Short Answer

Yes. In North Carolina, medical payments (MedPay) coverage is optional, so if your declarations page shows no MedPay premium, the insurer may be correct. Still, you can dispute the decision by reviewing the full policy and endorsements, asking for a written coverage position, seeking help from the N.C. Department of Insurance, and, if needed, filing a civil action for a court declaration of coverage. Act promptly because policy notice requirements and lawsuit deadlines apply.

Understanding the Problem

You want to know if you can challenge your North Carolina auto insurer’s statement that your policy has no MedPay. You are the insured, and your attorney has already asked the insurer, which confirmed no standalone MedPay; the policy does include a very limited auto protection plan. The single decision: can you dispute or appeal that coverage determination?

Apply the Law

In North Carolina, auto policies must include liability and certain uninsured/underinsured coverages, but MedPay is not mandatory. Whether MedPay exists turns on the contract—the declarations page, policy form, and endorsements. If you believe the insurer’s “no coverage” position conflicts with the policy language or another applicable policy (for example, a host driver’s policy when you were a passenger), you can pursue administrative help and, if needed, ask a court to declare your rights under the policy. The main forum for a coverage dispute is Superior Court, and general contract lawsuit deadlines and any policy “suit limitation” clauses apply.

Key Requirements

• Policy language that grants coverage: Identify MedPay or another benefit that applies based on the declarations, forms, and endorsements.
• Written coverage position: Ask the insurer to confirm in writing the reasons and policy provisions it relies on for “no MedPay.”
• Alternative sources: Check other potentially applicable auto policies (household vehicles, the car you occupied) for MedPay or similar benefits.
• Deadlines: Comply with policy notice/proof-of-loss requirements and any contractual “suit limitation,” and be mindful of general contract limitation periods.
• Proper forum: If disagreement remains, file a civil action for declaratory judgment (and related claims) in Superior Court.

What the Statutes Say

• North Carolina Gen. Stat. § 20-279.21 (Required auto coverages) - Requires liability and UM/UIM coverages; MedPay is optional and arises from contract.
• North Carolina Gen. Stat. § 1-253 (Declaratory judgments) - Allows courts to declare rights under written instruments, including insurance policies.
• North Carolina Gen. Stat. § 1-254 (Power to construe contracts) - Authorizes courts to construe contracts and determine parties’ rights before or after a breach.

Analysis

Apply the Rule to the Facts: Here, the insurer says there is no standalone MedPay, and the policy includes only a very limited auto protection plan. Start by obtaining the full policy and endorsements to verify whether any MedPay or similar medical expense benefit exists. If the declarations show no MedPay premium and no endorsement fills that gap, the insurer’s position may be consistent with the contract; however, you should also review any other applicable auto policy (for example, the policy on the vehicle you were in) that might provide a medical payments benefit.

Process & Timing

1. Who files: The insured or claimant. Where: Civil action in the Superior Court of the North Carolina county with proper venue. What: A complaint for declaratory judgment (and, if appropriate, breach of contract and related claims). Also consider a consumer complaint to the N.C. Department of Insurance. When: Promptly—policies often contain notice and “suit limitation” clauses; general contract limitations also apply.
2. After filing, the insurer answers; parties exchange information and may mediate. Timelines vary by county and case complexity.
3. The court enters a declaratory judgment stating whether the policy affords the medical expense coverage you claim.

Exceptions & Pitfalls

• If no MedPay was purchased, a court will not create it; look for other applicable policies (such as the host vehicle’s policy) that might include MedPay.
• Do not rely on summaries; the declarations, forms, and endorsements control. Request the full policy and the insurer’s written coverage analysis.
• Policy “suit limitation” clauses and notice requirements can shorten your time to act; missing them can bar recovery even if you are right on the merits.
• Do not confuse health-insurance appeal rules with auto policy disputes; different procedures and deadlines apply.
• Limited auto protection benefits often have strict sublimits and exclusions; match your expenses to covered categories before challenging a denial.

Talk to a Personal Injury Attorney

If you're dealing with an auto insurer’s “no MedPay” decision and need to understand your options and timelines, our firm has experienced attorneys who can help you evaluate the policy and pursue relief. Call us today at .

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.