Claiming Medical Payments (MedPay) from Your Auto Insurance in Delaware: A Step-by-Step FAQ

Short answer: Medical payments coverage (often called MedPay) on an auto policy generally pays for reasonable medical expenses after an auto accident regardless of who was at fault. To claim it in Delaware, you must notify your insurer promptly, submit medical bills and records, cooperate with the insurer’s investigation, and follow any policy deadlines. If the insurer pays, it may seek reimbursement from the at-fault party or that party’s insurer (subrogation). This article explains the process, what to expect, and how to protect your rights.

What is medical payments coverage?

Medical payments (MedPay) is an optional part of many auto insurance policies that helps pay for medical and sometimes funeral expenses for you and covered passengers after a vehicle accident. MedPay usually covers ambulance, emergency room, hospital, doctor, and sometimes x-ray and dental care, up to the policy limit.

How MedPay typically works in Delaware

MedPay is usually no-fault coverage: it pays regardless of who caused the crash.
Coverage is limited to the dollar limit shown on your policy (for example, $1,000, $5,000, $10,000).
MedPay is a contract term in your insurance policy and is regulated by Delaware insurance law. For a general reference to Delaware insurance statutes, see Delaware Code, Title 18 (Insurance): https://delcode.delaware.gov/title18/.
If your medical expenses exceed your MedPay limit, you may pursue a claim against the at-fault driver for additional damages.

Step-by-step: How to file a MedPay claim in Delaware

Seek and document medical care right away.

Get emergency or follow-up treatment immediately. Keep all bills, receipts, medical records, treatment notes, and any referrals. MedPay claims require documentation to show the treatment was related to the accident.
Notify your insurer promptly.

Call your auto insurer’s claims number and report the accident. Ask for a claim number and the name and contact info of the claims adjuster. Most policies require you to provide notice “as soon as reasonably possible.” Check your policy’s notice provision for exact timing.
Submit a written claim and documentation.

Send copies (not originals) of medical bills, itemized invoices, medical reports linking your treatment to the crash, and proof of payment if you already paid. Include your claim number and a short explanation of the injury and treatment. Keep a copy of everything you send.
Sign any required authorizations.

The insurer may ask you to sign medical authorizations so it can obtain records directly from healthcare providers. You should review the authorization for scope and duration. Signing a reasonable release helps the insurer process your claim faster.
Coordinate with other payers.

If you have health insurance, Medicare, Medicaid, or worker’s compensation that also covers your treatment, coordinate benefits. Which payer pays first depends on your policy language and other coverage rules. Ask the claims adjuster how the insurer will handle payments when other coverage exists.
Expect investigation and possible requests for more info.

The insurer may investigate the crash, ask for statements, request medical exams, or ask you to provide additional records. Cooperate but do not sign away your legal rights without careful review.
If the claim is approved, receive payment.

If the insurer accepts the claim, it will pay medical providers directly or reimburse you, depending on your instructions and provider agreements. Confirm whether payment will be subject to healthcare provider liens or assignments.
If the claim is denied, know your options.

If your insurer denies all or part of a claim, ask for a written denial explaining the reason. You can dispute the decision with the insurer, provide more evidence, file an internal appeal, or file a complaint with the Delaware Department of Insurance (see resources below). If necessary, consult an attorney to discuss legal options.

Common complications and what they mean

Coordination with health insurance:

Some medical providers bill your health insurer first and then seek payment from MedPay. Other times MedPay pays first. Check your policy and talk to both insurers so you know who will pay and whether there will be subrogation.
Subrogation and reimbursement:

If your MedPay insurer pays your bills and another party is at fault, the insurer often has a legal right to recover those amounts from the at-fault party or that party’s insurer (this is called subrogation). That means your insurer may pursue reimbursement and you may need to cooperate with that process.
Health-care provider liens or assignments:

Some providers will insist on payment up front or place a lien against any recovery from the at-fault driver. Understand any assignment agreements you sign; they can affect how recoveries are distributed.

Timing — how long will it take?

Processing time varies. Simple claims with clear bills and minimal investigation can resolve in a few weeks. Claims that require detailed investigation, additional records, or subrogation may take months. Submit complete documentation early to speed the process.

When to call a lawyer

Consider speaking with an attorney if:

Your insurer wrongfully denies MedPay coverage or offers an unreasonably low payment.
Your medical bills exceed your MedPay limit and you need to pursue the at-fault driver for more compensation.
You face aggressive subrogation demands from your insurer or a provider, and the distribution of any recovery is disputed.
You have complicated liability issues or serious injuries.

Delaware resources and statutes

Insurance matters in Delaware fall under the Delaware Insurance Code (Title 18) and motor vehicle matters appear in Title 21 of the Delaware Code. For general statutory resources, see:

Delaware Code, Title 18 (Insurance): https://delcode.delaware.gov/title18/
Delaware Code, Title 21 (Motor Vehicles): https://delcode.delaware.gov/title21/
Delaware Department of Insurance — consumer information and contact: https://insurance.delaware.gov/

Helpful hints

Read your policy declarations page to confirm your MedPay limit and any specific filing requirements.
Report the accident to your insurer even if you are unsure whether you will use MedPay. Prompt notice protects your rights.
Keep careful records: dates of treatment, provider names, itemized bills, and proof of payment.
Ask providers whether they will accept MedPay directly or require assignment of benefits.
If an adjuster requests a recorded statement, ask why and consider getting legal advice before providing one.
If another insurer accepts liability, coordinate payments to avoid duplicate payments or disputes between insurers.
If you have questions or believe your claim was mishandled, contact the Delaware Department of Insurance for guidance or to file a complaint: insurance.delaware.gov.

Disclaimer: This article is for general informational purposes only and does not constitute legal advice. I am not a lawyer. For advice about your specific situation, contact a licensed attorney in Delaware or consult the Delaware Department of Insurance.