What Coverage Questions Usually Mean
This question usually comes up when a passenger is hurt and the insurance company starts paying bills under one “bucket” (MedPay) even though the main claim should be handled as a bodily injury liability claim. The two coverages can exist at the same time, but they work differently and are often handled by different adjusters or teams.
Common Potential Sources of Payment (High-Level)
- MedPay (medical payments coverage): A first-party benefit that may pay certain medical bills up to the MedPay limit, often without waiting for a fault decision.
- Bodily injury liability coverage: A third-party claim against the driver/owner (or other responsible party) whose negligence caused the crash. This is the coverage that typically addresses the full injury claim.
- UM/UIM (if applicable): If the at-fault party has no coverage or not enough coverage, uninsured/underinsured motorist coverage may come into play. North Carolina’s auto policy framework (including required liability and UM/UIM structure) is addressed in N.C. Gen. Stat. § 20-279.21.
- Health insurance: Often pays first in real life while the injury claim is pending, with reimbursement issues sometimes addressed later (details depend on the plan and facts).
Information to Gather
- Which coverage is being used right now: Ask whether payments are being made under MedPay, BI liability, UM/UIM, or something else.
- Who the insured is for each coverage: MedPay is usually tied to a particular policy/vehicle; BI liability is tied to the party being claimed against.
- What the insurer is requesting: MedPay often focuses on medical bills/records; BI liability usually also focuses on how the crash happened and who was at fault.
- A simple treatment timeline: Dates of treatment and a running list of bills/charges can help keep the claim organized.
Common Coverage Disputes and Practical Next Steps
- MedPay vs. liability is not just a label: If a claim is handled only as MedPay, it may limit the discussion to medical bills and may not address broader damages that are typically part of a liability bodily injury claim.
- Different proof burdens: MedPay commonly pays without proving fault. A BI liability claim generally requires showing the other party was negligent and that negligence caused the passenger’s injuries.
- Different damages: MedPay is usually aimed at medical expenses. A BI liability claim can include medical expenses, lost income, pain and suffering, and other losses tied to the injury (depending on proof).
- Coordination and reimbursement issues: MedPay is often treated like no-fault coverage for reimbursement purposes in many systems, while liability payments are treated as tort recoveries. This difference can affect how reimbursement claims are handled later.
- Reassignment to the right adjuster: It is common for a lawyer to ask the insurer to open (or correct) a separate BI liability claim and assign it to the appropriate liability adjuster, especially when the passenger is pursuing a negligence-based injury claim.
How This Applies
Apply to the facts: Here, the passenger was injured in a bus crash and is pursuing an injury claim. If the insurer opened the file under MedPay, that may help with some medical bills, but it does not necessarily address the larger question of who was at fault and what full damages may be owed under bodily injury liability coverage. Asking to correct the claim to BI liability coverage and reassign it to the proper adjuster is a common step to make sure the claim is evaluated under the right framework.
What the Statutes Say (Optional)
- N.C. Gen. Stat. § 20-279.21 (Motor vehicle liability policy) – Describes required liability coverage structure in North Carolina and the related UM/UIM framework.
Conclusion
MedPay and bodily injury liability coverage serve different purposes for an injured passenger. MedPay is usually a no-fault medical-bill benefit tied to a policy, while BI liability is the coverage that typically pays when someone else’s negligence caused the crash and broader damages are claimed. If your claim is being handled under the wrong coverage type, it can affect how the insurer evaluates the case. One practical next step is to confirm—in writing—which coverage is being used and request that the correct BI liability claim be opened and assigned.
