What is the process for using my Medical Payments (MedPay) coverage for injuries after an accident in California?
To use your MedPay coverage, you notify your insurance company about the accident and submit your medical bills directly to them for payment, regardless of who was at fault. Here is the typical process:
Step 1: Report the Accident and Your Injuries
Immediately call your auto insurance company's claims hotline, which is usually found on your insurance card or their website. Inform them that you were in an accident and have sustained injuries. Have your policy number and the basic details of the accident (date, time, location) ready.
Step 2: Specifically Open a MedPay Claim
When you speak to the representative, clearly state that you want to open a claim under your Medical Payments (or MedPay) coverage. Your insurer will assign a claims adjuster who will manage your MedPay benefits. They should provide you with a claim number.
Step 3: Collect All Medical Bills and Receipts
Gather all documentation related to your medical care. This includes itemized bills from the hospital, doctors, ambulance, chiropractors, and physical therapists. Also, keep receipts for any out-of-pocket expenses like prescriptions or required medical devices.
Step 4: Submit Your Bills to the Adjuster
Send copies of your medical bills and receipts directly to the assigned MedPay adjuster. Most insurers have an online portal, email address, or mailing address for submitting documents. Always keep the original copies for your own records.
Important Details and Nuances
MedPay is "no-fault" coverage, meaning you can use it even if you caused the accident. Payments are made up to your policy limit (e.g., $1,000, $5,000, etc.). It can cover costs your primary health insurance does not, such as deductibles and copayments. Under California regulations, your insurer must acknowledge your claim within 15 days and, once you have provided reasonable proof of your expenses, they must accept or deny the claim within 40 days.
Warnings and Limitations
Using your MedPay coverage is not an admission of fault. If you later recover money from the at-fault driver's insurance, your own insurance company may have a right to be reimbursed for the MedPay benefits it paid. This is called "subrogation" and will be outlined in your policy. Always file your claim as soon as possible, as your policy contains strict deadlines.
This is general information and does not constitute legal advice. For complex situations, such as those involving serious injuries or disputes with an insurance company, you should consult with a qualified California attorney.
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Disclaimer:
This information is for general guidance only and should not be considered as legal advice. Please consult with a qualified attorney for specific legal matters.
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Updated: August 13, 2025
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