What dispute deadlines should providers track in Georgia?

Accident Notice: Notice to insurer as soon as reasonably practicable; MedPay Claim Submission: Submission within standard policy billing deadlines (typically 1 to 3 years); Insurer 60-Day Demand Window: 60 calendar days from formal written demand before statutory bad-faith penalty applies (O.C.G.A. § 33-4-6). Verify the trigger date, current agency notices, and any extension before acting.

Which agencies administer these rules in Georgia?

The guide identifies Georgia Office of Commissioner of Insurance and Safety Fire. The correct agency depends on the plan and claim jurisdiction.

Auto Accident, PIP & Medical Billing State Guides

Georgia Auto Accident, PIP & Medical Billing Laws

Georgia operates an At-Fault automobile insurance framework under Title 33 and Title 51 of the Official Code of Georgia Annotated (O.C.G.A.). Motor vehicle liability is governed by modified comparative negligence with a 50% bar. Medical providers utilize optional first-party Medical Payments (MedPay) and enforce statutory healthcare provider liens against third-party liability proceeds under O.C.G.A. § 44-14-470.

Accountability & Review

Reviewed by Millennova Legal Operational Integrity Team, Senior Audit and Arbitration Analysts

Last Reviewed

2026-03-01

Plain-language overview

At-Fault / Traditional Tort (Modified Comparative Fault & Statutory Medical Liens)

Georgia does not mandate Personal Injury Protection (PIP) insurance. Medical costs resulting from auto accidents are addressed through optional first-party MedPay, private health insurance, or third-party liability insurance maintained by an at-fault driver. Under O.C.G.A. § 33-24-56.1 (Georgia's Complete Compensation Rule), an insurer paying MedPay or medical benefits cannot subrogate against a tort recovery until the injured person is completely compensated for all economic and non-economic losses. Providers secure unpaid medical receivables by recording liens in the superior court under O.C.G.A. § 44-14-470.

PIP and MedPay coverage

Optional Med Pay Coverage

MedPay is optional in Georgia (typically $1,000 to $10,000+ per person), providing direct reimbursement for reasonable medical and funeral expenses incurred due to a motor vehicle crash regardless of fault

Complete Compensation Rule

Under O.C.G.A. § 33-24-56.1, an insurer has no right of reimbursement or subrogation from an injured party's third-party recovery unless the injured party has been fully and completely compensated for all damages

Assignment Of Benefits

Healthcare providers routinely accept patient assignments of MedPay benefits for direct claims submission

Medical fee schedule and reimbursement rules

Name

Reasonable and Necessary Charges Standard

Rules

Georgia does not maintain a statutory fee schedule table for motor vehicle accident medical billing. Healthcare providers bill their standard reasonable and customary fees prevailing in the community for comparable medical services.

Cpt Basis

CPT/HCPCS itemized coding on standard CMS-1500 or UB-04 billing claims

Preauthorization and utilization review

Requirement

Preauthorization is not required by statute for acute emergency services or initial diagnostic imaging. Elective surgical interventions and extended physical therapy plans are evaluated under insurer medical necessity guidelines.

Insurer Reviews

Auto liability and MedPay carriers may request medical records or independent peer reviews to evaluate causal relationship to the accident.

Appeals and dispute resolution

Statutory Bad Faith Penalty

Under O.C.G.A. § 33-4-6, if an insurer fails to pay a covered loss within 60 days after demand, and the refusal is found to be in bad faith, the insurer is liable for a penalty of up to 50% of the liability or $5,000 (whichever is greater), plus all reasonable attorney fees.

Medical Provider Lien Statute

Under O.C.G.A. § 44-14-470 et seq., hospitals, physician practices, traumatic burn centers, and chiropractic clinics have a statutory lien upon personal injury causes of action, settlements, and judgments. To perfect the lien, the provider must file a verified statement of lien in the office of the clerk of the superior court of the county where the provider is located and the county where the patient resides (within 75 days of discharge for hospitals; within 30 days for physician practices).

Dispute Forum

Georgia State Court or Superior Court for civil contract and lien enforcement actions.

Claim and dispute deadlines

Deadlines can depend on the trigger event and may be affected by agency relief notices. Confirm the live rule before filing.

Event	Timeframe
Accident Notice	Notice to insurer as soon as reasonably practicable
MedPay Claim Submission	Submission within standard policy billing deadlines (typically 1 to 3 years)
Insurer 60-Day Demand Window	60 calendar days from formal written demand before statutory bad-faith penalty applies (O.C.G.A. § 33-4-6)
Hospital Lien Perfection	Must be filed with superior court clerk within 75 days of discharge (O.C.G.A. § 44-14-471)
Physician Practice Lien Perfection	Must be filed with superior court clerk within 30 days of service (O.C.G.A. § 44-14-471)
Statute of Limitations	2 years from accident date for personal injury tort claims (O.C.G.A. § 9-3-33); 6 years for written contract claims

Documentation checklist

Georgia MedPay Claim Form and Patient Authorization
Executed Assignment of Benefits (AOB) and medical records release
Itemized CMS-1500 or UB-04 billing statement with CPT/HCPCS codes and ICD-10 diagnostic coding
Contemporaneous medical records, emergency intake notes, operative reports, and imaging findings
Filed Notice of Medical Lien with superior court clerk recording stamp (for provider lien claims under O.C.G.A. § 44-14-471)
Insurer Explanation of Benefits (EOB) or written explanation of claim reduction

Responsible agencies

Georgia Office of Commissioner of Insurance and Safety FireStatewide Regulation of Auto Insurers, Market Conduct & Consumer Services

Primary legal and regulatory sources

Official Code of Georgia Annotated Title 44, Chapter 14, Article 8, Part 7 (Hospital and Medical Liens)Georgia General Assembly · 2024
Official Code of Georgia Annotated Section 33-24-56.1 (Medical Collateral Benefits; Subrogation)Georgia General Assembly · 2024

This operational reference is educational, is not legal advice, and does not create an attorney-client relationship.

Common questions

What rules govern auto accident, pip & medical billing state guides in Georgia?: Georgia operates an At-Fault automobile insurance framework under Title 33 and Title 51 of the Official Code of Georgia Annotated (O.C.G.A.). Motor vehicle liability is governed by modified comparative negligence with a 50% bar. Medical providers utilize optional first-party Medical Payments (MedPay) and enforce statutory healthcare provider liens against third-party liability proceeds under O.C.G.A. § 44-14-470.
What dispute deadlines should providers track in Georgia?: Accident Notice: Notice to insurer as soon as reasonably practicable; MedPay Claim Submission: Submission within standard policy billing deadlines (typically 1 to 3 years); Insurer 60-Day Demand Window: 60 calendar days from formal written demand before statutory bad-faith penalty applies (O.C.G.A. § 33-4-6). Verify the trigger date, current agency notices, and any extension before acting.
Which agencies administer these rules in Georgia?: The guide identifies Georgia Office of Commissioner of Insurance and Safety Fire. The correct agency depends on the plan and claim jurisdiction.