Car Accident Medical Bills: PIP and Med Pay

Written by Aptiva Health Editorial Team · Reviewed by Taylor Sorrels, Esq. and Crystal Brake, RCM Director · Editorial & review standards · How we research

After a car crash, medical bills can come from many places: the ER, imaging, physical therapy, follow-up visits. Who pays first depends on the state where the crash happened and on the coverage you have.

Kentucky has a no-fault system with personal injury protection (PIP), which state law calls basic reparation benefits. Indiana does not. This guide explains the basics in both states and what to do if an auto insurer won’t pay. It is part of the Coverage & Appeals Center.

At a glance

Kentucky: personal injury protection (PIP)

Who gets PIP

In Kentucky, anyone hurt in a motor vehicle accident has a right to basic reparation benefits, unless they formally rejected the limits on their right to sue (KRS 304.39-030).

How much it pays

PIP pays up to $10,000 per person per accident for all economic loss. That includes medical bills, and also things like lost wages (KRS 304.39-020). Medical bills can use up the $10,000 quickly.

Which policy pays

Generally, the policy covering the vehicle you were in pays first. If you were a pedestrian, it is generally the policy of the vehicle that hit you (KRS 304.39-050).

Workers’ comp and health insurance

• Workers’ comp comes first. If the crash happened while you were working, workers’ comp benefits are subtracted from what PIP pays (KRS 304.39-120).
• Health insurance. The PIP law does not list health insurance as something to subtract. So PIP generally pays your car accident medical bills before, or regardless of, your health plan.
• Your health plan’s rules. Your health plan may have its own rules about car accident claims, such as coordination of benefits or getting paid back from a settlement.

How fast PIP must pay

• PIP benefits are overdue if not paid within 30 days after the insurer gets reasonable proof of the loss and the amount (KRS 304.39-210).
• Overdue payments earn interest: 12% a year, or 18% if the delay had no reasonable basis.
• If the insurer rejects a claim, it must give you prompt written notice with the reason.
• You can ask the insurer to pay your medical providers directly.
• Providers generally must send their bills to the PIP insurer within 180 days of the service.

Indiana: no PIP

Indiana does not have a no-fault (PIP) system. Indiana requires drivers to carry liability insurance, which pays for injuries you cause to others. The minimum is $25,000 for bodily injury to one person (IC 9-25-4-5).

That means your car accident medical bills may be paid by:

• Medical payments (med pay) coverage, if your policy has it. It pays medical bills for you and usually your passengers, up to the policy limit, if you’re hurt in the car (IDOI: Auto Insurance). Med pay is optional in Indiana. Indiana law does not require insurers to offer it.
• Your health plan. It may pay and then seek repayment if another driver’s insurer pays later.
• The other driver’s liability insurance, if they caused the crash.

Insurers must also make uninsured and underinsured motorist coverage available, though you can reject it in writing (IC 27-7-5-2).

If an auto insurer denies or delays payment

1. Ask for the reason in writing. In Kentucky, a PIP insurer that rejects a claim must tell you why in writing (KRS 304.39-210).
2. Send proof of your loss. Include itemized bills, records and the claim number. Keep copies.
3. Track the 30 days. In Kentucky, payment is overdue 30 days after the insurer has reasonable proof. The appeal deadline calculator can help you track dates.
4. Tell your providers which insurer to bill. Give them your auto claim number and your health plan card.
5. File a complaint if needed. Contact your state Department of Insurance (see below).
6. If your health plan denies a crash-related bill, follow its normal appeal steps. See fully insured plans or self-funded employer plans.

[Your name]
[Your address] · [Your phone] · [Your email]

[Date]

[Auto insurer name] — Claims Department
[Address from your claim paperwork]

RE: Unpaid medical benefits
Claimant name: [Name]
Policy number: [Number]
Claim number: [Number]
Date of accident: [Date]

To whom it may concern:

I am writing about medical bills from my accident on [date]. I sent proof of these bills on [date]:
- [Provider], [date of service], $[amount]
- [Provider], [date of service], $[amount]

These bills have not been paid. [Kentucky:] Under KRS 304.39-210, benefits are overdue if not paid within 30 days after you receive reasonable proof of the loss.

Please pay these bills, or tell me in writing the specific reason you will not pay them.

[Optional:] Please pay my providers directly.

Sincerely,
[Signature]
[Printed name]

The appeal letter builder can help you write other letters.

What to keep after a crash

• Your auto claim number and the adjuster’s name and phone.
• The police or crash report number, if there is one.
• Every itemized medical bill and explanation of benefits.
• Copies of everything you send, with the date you sent it.
• A call log: date, name and what was said.

Common mistakes

• Sending crash bills only to your health plan in Kentucky. PIP generally pays car accident medical bills first.
• Not telling providers about the crash. Give them your auto claim number so they bill the right insurer.
• Assuming Indiana has PIP. It doesn’t. Check whether your policy has med pay.
• Forgetting workers’ comp. If you were working, workers’ comp may come first.
• Waiting to send proof. In Kentucky, the 30-day payment clock starts when the insurer gets reasonable proof.

Where to get help

Both departments take complaints in writing. Not sure who should pay? Try the appeal route wizard, and use the denial decoder to read the codes on any denial.