Liability coverage and uninsured and underinsured motorist coverage each pay because a driver was at fault for the accident. The North Carolina Department of Insurance says med pay may provide some assistance with your doctor and hospital bills, regardless of fault. The sections below stand on their own beside the video on this page and cover what med pay pays, whether the law requires it, who it reaches, fault, repayment, provider liens and notice to your insurer.
Med pay pays reasonable and necessary accident medical and funeral expenses
Medical payments coverage on a North Carolina auto policy pays for reasonable and necessary medical and funeral expenses due to an automobile accident, according to the North Carolina Department of Insurance. The Department lists it alongside liability coverage, coverage for damage to your auto and uninsured and underinsured motorist coverage.
The med pay limit applies to each person injured
The med pay limit is a number in your own policy. The Department of Insurance says the policy will pay up to the limits listed in your policy for each individual injured.
Med pay is coverage on your own policy. Its limit applies to each injured person, and the policy itself shows the number.
Is med pay required in North Carolina, or optional?
Medical payments coverage is optional in North Carolina. G.S. 20-279.21 requires an owner's policy to carry bodily injury liability coverage under subdivision (b)(2), uninsured motorist coverage under (b)(3) and underinsured motorist coverage under (b)(4). The section does not mention medical payments coverage.
G.S. 20-279.21(g) lets a policy that grants the required coverage also grant any lawful coverage in excess of or in addition to it. That excess or additional coverage is not subject to the provisions of the Article. The chart in the North Carolina Department of Insurance consumer guide answers the question directly, and its column headed Is it required reads No for medical payments.
| Coverage | Where North Carolina law addresses it | Required | Whose loss it answers for |
|---|---|---|---|
| Bodily injury liability | G.S. 20-279.21(b)(2) | Yes, at least $50,000 for one person and $100,000 for two or more people in one accident | Other people's injuries for which an insured driver becomes legally responsible |
| Uninsured motorist | G.S. 20-279.21(b)(3) | Yes | Persons insured who are legally entitled to recover damages from owners or operators of uninsured and hit-and-run motor vehicles |
| Underinsured motorist | G.S. 20-279.21(b)(4) | Yes, in addition to the (b)(2) and (b)(3) coverages | A covered person injured by an underinsured driver who is at fault |
| Medical payments | Not named in G.S. 20-279.21. Subsection (g) allows coverage in addition to what the section requires | No, per the Department of Insurance consumer guide | Reasonable and necessary medical and funeral expenses of the people the coverage protects |
The Department of Insurance adds that a policy with only liability coverage does not pay your own medical bills, because liability insurance only pays for other people's injuries and property damage for which an insured driver becomes legally responsible.
The car accident page covers the liability minimum and underinsured motorist coverage in more detail.
Med pay is an addition to the required coverages and not one of them.
Who med pay covers in your car, another car and on foot
Medical payments coverage protects you and any family member while occupying any automobile, or as a pedestrian when struck by a motor vehicle, according to the North Carolina Department of Insurance. It also protects any other person while occupying your covered automobile. The same holds in a private passenger automobile or trailer licensed for road use that you or a family member is driving.
You and family members
The Department's wording follows you and family members into any automobile. It also reaches you and family members on foot when a motor vehicle strikes you.
Passengers and other occupants
Any other person is covered while riding in your covered automobile. The same holds in a private passenger automobile that you or a family member is driving.
For the liability side of a wreck in a rented car, the rental car accident post covers whose insurance answers.
Exception. The Department of Insurance says medical payments coverage will not cover any expenses if the injuries occur while occupying a motorized vehicle with less than four wheels. The Miscellaneous Type Vehicle Endorsement can be bought in addition to the basic coverages, and when the covered vehicle is a motorcycle it extends medical payments coverage to motor vehicles with fewer than four wheels. Riders have their own motorcycle accident page.
Med pay pays regardless of fault, unlike the other driver's liability
Medical payments coverage, if purchased, may provide some assistance for your doctor and hospital bills, regardless of fault, according to the North Carolina Department of Insurance. The claim against the other driver works on a different rule in North Carolina.
Contributory negligence is the North Carolina rule that bars recovery when the injured person's own negligence joins with the defendant's negligence in proximately causing the injury. N.C.P.I.-Motor Vehicle 104.10, the pattern jury instruction, tells jurors that in that case the plaintiff cannot recover. The burden of proof on that issue is on the defendant.
The Department of Insurance after-accident page says North Carolina contributory negligence law bars a driver from collecting damages if determined to be partially at fault.
The med pay claim on your own policy
The Department says med pay may provide some assistance with your bills, regardless of fault. The claim runs to your own insurer under your own policy.
