Auto Accident, PIP & Medical Billing State Guides
Indiana Auto Accident, PIP & Medical Billing Laws
Indiana operates an At-Fault automobile insurance framework under Title 27 and Title 34 of the Indiana Code. Motor vehicle liability is governed by modified comparative fault with a 51% bar. Medical providers utilize optional first-party Medical Payments (MedPay) and enforce statutory hospital liens on third-party settlements under Ind. Code § 32-33-4.
Plain-language overview
At-Fault / Traditional Tort (Modified Comparative Fault & Indiana Hospital Lien Act)
Indiana does not require Personal Injury Protection (PIP) insurance. Medical costs resulting from auto crashes are billed to optional first-party Medical Payments (MedPay) coverage, health insurance, or third-party liability insurance maintained by the responsible driver. Under Ind. Code § 34-51-2-19, any subrogation claim by a MedPay insurer against a tort recovery must be diminished in proportion to the claimant's comparative fault and reduced by a pro-rata share of attorney fees. Hospitals secure unpaid balances through the Indiana Hospital Lien Act under Ind. Code § 32-33-4.
PIP and MedPay coverage
Optional Med Pay Coverage
MedPay is optional in Indiana (commonly written in limits of $1,000 to $10,000+ per person), covering reasonable and necessary medical, surgical, dental, hospital, and ambulance expenses incurred as a result of an automobile collision
Statutory Subrogation Reduction
Under Ind. Code § 34-51-2-19, an insurer's subrogation claim against a third-party recovery must be diminished in terms of the claimant's percentage of comparative fault, and the insurer must bear a pro-rata share of all attorney fees and litigation costs
Assignment Of Benefits
Healthcare providers routinely obtain patient assignments of MedPay benefits for direct reimbursement from auto insurers
Medical fee schedule and reimbursement rules
Name
Reasonable and Customary Fee Standard
Rules
Indiana does not enforce a statutory fee schedule table for motor vehicle accident medical bills. Providers bill based on reasonable and customary charges prevailing in the local medical community for comparable care.
Cpt Basis
CPT/HCPCS itemized coding on standard CMS-1500 or UB-04 billing claims
Appeals and dispute resolution
Prompt Payment Statute
Under Ind. Code § 27-8-5.7-6, insurers must pay clean claims within 30 calendar days for electronic submissions (45 days for paper submissions). Overdue clean claims accrue statutory interest.
Hospital Lien Act
Under the Indiana Hospital Lien Act (Ind. Code § 32-33-4-1 et seq.), any hospital in Indiana has a statutory lien upon personal injury claims, settlements, and judgments for reasonable hospital charges. The lien must be recorded with the clerk of the circuit court of the county where the hospital is located within 90 days of patient discharge.
Dispute Forum
Indiana Superior Court or Circuit Court (or small claims division for claims up to $10,000) for civil recovery 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) |
| Clean Claim Payment Window | 30 calendar days for electronic claims; 45 days for paper claims (Ind. Code § 27-8-5.7-6) |
| Hospital Lien Perfection | Must be filed with county circuit court clerk within 90 days of discharge (Ind. Code § 32-33-4-4) |
| Statute of Limitations | 2 years from accident date for personal injury tort claims (Ind. Code § 34-11-2-4); 6 years for contract claims |
Documentation checklist
- Indiana MedPay Claim Application Form
- Executed Assignment of Benefits (AOB) and medical records authorization
- Itemized CMS-1500 or UB-04 billing form with CPT/HCPCS codes and ICD-10 diagnostic coding
- Contemporaneous medical records, emergency intake documentation, operative reports, and imaging findings
- Filed Notice of Hospital Lien with circuit court clerk recording stamp (for hospital claims under Ind. Code § 32-33-4-4)
- Insurer Explanation of Benefits (EOB) or written explanation of claim determination
Responsible agencies
- Indiana Department of Insurance (IDOI)Statewide Regulation of Auto Insurers, Rate Filings & Consumer Inquiries
Primary legal and regulatory sources
- Indiana Code Title 32, Article 33, Chapter 4 (Hospital Liens)Indiana General Assembly · 2024
- Indiana Code Title 34, Article 51, Chapter 2, Section 19 (Diminution of Subrogation Claims)Indiana 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 Indiana?
- Indiana operates an At-Fault automobile insurance framework under Title 27 and Title 34 of the Indiana Code. Motor vehicle liability is governed by modified comparative fault with a 51% bar. Medical providers utilize optional first-party Medical Payments (MedPay) and enforce statutory hospital liens on third-party settlements under Ind. Code § 32-33-4.
- What dispute deadlines should providers track in Indiana?
- Accident Notice: Notice to insurer as soon as reasonably practicable; MedPay Claim Submission: Submission within standard policy billing deadlines (typically 1 to 3 years); Clean Claim Payment Window: 30 calendar days for electronic claims; 45 days for paper claims (Ind. Code § 27-8-5.7-6). Verify the trigger date, current agency notices, and any extension before acting.
- Which agencies administer these rules in Indiana?
- The guide identifies Indiana Department of Insurance (IDOI). The correct agency depends on the plan and claim jurisdiction.