Short Answer

In North Carolina, the most reliable way to confirm whether an auto policy has Medical Payments (“MedPay”) coverage is to get the policy’s declarations page (or a written coverage confirmation) from the insurer or the insured. MedPay is optional “additional” coverage, so it will not appear in the mandatory liability/UM/UIM disclosures unless it was purchased. To open or process MedPay, insurers typically require basic claim identifiers plus medical documentation and signed authorizations before they will evaluate and pay benefits.

Understanding the Problem

If you are handling a North Carolina injury claim under another party’s auto policy and you need to know whether you can use that policy’s MedPay coverage, the key question is: can you confirm (from the insurer’s own documents) that MedPay exists on that policy and what the insurer needs from you to start paying medical bills, especially when you are already working an existing claim.

Apply the Law

In North Carolina, MedPay is generally an optional, “extra” coverage that may be added to an auto policy. Unlike liability coverage and certain uninsured/underinsured motorist coverages that North Carolina law requires in most auto policies, MedPay is not mandated by the Motor Vehicle Safety and Financial Responsibility Act. As a result, you usually confirm MedPay by obtaining the declarations page (the part of the policy that lists each coverage and its limit) or a written coverage letter from the carrier.

Practically, carriers often treat MedPay as a separate “first-party style” benefit with its own intake requirements (even when you are pursuing liability against their insured). Expect the adjuster to request proof the claimant qualifies as an “insured” for MedPay under that policy’s definitions, and proof the medical charges relate to the crash and are within the coverage terms.

Key Requirements

• Proof MedPay was purchased: The declarations page (or a written coverage confirmation) should show “Medical Payments” (or similar wording) and the limit.
• Proof the claimant qualifies under the policy: MedPay usually applies only to people the policy defines as covered (often the named insured, household family members, and sometimes occupants of the covered vehicle). The exact definition depends on the policy language.
• Accident and claim identifiers: Date of loss, claim number, insured’s name, vehicle information, and a short description tying the medical treatment to the crash.
• Medical documentation: Itemized bills and/or records showing dates of service, providers, diagnoses, and charges connected to the collision.
• Authorizations and coordination information: Insurers commonly ask for a signed medical authorization and information about other available payers (health insurance, workers’ compensation) to coordinate payments and avoid duplicate payment issues.

What the Statutes Say

• N.C. Gen. Stat. § 20-279.21 (Motor vehicle liability policy requirements) - Sets required liability/UM/UIM rules and explains that policies may include additional lawful coverages beyond what the statute requires.
• N.C. Gen. Stat. § 20-166.1 (Accident reports; financial responsibility info) - Requires crash reports to include financial responsibility information and governs access to accident reports, which often helps identify the correct insurer and policy information to request.

Analysis

Apply the Rule to the Facts: Because you are representing an injured client on an existing claim under the other party’s policy, you should not assume MedPay exists. You confirm it by obtaining the declarations page or a written coverage confirmation showing MedPay and its limit. Once confirmed, the carrier will typically require medical bills/records and signed authorizations to evaluate whether the treatment relates to the crash and fits within the policy’s MedPay terms.

Process & Timing

1. Who files: The injured person (through counsel) typically makes the MedPay request. Where: With the auto insurer’s claims department handling the loss in North Carolina. What: A written request for (1) the declarations page and (2) written confirmation whether MedPay applies and the limit, plus the insurer’s MedPay submission checklist. When: As early as possible after you identify the correct carrier and claim number.
2. Next step: After coverage is confirmed, submit the insurer’s requested MedPay packet (commonly: itemized bills, dates of service, proof of payment status, and signed medical authorizations). The adjuster may also ask for a short causation summary tying each provider to the crash.
3. Final step: The insurer issues a written coverage position and, if approved, pays MedPay benefits according to the policy terms (often directly to providers or as reimbursement, depending on the policy and the submission).

Exceptions & Pitfalls

• MedPay may not exist at all: Many policies do not include MedPay. If it is not on the declarations page, it is usually not available.
• “Who is covered” disputes: Even if the policy has MedPay, the claimant may not qualify under the policy definition (for example, not an occupant of the covered vehicle and not a household family member of the named insured).
• Documentation gaps: Missing itemized bills, unclear dates of service, or no records tying treatment to the crash can delay or reduce payments.
• Authorization issues: If you send an overbroad authorization, you may create privacy and scope disputes; if you send none, the carrier may refuse to process the request. Use a tailored authorization consistent with what the carrier reasonably needs.
• Coordination with other payers: Health insurance, workers’ compensation, or other coverages can affect how the carrier processes MedPay and what it requests from you.

Conclusion

To find out whether an auto policy has MedPay coverage in North Carolina, you generally need the declarations page (or a written coverage confirmation) showing MedPay and its limit, because MedPay is optional and not part of the required liability coverages. Once confirmed, the next step is to submit the insurer’s MedPay packet—typically itemized medical bills and supporting records—promptly under the policy’s notice and proof requirements.

Talk to a Personal Injury Attorney

If you’re trying to confirm whether MedPay exists on an auto policy and what the insurer needs to open and pay that portion of the claim, our firm has experienced attorneys who can help you request the right documents, avoid common coverage traps, and keep the claim moving on a clear timeline. Call undefined.

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.