Understanding medical payments (MedPay) in Montana auto insurance

Short answer: Medical payments coverage (commonly called MedPay) is a first‑party portion of many auto policies that can pay reasonable medical and related expenses for you and your passengers after an auto crash, regardless of fault. To claim it in Montana, you must follow your policy’s notice and proof requirements, submit medical bills and records, cooperate with your insurer’s investigation, and be aware of coordination, subrogation, and legal deadlines.

Detailed answer — how MedPay works and the step‑by‑step Montana process

What MedPay is: MedPay is optional coverage sold with auto policies. It typically pays medical costs, ambulance fees, sometimes funeral costs, and in some policies ancillary items like childcare or household services for injuries related to a covered auto accident. It is first‑party coverage, meaning you claim it from your own insurer even if another driver caused the crash.

Step 1 — Check your policy first

• Locate the declaration page and the MedPay section of your policy. Note the limits (for example, $1,000, $5,000, $10,000), covered persons (insured, family members, permissive users), covered expenses, any time limits for filing, and proof‑of‑loss requirements.
• If you cannot find the policy, call your agent or the insurer immediately and ask for a copy of the declarations and the medical payments endorsement.

Step 2 — Give timely notice

• Give your insurer prompt notice of the accident and your injuries. Most policies require notice “as soon as reasonably possible.” Even if you plan to use another insurer or the at‑fault driver’s coverage, telling your own insurer about your injuries preserves your MedPay claim.
• When you call, get a claim number and the name and contact info of the adjuster.

Step 3 — Get and submit proof of loss

• Collect medical records, itemized bills, ER reports, ambulance receipts, and receipts for related expenses (prescriptions, medical devices). Ask providers to bill your insurer directly when possible.
• Sign and provide any required medical authorization forms so your insurer can obtain records. Without records, the insurer can deny payment or request more proof.

Step 4 — Understand coordination of benefits and subrogation

• MedPay is usually primary to health insurance for the accident‑related medical bills, but exact coordination depends on your policy language. If MedPay pays bills that later another insurer (like the at‑fault driver’s liability carrier) must pay, your insurer generally has a right to recover amounts paid (subrogation). Read your policy’s subrogation language carefully.
• Be careful when accepting payments from other parties. Settling with the at‑fault driver’s insurer without protecting your MedPay subrogation rights can create disputes or require you to repay MedPay benefits.

Step 5 — Follow up and appeal denials

• Keep written records of all communications, copies of bills, medical records, and claim notes (dates, names, what was said).
• If the insurer delays or denies payment, ask for a written explanation. Many denials cite lack of medical proof, late notice, treatment unrelated to the crash, or policy exclusions.
• Use the insurer’s internal appeal process first. If you remain unsatisfied, you may file a complaint with the Montana Commissioner of Securities and Insurance (link below) or consider filing a claim in Montana court or small claims court, depending on the amount.

Montana law and consumer protections

Insurance contracts and claims in Montana are regulated at the state level. While MedPay itself is a contract term in your policy and not mandated in exact form by statute, Montana law regulates insurer conduct and unfair claim settlement practices. For help or to file a complaint, contact the Montana Commissioner of Securities and Insurance:

• Montana Commissioner of Securities and Insurance (csimt.gov)
• For Montana statutes and to read the insurance code and rules, see the Montana Code Annotated at the Montana Legislature site: Montana Code Annotated (leg.mt.gov)

Timing and common limits

• Policy limits — MedPay pays only up to your policy’s limit. If your bills exceed the limit, you will need other sources of payment (health insurance, settlement from the at‑fault party).
• Deadlines — Policies commonly require you to submit proof of loss within a set time after the accident or after treatment. Follow policy deadlines closely to avoid denial.
• Treatment relationship — Insurers often require proof that the medical treatment related to the accident and was reasonable and necessary.

When to get a lawyer

You do not always need a lawyer to obtain MedPay benefits, but consider consulting or hiring an attorney if:

• The insurer denies payment and you have clear, accident‑related medical bills;
• You face complicated subrogation claims from your insurer after you settle with the at‑fault party;
• Your injuries are severe, the bills approach or exceed your MedPay limit, and you need help maximizing recovery from the at‑fault party;
• The insurer engages in bad‑faith or unfair claims conduct (you can report that to the Commissioner).

Helpful Hints

• Notify your insurer immediately after the crash, even if you plan to use the other driver’s liability policy.
• Ask providers to submit itemized bills and diagnosis/treatment notes to your MedPay insurer—not just statements saying “amount due.”
• Keep a folder (digital or paper) of all medical records, bills, claim numbers, and communication logs.
• Do not sign away subrogation rights or accept a full settlement from an at‑fault driver without confirming how it affects your MedPay repayment obligations.
• If the insurer requests a recorded statement, you may request an attorney before giving one; consider consulting counsel first if coverage or fault is disputed.
• If you have health insurance, notify that provider; coordination rules differ by policy—ask both insurers how they will coordinate benefits.
• If the insurer stalls or denies without a good reason, file a complaint with the Montana Commissioner of Securities and Insurance at https://csimt.gov/ and ask about dispute resolution options.

Where to get help:

• Montana Commissioner of Securities and Insurance — consumer assistance and complaint filing: https://csimt.gov/
• Montana Code Annotated (insurance statutes and rules): https://leg.mt.gov/bills/mca/
• Montana Judicial Branch — small claims and court information: https://courts.mt.gov/

Disclaimer: I am not a lawyer and this is not legal advice. This information explains general Montana insurance concepts and typical claim steps only. For advice about your specific policy, claim, or legal options, consult a licensed attorney or contact the Montana Commissioner of Securities and Insurance.