Short Answer

Often, yes. In North Carolina, “medical payments” (commonly called “MedPay”) is typically a no-fault, medical-expense benefit that can be opened and paid based on covered medical bills and proof of the accident-related treatment, even while liability (who caused the crash) is still being investigated or disputed.

That said, MedPay is not required in every auto policy, and the insurer can still require basic documentation and confirm that the claimant qualifies as an “insured” under that policy’s MedPay terms.

Understanding the Problem

If you are handling a North Carolina auto injury claim under another party’s policy, a common question is: can you ask the carrier to open and process the MedPay portion of the claim now, even though fault is still being investigated or disputed, so medical bills can be addressed sooner?

Apply the Law

North Carolina is not a “no-fault” auto insurance state for liability claims. Most injury claims still turn on negligence and defenses like contributory negligence. MedPay, however, is usually an optional “additional coverage” in an auto policy that pays reasonable and necessary medical expenses for covered people after an auto accident, without requiring a final liability decision first.

Because MedPay is generally contractual (it depends on the policy language), the key legal question is not “who is at fault?” but “does the policy provide MedPay, and does the claimant meet the policy’s definition of a covered person for that benefit?” The insurer can also require documentation to evaluate whether the bills are accident-related and within the policy’s MedPay terms.

As a practical matter, when you are pursuing benefits under another party’s policy, the carrier may treat MedPay as a separate coverage part from bodily injury liability. Even if the liability adjuster is still investigating fault, the carrier can often assign MedPay handling to a different unit once coverage is confirmed.

Key Requirements

• MedPay must exist on the policy: MedPay is typically optional “additional coverage,” so you must confirm it is actually listed on the declarations page and identify the limit.
• The claimant must qualify as covered for MedPay: Policies usually limit MedPay to certain people (for example, the named insured and household relatives, occupants of the covered auto, or sometimes pedestrians struck by the covered auto). The exact definition controls.
• The medical expenses must be the type MedPay covers: MedPay usually applies to reasonable medical, dental, ambulance, hospital, and sometimes funeral expenses, subject to the policy’s definitions and exclusions.
• The expenses must be accident-related: The carrier can request records/bills to confirm the treatment relates to injuries from the crash rather than an unrelated condition.
• Timely notice and cooperation: Even no-fault benefits generally require prompt notice and reasonable cooperation (for example, providing bills, records, and authorizations the policy allows).
• No duplicate payment issues: MedPay may coordinate with other payers (health insurance, workers’ compensation, or other MedPay). The policy’s “other insurance” and reimbursement/subrogation terms matter.

What the Statutes Say

• N.C. Gen. Stat. § 20-279.21 (Motor vehicle liability policy; required coverages vs. additional coverages) - Explains required parts of a motor vehicle liability policy and recognizes that policies may also include lawful additional coverages beyond the required minimums.
• N.C. Gen. Stat. § 7A-38 (Prelitigation mediation of insurance claims) - Provides a process an insurer may use to initiate prelitigation mediation in certain situations and includes a tolling provision once a request is filed.

Analysis

Apply the Rule to the Facts: Here, you are already pursuing an injury claim under another party’s policy and want to verify available coverages and what to submit to open MedPay. Because MedPay is typically a no-fault medical-expense benefit, you can usually request that the carrier confirm whether MedPay exists and open that portion of the claim without waiting for a final liability decision. The carrier will still evaluate whether your client is a covered person for MedPay under that policy and whether the submitted bills and records show accident-related treatment.

Process & Timing

1. Who files: The injured person (or their attorney). Where: With the at-fault driver’s auto insurer’s claims department (not a court). What: A written request to open MedPay plus a coverage verification request (declarations page and applicable policy forms/endorsements for MedPay). When: As early as possible after the crash and once you have a claim number; do not wait for the liability investigation to finish if bills are accruing.
2. Submit the core MedPay packet: itemized bills, proof of payments (if any), treatment records tying care to the crash, and a signed medical authorization if the carrier requires it under the policy. If the carrier uses a MedPay application or questionnaire, complete it promptly and keep a copy.
3. Carrier review and payment: the adjuster typically confirms (a) MedPay exists and the limit, (b) your client qualifies as covered, and (c) the charges are within the MedPay terms. If approved, the carrier may pay providers directly or reimburse the claimant, depending on the policy and the documentation provided.

Exceptions & Pitfalls

• No MedPay on the policy: Many North Carolina policies do not carry MedPay, or the limit is small. Always confirm via the declarations page and endorsements.
• “Covered person” disputes: When you are seeking MedPay under another party’s policy, the carrier may argue the claimant does not fit the policy’s MedPay definition (for example, not an occupant/pedestrian covered by that coverage part).
• Causation documentation gaps: MedPay can stall if records do not clearly connect the treatment to the crash. A short provider note addressing mechanism of injury and diagnosis can help.
• Coordination with health insurance or liens: MedPay payments can affect reimbursement claims (including health insurer or governmental payer rights). Plan the payment path (provider direct pay vs. reimbursement) to reduce later disputes.
• Policy conditions: Some carriers require specific forms, authorizations, or itemization before they will process MedPay. If you do not provide what the policy allows them to request, they may delay or deny until they receive it.

Conclusion

In North Carolina, medical payments coverage is usually a no-fault benefit that can often be opened and paid based on covered, accident-related medical bills even while fault is still being investigated or disputed. The key is confirming MedPay exists on the policy and that the injured person qualifies as covered under that MedPay language. Next step: request the declarations page and MedPay endorsements from the insurer and submit itemized bills and supporting records promptly.

Talk to a Personal Injury Attorney

If you’re dealing with an auto injury claim and need to confirm whether MedPay is available while liability is still being sorted out, our firm has experienced attorneys who can help you understand the coverage issues, what to submit, and how to keep the claim moving. Reach out today. Call [CONTACT NUMBER].

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.