Detailed Answer
This section explains, in plain language, how to claim the medical payments portion (often called “MedPay”) of your auto insurance policy in Missouri. MedPay is a first‑party benefit that can pay medical bills and related expenses after an auto crash regardless of who caused the accident. Coverage amounts, exclusions, and claim procedures depend on the language in your specific policy.
Step-by-step: How to make a MedPay claim
- Confirm you have MedPay and know your limits. Look at your policy declarations page for a line labeled “Medical Payments,” “MedPay,” or similar. It will show the limit (for example, $1,000, $5,000, $10,000). If you cannot find the declarations page, call your insurer’s customer service.
- Seek medical care right away. Obtain timely, documented treatment for any injury. Insurers will require itemized bills and medical records that show treatment relates to the crash.
- Report the claim promptly to your insurer. Most policies require you to notify the insurer as soon as reasonably possible. Call the phone number on your insurance card or the policy’s claims line. Ask for a claim number and the name of the claims adjuster.
- Collect and submit required documents. Typical documents include:
- a completed claim form (the insurer may send this or let you file online),
- itemized medical bills and receipts,
- medical records or provider statements linking treatment to the accident,
- a police crash report if one exists,
- proof of insurance (your declarations page or card), and
- any photos, witness statements, or other evidence about the crash or injuries.
- Cooperate with reasonable insurer requests. The insurer may request additional documentation, recorded statements, or medical authorizations. Provide what is reasonable and limited to the claim to avoid unnecessary delay.
- Understand how MedPay coordinates with other coverage. If you have health insurance, Medicare, or workers’ compensation that pays the same bills, your MedPay may act as primary or secondary depending on policy language. Insurers often seek subrogation or reimbursement if MedPay pays and another insurer later becomes responsible.
- Keep organized records of all communications. Track dates, names of people you spoke with, and claim numbers. Keep copies of every form and bill you send.
- Follow up on claim timing. Insurers generally must acknowledge and start adjusting your claim promptly. If the claim is denied or delayed, ask for a written explanation and the policy provision the insurer relied on.
What MedPay usually covers
MedPay typically covers reasonable and necessary medical expenses resulting from the crash, such as emergency care, hospital bills, X‑rays, surgery, chiropractic care, and sometimes funeral expenses. MedPay usually pays up to your policy limit on a first‑dollar basis (no deductible) but will stop at that limit.
Common issues and how to handle them
- If an insurer denies your claim for lack of causation, request a written denial and the specific policy language relied on. Provide additional medical records or a treating provider statement tying treatment to the crash.
- If your bills exceed MedPay limits, you may pursue the at‑fault driver’s liability insurance for unpaid medical bills, pain and suffering, or lost wages.
- If the insurer claims subrogation or reimbursement from a later recovery, ask for a clear accounting of amounts paid and legal basis for recovery.
When to consider getting an attorney
Consider consulting an attorney if:
- an insurer unfairly denies or unreasonably delays your MedPay claim;
- your medical bills exceed MedPay limits and you have a serious injury that will require negotiating with the at‑fault party’s insurer; or
- you face aggressive subrogation demands or disputes about who pays first.
Missouri resources and where to learn more
For Missouri‑specific consumer guidance about auto insurance, contact the Missouri Department of Commerce & Insurance Consumer Services page: https://insurance.mo.gov/consumers/auto/. For access to Missouri statutes and the state revisor site, see: https://revisor.mo.gov/.
Note about Missouri law: Insurance contract terms control how MedPay applies to your claim. Missouri’s insurance regulators enforce consumer protections and provide complaint procedures, but your policy is the primary source of rights and obligations. For specific statutory language or to research insurance statutes, use the Missouri Revisor of Statutes site linked above.
This is not legal advice. It is general information about how MedPay claims typically work and how to approach them in Missouri. For advice about your specific situation, contact a licensed Missouri attorney or the Missouri Department of Commerce & Insurance.
Helpful Hints
- Always keep the declarations page handy. It shows whether you have MedPay and exactly how much.
- Seek medical care immediately after an accident and tell providers the treatment relates to an auto crash.
- Ask for itemized bills and diagnosis/treatment notes from every provider.
- Get a police report if one is available; it helps establish the accident and timing of injuries.
- Ask your insurer for a written explanation of any denial or delay and the exact policy provision cited.
- Save every email, letter, and bill. Create a simple folder (electronic or paper) just for the claim.
- If you have health insurance, tell your health insurer you also have MedPay; ask how they coordinate benefits.
- If negotiations with insurers become complex or you have a serious injury, consider a free initial consult with a Missouri personal injury attorney to understand your options.
- Use the Missouri Department of Commerce & Insurance for consumer help: https://insurance.mo.gov/consumers/auto/
- If you want to read Missouri statutes generally, start at the State Revisor site: https://revisor.mo.gov/