STATE LAW – TEXAS LIBRARY – GUIDE 21
Texas PIP/MedPay, Hospital & EMS Liens, Subrogation & Reimbursement
PIP and MedPay benefits, provider liens and health-plan reimbursement are separate systems. Confirm the legal basis and amount of each asserted repayment demand.
PIP and medical-payments coverage
Insurance Code §§ 1952.151–.153 define PIP and its inclusion, written-rejection and minimum-benefit framework. The required minimum is $2,500 per person in the aggregate, with covered expenses subject to statutory requirements including timing. Higher purchased coverage may exist.
Section 1952.155 makes PIP payable without regard to crash fault or specified collateral sources. It generally restricts the paying insurer’s subrogation, but subsection (c) contains an exception involving a responsible person who had not established required financial responsibility. Do not describe the restriction as exceptionless. MedPay is a different coverage and requires its own terms.
Hospital and EMS liens
Property Code Chapter 55 sets conditions for hospital and qualifying emergency-medical-services liens. The hospital admission timing requirement generally concerns admission within 72 hours of the accident. The EMS provision has additional conditions, including the county-population requirement.
Sections 55.003–.005 address attachment, limitations and perfection. Obtain the filed notice, provider identity, treatment dates and calculation. Section 55.004 contains limits on hospital lien amounts, including the lesser-of framework; a hospital’s total billed charges are not automatically the valid lien amount.
Health-plan reimbursement
Civil Practice and Remedies Code Chapter 140 addresses specified contractual subrogation rights of health-benefit plan issuers. Its scope, reduction provisions and exclusions must be checked against the actual plan. Federal law, ERISA plan status, Medicare, Medicaid and other reimbursement systems can raise different rules.
Obtain the plan document and itemized demand, verify that the listed payments relate to the crash, and ask for the asserted legal basis. Do not apply a single percentage reduction or made-whole statement to every plan without reviewing the governing law.
Prepare a settlement distribution ledger
Track gross settlement, prior benefit payments, each lien or reimbursement demand, disputed amounts and written resolutions. Distinguish a provider’s unpaid bill from a perfected statutory lien and from a health plan’s reimbursement right. Resolve duplicate entries and unrelated treatment.
Before distributing proceeds, confirm releases or agreements for resolved demands and identify obligations that remain open. Negotiating an injury settlement does not automatically discharge these claims. Obtain advice about disputed priority, federal-plan issues and preservation of funds rather than assuming the carrier’s net-payment estimate resolves the entire ledger.
Authorities and source notes
- Texas UM/UIM and PIP — Insurance Code Chapter 1952; §§ 1952.060, .101, .106, .151–.155
- Hospital and EMS liens — Property Code §§ 55.002–.005
- Health benefit subrogation — Civil Practice and Remedies Code Chapter 140
- Texas Department of Insurance auto insurance guide — TDI consumer auto insurance guide
Official source links and cited propositions checked October 4, 2026. Full subsequent-history and legal-currentness review remains open. General information; individual facts, policy terms and deadlines require case-specific review.
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