Claiming Medical Payments (MedPay) from Your Auto Insurance in Hawaii

Quick answer: If your Hawaii auto policy includes Medical Payments (MedPay), it generally pays your reasonable medical expenses (and sometimes those of passengers) up to the policy limit regardless of fault. To claim it, you must (1) confirm the coverage and limit on your policy declarations page, (2) give prompt notice to your insurer, and (3) submit medical bills, records, and any required claim forms. Expect the insurer to evaluate the claim, pay covered amounts, and possibly seek reimbursement (subrogation) from any at-fault party’s insurer.

Detailed answer — how MedPay works in Hawaii and the step-by-step claims process

What MedPay is and why it matters

Medical Payments coverage (often called MedPay) is a first-party auto insurance benefit that pays medical costs for the insured and covered passengers after an auto crash, regardless of who caused the accident. MedPay typically covers ambulance, emergency care, doctor visits, X-rays, and sometimes funeral expenses up to the limit you purchased. It is not the same as liability insurance (which pays others) or uninsured/underinsured motorist coverage (which protects you against uninsured drivers).

Check your policy first

• Locate your policy declarations (“dec”) page. It lists coverage types and limits (e.g., MedPay $5,000).
• If you don’t have a copy, request one from your insurer or your insurance agent.
• If you’re unsure whether Hawaii requires or offers MedPay in your policy, the Hawaii Department of Commerce and Consumer Affairs (Insurance Division) explains common auto coverages: https://cca.hawaii.gov/ins/.

Step-by-step: Filing a MedPay claim in Hawaii

1. Report the accident promptly: Notify your auto insurer as soon as possible. Most policies require timely notice. Include basic facts (date, location, vehicles involved, injuries).
2. Obtain medical care and documentation: Seek immediate treatment and keep all medical records, itemized bills, invoices, receipts, and provider contact information. MedPay usually requires proof of reasonable and related medical expenses.
3. Submit a claim form: Your insurer will provide (or direct you to) a claim form. Complete it and attach medical bills, records, and any police report or accident report if available.
4. Cooperate with the insurer: Answer reasonable requests for documentation, medical authorizations, or statements. Insurers may request medical release forms to verify treatment.
5. Review payment and explanation: The insurer will decide which charges are covered and pay up to the policy limit. They should provide an explanation of benefits or claim decision notice explaining any reductions or denials.
6. Understand subrogation: If you later recover money from the at-fault party or their insurer, your insurer may have a right to repayment (subrogation) of amounts it paid under MedPay. Keep the company informed about third-party claims or settlements.

Common issues and how Hawaii law and state resources help

Hawaii regulates insurer conduct through state insurance laws and the DCCA Insurance Division. If you believe your insurer unreasonably denies or delays a MedPay claim, you can use the DCCA’s consumer resources or file a complaint: https://cca.hawaii.gov/ins/consumer/. For general information on Hawaii insurance law, see the state legislature’s site: https://www.capitol.hawaii.gov/.

Timing and deadlines

Policy language controls timing for notice and proof of loss. Give notice and file proof of your claim as soon as you can. Keep copies of everything and note dates you submitted forms or called your insurer.

When MedPay may not cover costs

• The treatment was unrelated to the crash.
• Charges exceed your MedPay limit.
• You missed a required notice deadline in the policy.
• Fraud or material misrepresentation issues (insurer can deny in those cases).

Interaction with other coverages and health insurance

MedPay is often primary for auto-related medical expenses, but sometimes health insurance will pay first and MedPay may reimburse co-pays or deductibles. Check your policy’s coordination-of-benefits language. If another driver is at fault and you recover a settlement, MedPay’s subrogation rights can affect the final recovery unless you negotiate repayment terms in settlement documents.

Helpful Hints

• Document everything immediately: photos, police report number, witness names, medical visits, and receipts.
• Keep an organized file with all medical bills, provider statements, and insurer correspondence.
• Read your policy’s MedPay section carefully for limits, covered persons, and any exclusions.
• Ask your medical providers whether they will bill your insurer directly and whether they accept payment from an insurer subject to subrogation.
• Tell your claims adjuster if you file a third-party claim against the at-fault driver—MedPay subrogation can affect settlement strategy.
• If the insurer denies or undervalues your claim, request a written explanation. If you still disagree, file a complaint with the Hawaii DCCA Insurance Division: https://cca.hawaii.gov/ins/consumer/.
• Consider talking to a lawyer if your injuries are serious, if the insurer improperly denies benefits, or if subrogation disputes reduce your recovery.

Where to get official help in Hawaii

• Hawaii Department of Commerce and Consumer Affairs — Insurance Division (consumer info and complaints): https://cca.hawaii.gov/ins/
• Hawaii State Legislature (access to the Hawaii Revised Statutes and insurance-related chapters): https://www.capitol.hawaii.gov/

Disclaimer: This article explains general information about claiming Medical Payments under Hawaii auto insurance policies. It is not legal advice and does not create an attorney-client relationship. For advice about a specific claim or dispute, consult a licensed attorney or contact the Hawaii DCCA Insurance Division.