We interviewed two subject matter experts, Missouri injury attorneys Patrick Hinrichs, Esq. and Dominic Sinclair, Esq. of The Bruning Law Firm, to give you the best possible answers on whether MedPay or the at-fault driver's liability insurance pays your medical bills after a Missouri crash. Patrick has handled injury claims since 2010, and both attorneys spent the early years of their careers on the insurance side, defending large companies and their insurers.
A NOTE BEFORE YOU READ
No two cases are the same, and while we can give you a general answer, we cannot give you yours without knowing your situation. What follows is a strong start on understanding your coverage, but it is no replacement for working directly with an attorney who has reviewed your policy and your claim. If at any point you would rather just talk to someone, you are welcome to call us at (314) 735-8100. No pressure, and it costs nothing to find out where you stand.
The first medical bills from the crash have arrived, and nothing about the crash itself is settled.
- The other driver's insurance company knows about your claim, and it has paid nothing so far.
- You have two auto policies attached to what happened, yours and theirs, and nobody has told you which one covers the bill in front of you.
- Someone told you to open your own policy and look for something called MedPay, and using your own insurance for a crash someone else caused feels backwards.
If that is where you are, this page was written for you. You are weighing MedPay versus liability insurance, trying to work out which of the two policies attached to this crash pays the bills arriving now. The short answer is that medical payments coverage, if your own policy carries it, can pay now, while fault is still being argued, and the at-fault driver's liability coverage pays once, at the end, when your case settles or a jury decides it.
In the next few minutes you will know how to check whether you have MedPay, what the other driver's coverage will do while your claim is open, and what to make of any letter that asks for money back out of your settlement. For most people a serious crash is a once-in-a-lifetime event, but for Patrick and Dominic it is the work of every day, and they know what the adjuster's file looks like from the inside. You have questions, and you are in the right place to get them answered before you sign anything.
Which Coverage Pays Your Medical Bills Now in Missouri, MedPay or the At-Fault Driver’s Liability Insurance?
If your own auto policy carries medical payments coverage, called MedPay, it can pay your crash medical bills now, up to the limit stated in the policy, and nobody has to settle fault before it pays. The at-fault driver's liability coverage pays once, at the end, when your case settles or a jury decides it.
- Missouri does not require MedPay, so the place to look is the declarations page of your own policy, the summary sheet that lists each coverage with a dollar amount beside it.
- The Missouri Department of Commerce and Insurance defines medical payment insurance as coverage that "pays for your medical costs up to the limit stated in the policy."
- Some of what pays early can take a share back at the end, and which letters carry that right depends on who signed them.
| Medical payments coverage (MedPay) | The at-fault driver's liability coverage | |
|---|---|---|
| Whose policy it sits on | Yours | The other driver's |
| When it pays | While you are still treating, as bills arrive | Once, at the end, at settlement or verdict |
| Does fault have to be settled first? | No | Yes |
| What caps it | The limit stated on your declarations page | The at-fault driver's policy limits |
| Required in Missouri | No | Missouri requires every owner of a registered vehicle to maintain financial responsibility for the harm their driving causes (RSMo § 303.025) |
The questions on that table tend to reach you in a particular order, and the first one is whether you have MedPay at all.
How Do You Confirm You Have MedPay on Your Missouri Auto Policy?
Find your declarations page and look for a line called medical payments, with a dollar amount beside it. The declarations page is the summary sheet that came with your policy, and it states each coverage you bought and what you paid for it. Plenty of Missouri drivers learn they carry MedPay only after a crash.
The dollar figure on that line is the ceiling on what this coverage pays, and no Missouri statute sets that figure or a range for it, so the number on your sheet is the number. Hold it against the bills you already have. If there is no medical payments line at all, open the endorsements before you treat that as final, because coverage added to a policy after it issued is recorded there.
One more question is worth a phone call to your own carrier: how your MedPay coordinates with health insurance. Some policies pay alongside your health plan, and some pay only what your health plan did not, so the answer changes what you send where.
If Someone Else Caused the Crash, Why Use Your Own Coverage First?
Because your own coverage pays without waiting for the fault argument to end, and the at-fault driver's insurer is under no obligation to pay your bills as they arrive. What that insurer produces while your claim is open is an opinion about fault, formed from its own investigation, and any early offer it makes is built on that opinion. You are free to disagree with it, and if the two sides never agree, a jury decides.
It helps to be clear-eyed about whose interests that company serves. According to Missouri car accident attorney Patrick Hinrichs of The Bruning Law Firm, the at-fault driver's insurer owes its duty to its own policyholder, not to the injured person whose bills are arriving.
"The insurance company's duty isn't to you, it's to the person who bought insurance through them."
PATRICK HINRICHS, THE BRUNING LAW FIRM
That is the reason the reading order on your own paperwork matters. Your health insurance and your MedPay pay while the question is open, they keep your account out of collections, and every payment they make is documented for the settlement. Waiting for the other driver's insurer to volunteer payment this month is the one strategy that reliably fails, because that coverage was never built to work that way.
Where the At-Fault Driver’s Liability Coverage Stops
Liability coverage pays one time, and it stops at the at-fault driver's policy limits. The number it pays is built from the record your claim carries, the bills, the imaging, the treatment notes, the work you missed, and none of that is knowable in the first weeks after a crash. Nothing ties the limits the at-fault driver bought to what your treatment costs.
Dominic Sinclair, a senior associate attorney at The Bruning Law Firm who defended Fortune 500 corporations and large insurance companies before joining the plaintiff side, teaches that gap with a hypothetical in which he is the at-fault driver carrying a minimum-limits policy, and the person he hit has medical bills of $40,000:
"You have a claim against my policy, we'll pay you the full $25,000, but now you have $40,000 of debt with $25,000, and you don't know what to do."