The claim against the other driver
The other driver's liability coverage pays only what that driver is legally responsible for. Contributory negligence on your side bars that recovery.
A wreck where fault is disputed still leaves the med pay portion of your own policy to read. I would not let the fault question keep anyone from opening that policy.
Can the med pay insurer take its payment back from a settlement?
The North Carolina Rate Bureau's 2002 amendatory endorsement to the North Carolina personal auto policy, form NC 00 12 (edition 01 02), said the insurer's subrogation and reimbursement rights did not apply to Part B, the medical payments coverage. It attached to NC 00 01 policies written on and after April 1, 2002.
Subrogation and reimbursement in Part F of the 2002 endorsement
In the 2002 wording, subrogation meant the insurer that made a payment was subrogated to the paid person's right to recover damages from another. Reimbursement required that person, on recovering damages from another, to hold the proceeds in trust for the insurer and reimburse it to the extent of its payment.
The 2002 endorsement wrote both rights into Part F, Our Right To Recover Payment, and excluded Part B from each.
Baxley v. Nationwide, and a policy that waived subrogation
In Baxley v. Nationwide Mutual Insurance Co., 334 N.C. 1 (1993), the Supreme Court of North Carolina read an endorsement stating that the Right to Recover Payment section does not apply to the medical payments part of the policy. The Court said the contract itself provides for recovery under both the medical payments and the underinsured motorist sections and waives any right to subrogation.
The Rate Bureau has revised its amendatory endorsements since 2002, and the form numbers moved. Circular A-12-5, dated March 19, 2012, attaches NC 00 13 to the NC 00 01 Personal Auto Policy and NC 00 12 to the NC 00 02 policy, a physical damage only policy. Circular A-18-1, dated May 14, 2018, revised both again. Baxley turned on the contract's own words, so the policy in force on the day of the wreck is the text to read.
The 2002 endorsement put the repayment rights in Part F, so the Part F wording of your own policy is the place to read.
G.S. 44-49 and 44-50 put medical provider liens on the recovery
G.S. 44-49(a) creates a lien on sums recovered as damages for personal injury in any civil action in North Carolina. The lien favors anyone the injured person owes for drugs, medical supplies, ambulance services or the services of a physician, dentist, nurse or hospital rendered in connection with the injury.
G.S. 44-50 attaches the same lien to all funds paid to any person in compensation for or settlement of the injuries, whether in litigation or otherwise.
| Question | What the statute says | Where |
|---|---|---|
| What the lien attaches to | Sums recovered as damages for personal injury in a civil action, and funds paid in compensation for or settlement of the injuries | G.S. 44-49(a) and 44-50 |
| Who has to hold money back | Any person that receives the funds retains enough to pay the just and bona fide provider claims, after having received notice of them | G.S. 44-50 |
| The ceiling on the lien | Exclusive of attorneys' fees, the lien cannot exceed one half of the amount of damages recovered | G.S. 44-50 |
| The State Health Plan | A lien held by the State Health Plan for Teachers and State Employees has priority over all nongovernmental liens and rights | G.S. 44-49(a) and 44-50 |
Exception. G.S. 44-49(b) says no lien under subsection (a) is valid unless the provider, upon request, furnishes to the attorney representing the injured person, without charge and within 60 days of receiving the request, an itemized statement, hospital record or medical report. The provider must also give that attorney written notice of the lien claimed.
Neither G.S. 44-49 nor G.S. 44-50 mentions medical payments coverage. Those sections govern what providers can claim from the injury recovery, and the med pay repayment question above turns on the policy.
When do I tell my own insurer about the wreck?
Notify your own insurance company as soon as reasonably possible, while the details are still fresh in your mind, according to the North Carolina Department of Insurance consumer guide. The Department also says to contact the other driver's insurance agent or company when another person is responsible for your damages.
The guide answers what a policy requires after an accident in four parts.
Say how, when and where it happened
Notify the insurance company of how, when and where the accident or loss happened.
Name the injured and the witnesses
Include the names and addresses of anyone who is injured and any witnesses.
Cooperate with the investigation
Cooperate with the investigation, in the guide's words.
Authorize the medical records
Obtain or authorize the insurance company to obtain appropriate documents, medical information and other pertinent records.
The bills that go to med pay are the reasonable and necessary medical and funeral expenses from the accident, as the Department describes the coverage. Its after-accident page says med pay may provide some assistance for doctor and hospital bills.
Keep every medical bill together with every letter from your own insurer.
Wherever you are in North Carolina, I can come to you. The first contact is by phone or video, and after that I meet you in person where you are. Whether we work together is decided in that meeting. The how it works page lays out each step, and the contact page is where to ask for the first call.
