Where This Fits in the Claim Process
This issue usually comes up at the very beginning of a claim—right after notice is given and the insurer sets up the file. Early on, the insurer should be doing two things at the same time: (1) confirming what coverages may apply, and (2) starting the basic investigation (what happened, who may be at fault, and what injuries and losses are being claimed). When the claim is coded under the wrong coverage, those early steps can get routed down the wrong track.
Practical Steps That Usually Help
- Control the communication: Ask (politely but clearly) for written confirmation of (a) the claim number(s), (b) the coverage type(s) being evaluated (MedPay vs. liability bodily injury), and (c) the name and contact information for the correct adjuster/claim unit. Keep a call log with dates, times, and what was said.
- Protect the record: If you provide information while the claim is misclassified, label it clearly (for example, “liability bodily injury claim”) so it does not get treated like a MedPay-only file. Save copies of all letters/emails and any documents sent.
- Escalation options: If reassignment does not happen after a reasonable follow-up, request supervisor review in writing. If the insurer’s handling appears unreasonably delayed or inconsistent, a North Carolina attorney can also evaluate whether the conduct fits patterns that can violate NC’s claim-handling standards (without assuming that’s the case in any particular situation).
Common Mistakes to Avoid
- Assuming “MedPay” means the insurer accepted fault: MedPay is commonly treated as a no-fault medical benefit. Liability bodily injury is the part that typically turns on negligence and legal responsibility.
- Giving a rushed recorded statement just to “get it fixed”: If a statement is requested, it is fair to ask what coverage it is for, what topics will be covered, and whether the statement is required to process the specific benefit being discussed.
- Letting the misclassification create gaps: When the wrong adjuster has the file, requests can get missed, deadlines can be unclear, and documents can land in the wrong place. Written follow-up helps prevent that.
How This Applies
Apply to the facts: Here, the claim appears to have been opened under MedPay even though the goal is a liability bodily injury claim arising from a bus crash. A written request to correct the coverage classification and reassign the file is a normal step, because MedPay handling and liability investigation often involve different questions and different adjusters. Until the correction is confirmed, it helps to document every contact and clearly label any submissions as related to the liability bodily injury claim.
Conclusion
When an insurer opens a claim under the wrong coverage type, the biggest risks are delay and confusion—not necessarily a final denial. The practical goal is to get written confirmation that the insurer is evaluating the correct coverage and that the file is with the right adjuster. One next step that often helps is sending a short, dated written request confirming the correct coverage type and asking for reassignment and updated contact information.