DOMINIC SINCLAIR, THE BRUNING LAW FIRM
Part of what an attorney does in that position is look for every layer of coverage that reaches the crash, because the first policy on the table is often not the only one.
The other version of that ceiling is the driver who carried no policy at all. Missouri requires uninsured motorist coverage in every auto liability policy issued for a vehicle registered in the state (RSMo § 379.203), so if the driver who hit you was uninsured, your own policy stands in for theirs, and your medical bills become part of a claim against your own insurer. The same coverage reaches most hit-and-run crashes, where the driver is never identified. Your insurer handles that claim the way any insurer does, so the same care with early offers applies even though the company is your own.
Does Missouri Require MedPay Coverage?
No. No section of the Revised Statutes of Missouri requires an insurer to provide, or a driver to carry, medical payments coverage. What Missouri requires of a registered vehicle's owner is financial responsibility for liability, and uninsured motorist coverage inside every auto liability policy issued here. MedPay is bought by contract and governed by the words of your own policy, which is why the declarations page, and not a statute, answers whether you have it and how much of it you have.
Missouri is a fault state, and personal injury protection is a different coverage from a different system; our companion guide covers how the two differ and in which states each one applies.
Does MedPay Have to Be Paid Back Out of Your Settlement?
Missouri appellate courts have held that, absent a statute, your own auto insurer cannot enforce a claim on your recovery from the at-fault driver for the medical payments it made. The rule goes back to Jones v. Aetna Casualty & Surety Co., 497 S.W.2d 809 (Mo. App. 1973), where a woman hurt in a collision had her medical expenses paid by her own auto insurer, settled with the negligent driver, and kept her settlement, because no statute gave the insurer a right to what she collected.
That answer reaches your own MedPay carrier and stops there. For one neighboring coverage the legislature wrote the opposite rule: an insurer that pays under the uninsured motorist coverage described above is entitled, in the statute's words, "to the extent thereof," to "the proceeds of any settlement or judgment" from your recovery against the person responsible.
Money that paid your treatment can also come from a health plan, a hospital, a government program, an employer, or another payer entirely, and each of those senders answers to its own rule, some of them federal. Which rule reaches your settlement depends on who signed the letter in your hand, so establish the sender before you agree to anything in it, and let an attorney read it before you sign anything about it. The difference between what a sender demands and what the law lets it keep is real money, and sorting that out is part of the work of settling the claim.
What to Do This Week, in Your Situation
If your declarations page shows a medical payments line, call your own carrier, open the MedPay claim, and send it the crash bills you already have. Keep routing treatment through your health insurance as well, and ask the carrier how the two coordinate, because the answer decides what you send where.
If there is no medical payments line, your health insurance is the tool for right now. Use it for every crash-related visit, starting with the emergency room, and keep every bill and every insurer letter in one folder, dated as it arrives. The claim is proven dollar by dollar through those documents.
If the driver who hit you was uninsured, or left the scene, your own uninsured motorist coverage stands in. Open that claim with your own carrier, and treat the conversation with the same care you would give the other driver's insurer, because the claim is handled the same way.
If a letter is asking for money back, find who signed it before you respond. Your own MedPay carrier sits under one rule, and other senders sit under others, so the signature decides the answer. Nothing about that letter needs to be resolved this week, and nothing in it should be agreed to before someone who does this work has read it.
If an offer is already on the table, remember what the offer is priced on. The at-fault driver's insurer pays once, and a number that arrives before your treatment is finished was built without knowing what your treatment costs.
When to Get an Attorney Involved
The MedPay question is answered out of documents: your declarations page, the letters from both carriers, and anything you have already signed. If those documents agree with each other and you know your next three steps, you may be fine on your own. Most people reading this page are somewhere else, with an opinion about fault they disagree with, a bill nobody has paid, and a letter they are not sure how to answer. Patrick Hinrichs's caution for anyone taking an adjuster's read of the claim as the final word:
"The adjusters don't determine the law in Missouri. The courts determine the law."
PATRICK HINRICHS, THE BRUNING LAW FIRM
Hiring a lawyer is also a decision this firm will sometimes talk you out of, because when taking a fee would leave you worse off, the answer is no. Bring your folder to a St. Louis car accident lawyer and let the review sort out which kind of case you have.
Medical Payments Coverage FAQs
Should you use MedPay or liability insurance for your medical bills after a Missouri car accident?
Use the coverage that can pay now. If your own policy carries medical payments coverage, it pays your crash bills up to its stated limit without waiting on the fault question. The at-fault driver's liability coverage pays one time, at the end, when your case settles or a jury decides it, so the bills that arrive before that day are handled through your own coverages.
Does the fault question have to be settled before MedPay pays?
No. Medical payments coverage is written to pay your medical costs up to the limit stated in the policy, and no finding of fault is required first. The coverage that waits on the fault argument is the at-fault driver's liability coverage, and while that argument runs, its insurer is under no obligation to pay your bills as they arrive.
What if the driver who hit you had no insurance?
Missouri requires uninsured motorist coverage in every auto liability policy issued for a vehicle registered in the state, so your own policy stands in for the missing one, and your medical bills become part of a claim against your own insurer. The same coverage reaches most hit-and-run crashes where the driver is never identified.
Does your MedPay carrier get repaid out of your Missouri settlement?
Missouri appellate courts have held that, absent a statute, your own auto insurer cannot enforce a claim on your recovery for the medical payments it made. That answer is about your own MedPay carrier. A letter from a different sender runs on a different rule, so have The Bruning Law Firm, or any attorney who does this work, read it before you agree to anything in it.
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