What Coverage Questions Usually Mean
When a policy has no MedPay, the real issue is usually: “What can pay medical bills now, while the injury claim is pending?” MedPay is a no-fault benefit some policies include, but it is not the only way bills can get paid after a crash. In North Carolina, the most common alternatives are (1) the other driver’s liability coverage, (2) UM/UIM coverage, and (3) health insurance or other benefit plans.
Common Potential Sources of Payment (High-Level)
- At-fault driver’s liability coverage: If another driver caused the crash, their liability insurance is often the main source of recovery for medical expenses as part of the bodily injury claim. Practically, though, liability insurance does not always pay bills “as they come in” and may pay later as part of a settlement.
- Uninsured motorist (UM) coverage: North Carolina auto policies generally include UM coverage to protect insured people who are legally entitled to recover damages from an uninsured or hit-and-run driver. UM is required in most non-fleet private passenger policies. See N.C. Gen. Stat. § 20-279.21.
- Underinsured motorist (UIM) coverage: UIM can apply when the at-fault driver has liability coverage, but it is not enough compared to the injured person’s damages, and certain conditions are met. North Carolina ties UM/UIM requirements and structure to N.C. Gen. Stat. § 20-279.21.
- Health insurance: Health insurance often becomes the practical “front-end” payer when MedPay is not available. A key issue is that some health plans may later claim a right to be reimbursed from a settlement, while others may be limited by North Carolina’s general anti-subrogation rules and exceptions (the details depend heavily on the type of plan and who funds it).
- Workers’ compensation (if the crash was work-related): If the crash happened while the injured person was doing their job, workers’ compensation may pay medical treatment and wage benefits. Workers’ comp can also affect how any third-party recovery is handled, and it can create reimbursement issues. See generally N.C. Gen. Stat. § 97-10.1 (exclusive remedy against the employer in most covered situations).
Information to Gather
- Auto policy documents: Declarations pages for the relevant policies (the injured person’s policy, the vehicle’s policy, and any household policies that might apply), plus any UM/UIM selection forms if available.
- Claim details: Date of loss, general crash facts, and contact information for the adjusters handling the bodily injury claim(s).
- Medical billing picture: A running list of providers, dates of service, and whether bills were submitted to health insurance (and what was paid/denied).
- Work status: Whether the injured person was working at the time, driving for work, or running a work errand (this can change the analysis).
Common Coverage Disputes and Practical Next Steps
- Don’t assume “no MedPay” means “no help”: UM/UIM may still exist even when MedPay does not, and UM/UIM is a major protection in North Carolina. The declarations page usually shows the UM/UIM limits.
- Separate “paying bills now” from “who ultimately pays”: Health insurance may pay first, and then reimbursement questions may come up later if there is a settlement. Planning early helps avoid surprises at the end of the case.
- Watch for reimbursement/lien issues: Public payers (like Medicare/Medicaid) and some benefit plans often have reimbursement rights that must be addressed before final distribution of settlement funds. Even some private plans may assert reimbursement depending on the plan type and funding source.
- Be careful with recorded statements and paperwork: Coverage decisions can turn on small facts (who was in the car, permission to use the vehicle, residency/household status, work use). Consistent documentation matters.
How This Applies
Apply to the facts: Here, the carrier has confirmed there is no MedPay listed on the auto policy connected to the injury claim. The next practical step is to verify whether UM and/or UIM coverage applies under that policy (or any other applicable policy), because North Carolina generally requires UM and also provides for UIM in most non-fleet private passenger policies under N.C. Gen. Stat. § 20-279.21. In the meantime, health insurance (or workers’ compensation if the crash was job-related) is often the way medical bills are handled while the liability claim develops.
What the Statutes Say (Optional)
- N.C. Gen. Stat. § 20-279.21 (UM/UIM requirements) – Explains North Carolina’s framework for required uninsured motorist coverage and underinsured motorist coverage in most auto liability policies.
Conclusion
No MedPay usually means you need a different plan for getting medical bills handled while the claim is pending. In North Carolina, that often means looking to the at-fault driver’s liability coverage, UM/UIM coverage, and health insurance (and sometimes workers’ compensation). Because reimbursement and coverage questions can affect the net recovery later, a good next step is to gather the declarations pages for all potentially applicable policies and review them with a licensed North Carolina personal injury attorney.
