Should I also open a claim with my own insurance to use medical payments coverage, and could that raise my premiums if I wasn’t at fault?: North Carolina

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Should I also open a claim with my own insurance to use medical payments coverage, and could that raise my premiums if I wasn’t at fault? - North Carolina

Short Answer

Yes—if you carry Medical Payments (MedPay) coverage in North Carolina, you can and usually should open a claim with your own auto insurer to get your accident-related medical bills paid quickly, regardless of fault. Using MedPay typically does not raise your premium when you were not at fault because North Carolina’s rating rules do not add surcharge points for not-at-fault accidents. Policy notice and proof-of-loss deadlines can apply, so act promptly.

Understanding the Problem

You want to know whether you should use your own MedPay coverage after a North Carolina car wreck and whether that could increase your premiums when you were not at fault. In North Carolina, the driver seeks payment of medical bills through their own optional MedPay coverage after a collision; the key decision is whether to file that first-party claim now. Here, you were rear-ended while turning and needed medical treatment.

Apply the Law

In North Carolina, MedPay is an optional, first-party auto insurance benefit. It pays reasonable and necessary medical expenses caused by a covered auto accident for you (and often your passengers), up to your policy limit, without regard to fault. It operates alongside any liability claim against the at-fault driver. North Carolina’s Safe Driver Incentive Plan (SDIP) governs when insurers can add surcharge points; not-at-fault accidents do not receive SDIP points.

Key Requirements

  • Coverage in force: You (or a resident family member) must have MedPay on an auto policy that covers the accident.
  • Accident-related care: Medical charges must be reasonable, necessary, and caused by the crash, incurred within the policy’s time window.
  • Proof and notice: You must give prompt notice and submit itemized bills/records as your policy requires.
  • Fault is irrelevant for payment: MedPay pays regardless of who caused the wreck and does not limit your claim against the at-fault driver.
  • Premium impact: A not-at-fault accident does not generate SDIP surcharge points; a MedPay claim by itself should not add points.

What the Statutes Say

Analysis

Apply the Rule to the Facts: You were rear-ended while turning and received medical treatment. If your policy includes MedPay, you can open a claim with your own insurer now to have covered bills paid up to your limit, regardless of fault. Because rear-end collisions like yours are typically treated as not-at-fault for the lead driver, the SDIP should not assign surcharge points, so a MedPay claim alone should not raise your premium under those rules.

Process & Timing

  1. Who files: You (or your attorney). Where: Your auto insurer’s claims department in North Carolina. What: Report a “Medical Payments” claim; submit the accident report (if available), itemized medical bills, treatment records, and a claim/Proof of Loss form your insurer provides. When: Give notice as soon as possible; many policies require prompt notice and that expenses be incurred within a set period after the accident.
  2. Your insurer reviews and may request limited medical authorizations and proof that treatment relates to the crash. Once documentation is complete, many carriers issue rolling payments as bills come in, up to your MedPay limit.
  3. After payment, you receive checks (to you or directly to providers) and an explanation of what was paid. Keep copies for your separate claim against the at-fault driver.

Exceptions & Pitfalls

  • No MedPay on your policy? You may still qualify under a resident family member’s policy; ask your insurer to check all applicable policies.
  • Policy reimbursement language varies. Before agreeing to repay MedPay from a settlement, have the policy reviewed under North Carolina law.
  • Do not sign overly broad medical authorizations; limit releases to crash-related records and dates.
  • Avoid gaps in treatment and keep itemized bills; insurers pay documented, crash-related charges only.
  • If you are wrongly surcharged for a not-at-fault accident, dispute it with your insurer and, if needed, seek help through the North Carolina Department of Insurance.

Conclusion

In North Carolina, if you carry MedPay, you should open a claim with your own insurer to pay crash-related medical bills quickly, regardless of fault, up to your policy limit. Not-at-fault use of MedPay should not add SDIP surcharge points to your premium. The next step is to notify your insurer immediately, request a MedPay claim, and submit itemized bills and records within your policy’s time limits.

Talk to a Personal Injury Attorney

If you were hurt in a North Carolina crash and want to use MedPay without jeopardizing your premiums, our firm has experienced attorneys who can help you understand your options and timelines. Reach out today at (919) 341-7055.

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.

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