What Coverage Questions Usually Mean
Most people are trying to answer one practical question: what buckets of insurance money might be available for medical bills and other losses after a crash. In an injury claim, there is often a difference between (1) the at-fault driver’s liability coverage and (2) coverages on an auto policy that can pay regardless of fault (often called first-party benefits), such as MedPay, and protections like uninsured/underinsured motorist coverage.
Common Potential Sources of Payment (High-Level)
- At-fault party liability coverage: Pays (up to limits) if the other driver is legally responsible.
- Uninsured motorist (UM) coverage: North Carolina generally requires UM coverage on auto liability policies issued for vehicles registered or principally garaged in the state, subject to statutory rules and exceptions. UM can matter if the at-fault driver has no liability coverage or in certain hit-and-run situations.
- Underinsured motorist (UIM) coverage: Often comes into play when the at-fault driver has liability coverage, but the available limits are not enough compared to the losses. North Carolina law ties UIM availability and limits to statutory requirements and the policy’s terms.
- Medical Payments (MedPay): Typically an optional, first-party benefit on many auto policies. If it is not shown on the declarations page, it may not be part of that policy for that time period.
- Health insurance: Often pays medical bills first while the injury claim is pending (coordination issues can arise later, but that is separate from confirming what auto coverages exist).
Information to Gather
- The declarations page for the correct dates: The dec page is the quickest snapshot of coverages, limits, and listed vehicles/drivers for that policy period.
- The full policy and endorsements: Endorsements are important because they can add, remove, or change coverages (including MedPay) even if the base policy looks standard.
- Any notices or change documents: If coverage was added/removed mid-term, there is often paperwork showing the effective date of the change.
- Basic claim identifiers: Policy number, claim number, date of loss, and the named insured’s information (kept private and shared only as needed).
Common Coverage Disputes and Practical Next Steps
- “It’s not on the policy” vs. “it’s not available for this loss”: Those are different statements. If MedPay is truly not purchased, it usually will not appear on the dec page. If it is purchased, disputes sometimes focus on whether it applies to the person/vehicle/accident.
- Wrong policy period: A common mistake is reviewing the current renewal dec page instead of the one that was in effect on the date of the crash.
- UM/UIM confusion: In North Carolina, UM and UIM are governed by detailed statutory rules, and the limits are often tied to the policy’s liability limits unless different limits were selected. Getting the dec page and endorsements is key to confirming what applies.
- Practical next step: Request (in writing) a complete copy of the policy package for the date of loss, including the declarations page and all endorsements, and ask the insurer to identify where MedPay would appear if it existed.
How This Applies
Apply to the facts: Here, the carrier told the law firm that there is no MedPay listed on the auto policy connected to the injury claim. The cleanest confirmation step is to obtain the declarations page for the date of the crash and the full policy/endorsements for that same period, then verify whether MedPay appears as a line item with limits and premium. If it does not appear, ask for written confirmation that MedPay was not purchased (or was removed) and the effective dates of any changes.
What the Statutes Say (Optional)
- N.C. Gen. Stat. § 20-279.21 – Sets key requirements for North Carolina motor vehicle liability policies, including statutory rules for uninsured and underinsured motorist coverage.
Conclusion
To confirm what coverages are actually on the policy for your North Carolina accident, rely on documents—not summaries. Ask for the declarations page for the correct policy period and the full policy with endorsements, then verify whether MedPay (and other coverages) are listed with limits and premiums. If something is missing, request written confirmation and the paperwork showing when the coverage was added, changed, or removed. One practical next step is to send a written request for the complete policy package for the date of loss.
