New Hampshire Claims Dispute & Statutory Guide
New Hampshire operates an At-Fault automobile insurance framework under Title XXI and Title XXXVII of the New Hampshire Revised Statutes Annotated (RSA). Under RSA 264:16, whenever auto liability insurance is purchased, it must include at least $1,000 in Medical Payments (MedPay) coverage. Motor vehicle liability is governed by modified comparative fault with a 51% bar under RSA 507:7-d, and hospitals enforce statutory liens under RSA 448-A.
Statutory Framework & Jurisdiction
At-Fault / Traditional Tort (Mandatory $1,000 MedPay When Insured & New Hampshire Hospital Lien Act)
New Hampshire is the only state that does not mandate purchase of auto liability insurance (operating under financial responsibility laws), but under RSA 264:16, if an automobile liability policy is issued, it must provide first-party Medical Payments (MedPay) coverage of at least $1,000 per person. Motor vehicle accident claims are governed by modified comparative fault under RSA 507:7-d, allowing recovery if the claimant's fault was not greater than the fault of the defendants. Hospitals secure unpaid inpatient and outpatient medical balances by asserting statutory liens under RSA Chapter 448-A.
PIP / MedPay Coverage & Medical Fee Rules
mandatory Med Pay Offering
Under RSA 264:16, every auto liability policy issued in New Hampshire must provide at least $1,000 in MedPay coverage per person (with higher optional limits available), paying reasonable medical, surgical, dental, hospital, and funeral expenses incurred within 3 years of the collision
made Whole Doctrine
Under New Hampshire common law, an automobile insurer's subrogation right for MedPay benefits is subordinate to the Made-Whole doctrine, preventing insurer recovery from a third-party settlement until the injured insured is fully compensated
assignment Of Benefits
Healthcare providers routinely obtain patient assignments of MedPay benefits for direct claims submission to automobile insurers
Official Medical Fee Schedule & Reimbursement Standards
name
Reasonable and Customary Fee Standard
rules
New Hampshire does not enforce a statutory fee schedule table for motor vehicle accident medical bills outside of workers' compensation. Providers bill standard 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
Preauthorization & Decision Point Review
requirement
Preauthorization is not required by statute for emergency trauma care or initial acute stabilization. Elective surgical interventions and prolonged physical therapy regimens are evaluated under insurer medical necessity guidelines.
carrier Examinations
Under standard auto policy terms, insurers may request medical records or independent physician reviews to evaluate causal relationship to the motor vehicle collision.
Administrative Appeals & Dispute Mechanism
prompt Payment Statute
Under RSA 415:6-h, insurers must pay clean claims within 30 calendar days of receipt. Claims not paid within 30 days accrue statutory interest from the date the claim became overdue.
hospital Lien Act
Under RSA Chapter 448-A (Liens in Favor of Hospitals), any licensed hospital in New Hampshire has a statutory lien upon personal injury claims, verdicts, and settlements for reasonable hospital charges. To perfect the lien, the hospital must file notice with the clerk of the city or town where the hospital is situated and serve written notice on the patient and liability insurer prior to distribution of proceeds.
dispute Forum
New Hampshire Superior Court (or Circuit Court District Division for claims up to $25,000) for civil recovery actions.
Critical Statutory & Dispute Deadlines
| Dispute Phase / Trigger Event | Statutory Timeline / Deadline |
|---|---|
| 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 from receipt of clean claim (RSA 415:6-h) |
| Municipal Clerk Lien Filing | Must be filed with city/town clerk and served on insurer prior to payment (RSA 448-A:2) |
| Statute of Limitations | 3 years from accident date for personal injury tort claims (RSA 508:4); 3 years for contract claims |
Required Evidentiary Filing Checklist
- ✓New Hampshire 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 municipal clerk recording stamp (RSA 448-A:2)
- ✓Insurer Explanation of Benefits (EOB) or written explanation of claim determination
Official Primary Sources & Legislative Authorities
Governing Regulatory Authorities
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