expenses (not the full set of losses).
- Health insurance as an immediate payer: Health insurance may pay treatment bills while the liability claim is investigated, with reimbursement issues sometimes addressed later.
What Changes When a Claim Moves from MedPay to Liability Bodily Injury
- The types of losses you can claim usually expand. A liability bodily injury claim typically includes medical expenses, lost wages/lost earning capacity, pain and suffering, and other proven harm caused by the crash. MedPay is usually focused on medical bills (and sometimes closely related medical expenses), up to a limit.
- The proof requirements usually increase. With MedPay, the main questions are often whether the treatment was related and reasonable. With liability, you generally must show negligence (fault) and that the crash caused the injuries and losses.
- Defenses matter more in liability claims. North Carolina follows contributory negligence in most negligence cases. That means if the injured person is found even slightly at fault, recovery can be barred in many situations. (This is less of a “fault” issue for MedPay benefits.)
- How bills get handled can look different. MedPay may pay providers directly or reimburse you (depending on the claim handling). Liability claims often resolve later, and medical bills may remain outstanding until settlement or judgment—so tracking balances, payments, and any reimbursement claims becomes important.
What Medical Bills Can Be Claimed in a Liability Bodily Injury Claim?
In a North Carolina liability injury claim, the usual goal is to recover reasonable medical expenses that were caused by the crash (past and, when supported, future). Even if some bills were paid by a “collateral source” (like health insurance), the medical expenses can still be part of the damages claim in many situations—though reimbursement/lien issues may need to be addressed as part of the resolution.
Other Losses That Are Commonly Part of a Liability Bodily Injury Claim
- Lost income: time missed from work and, in some cases, reduced ability to earn going forward.
- Pain and suffering: the human impact of the injury (not just physical pain, but also how the injury affects daily life), when supported by the evidence.
- Out-of-pocket costs: injury-related expenses that are documented and tied to the crash (for example, certain transportation costs), depending on the facts.
Information to Gather
- Claim identifiers and contacts: the claim number(s) and the adjuster contact information for both MedPay and liability, if they exist.
- Medical documentation: visit summaries, discharge instructions, and itemized billing statements (not just “balance due” pages).
- Loss documentation: work notes, pay stubs, and a simple timeline of symptoms and appointments.
- Crash basics: date, general location, and how the crash happened (keep it consistent across communications).
Common Coverage Disputes and Practical Next Steps
- Misrouted claims happen. Especially with passengers, a claim can be opened under the wrong coverage type. Reassigning to the correct adjuster can help the claim get evaluated under the right standards.
- Keep MedPay and liability conceptually separate. MedPay may help with early medical bills, while liability is where the broader damages are pursued. Your attorney can often coordinate both tracks so payments and documentation don’t conflict.
- Be careful with statements. Liability adjusters often focus on fault and causation. Inconsistent descriptions of how the crash happened or how symptoms started can slow things down or create disputes.
How This Applies
Apply to [FACTS]: Because [CLIENT] was a passenger on a bus, it makes sense that MedPay could be one early source for medical bills, but it may not cover the full range of losses from the crash. Correcting the claim to a bodily injury liability claim typically allows [CLIENT] to pursue broader damages (not just medical bills) if the evidence supports that another party’s negligence caused the injuries. The reassignment to the appropriate adjuster is often a practical step so the claim is evaluated under the correct coverage and standards.
What the Statutes Say (Optional)
- N.C. Gen. Stat. § 20-279.21 (Motor vehicle liability policy) – describes required liability coverage and related UM/UIM framework under North Carolina’s financial responsibility law.
- N.C. Gen. Stat. § 1-139 (Burden of proof of contributory negligence) – places the burden on the party asserting contributory negligence as a defense.
Conclusion
Changing a claim from MedPay to bodily injury liability usually does not take away your ability to claim crash-related medical bills—but it often adds other categories of losses you can pursue, like lost income and pain and suffering, if negligence and causation can be proven. It also tends to bring more scrutiny about fault and documentation. A practical next step is to gather your medical and wage-loss paperwork and make sure the claim is being handled under the correct coverage type.
