What Should I Do When My Auto Medical Expense Benefit Coverage Is Exhausted?

Under North Carolina law, medical expense (MedPay) coverage through your auto policy pays reasonable medical costs up to your policy limit regardless of fault. When you receive a notice that this benefit is exhausted, it means your insurer has paid the maximum amount you purchased. You then must pursue other sources for ongoing medical bills. First, confirm the insurer mailed the MedPay check to your attorney’s office or directly to you. If you haven’t received it within 7–10 business days, contact your insurer’s claims department, referencing your claim number and policy details. Keep a record of all calls and letters. Next, discuss with your healthcare providers whether they permit deferred or reduced billing until you secure additional coverage. Many providers will place your account on hold if you explain that you’re awaiting further recovery through liability insurance or uninsured/underinsured motorist (UM/UIM) coverage. If the at-fault driver’s liability coverage applies, you may recover medical costs exceeding your MedPay limit when you settle your liability claim. Likewise, if you carry UM/UIM coverage, file a claim under that portion of your policy for any gap. Finally, organize your medical records, bills, and MedPay payment information. Present these to the adjuster handling liability or UM/UIM claims. That documentation speeds up evaluation and ensures you recover in full. For more background on handling exhausted medical payments coverage, see our detailed blog post: What to Do When MedPay is Exhausted.

Handling a car accident claim on your own can save fees, but you must follow North Carolina’s specific rules. Start by reporting the collision to law enforcement if injuries or significant property damage occurred. The officer’s report provides an objective account that strengthens your case. Next, promptly notify your auto insurer. Provide the date, location, and details about the other driver and witnesses. Ask for your 9-digit claim number and the adjuster’s contact. Record the time and person you spoke with. Gather evidence at the scene: take clear photos of vehicle damage, skid marks, traffic signals, and road conditions. Get names and contact information of witnesses and everyone involved. Even if damage seems minor, photos immediately after the crash prevent disputes later. Track all medical treatment from day one. Keep copies of diagnostic reports, billing statements, prescriptions, and expert evaluations. Submit these promptly to your adjuster. Missing or delayed records can reduce your recovery. When negotiating a settlement, open with a written demand letter summarizing facts, injuries, treatment, costs, and a clear dollar amount. Support it with medical records and repair estimates. Allow the insurer time to respond, but follow up within two weeks if you receive no reply. If you must represent yourself in court, file a civil complaint within three years of the accident under N.C.G.S. § 1-52. Before trial, exchange evidence under North Carolina’s discovery rules. Stick to deadlines for depositions, interrogatories, and motions. Being organized shows the court you take your case seriously. For step-by-step guidance through each phase of your claim, see our blog post: Self-Represented Auto Claims in NC.