WYOMING GUIDE 21

MedPay, Subrogation & Medical Reimbursement

The source that initially pays a crash-related medical bill is not necessarily the party that ultimately bears that expense. MedPay, health insurance, Medicaid, workers’ compensation and medical-provider assignments can all create different payment and reimbursement rights.

MedPay Is a First-Party Insurance Benefit

When the automobile policy includes medical-payments coverage, qualifying medical expenses can be submitted to the injured person’s own automobile insurer.

The insured does not have to wait for the negligence claim against another driver to be finally resolved before presenting a first-party MedPay claim.

Do Not Leave MedPay Unused While Medical Bills Accumulate

Identify MedPay early, obtain the applicable limit and submit qualifying bills with the documentation required by the policy.

Preserve proof of when the insurer received the claim and supporting bills.

The 45-Day Claims Rule

Wyoming law generally requires a property or casualty insurance claim to be accepted and paid, or rejected, within 45 days after receipt of the claim and supporting bills.

Payment May Create Subrogation Rights

Subrogation generally permits a payer that satisfied another person’s loss to step into that person’s rights against the party legally responsible for the loss, to the extent allowed by the applicable contract or law.

Do not distribute a settlement without identifying every asserted subrogation interest.

Different Payers, Different Rules

Payment Source	What Must Be Investigated
Auto MedPay	Policy terms, assignment or subrogation language and amounts paid.
UM Insurer	Statutory and contractual subrogation rights against legally responsible persons.
Private Health Plan	Actual plan document, reimbursement terms, ERISA status and governing federal or state law.
Wyoming Medicaid	Statutory lien, assignment, subrogation and settlement-notice requirements.
Workers’ Compensation	Wyoming’s statutory third-party recovery and reimbursement provisions.
Medical Provider	Assignment, contractual lien, insurance-benefit assignment or other lawful basis for claiming settlement proceeds.

“Lien” Is Not One Single Legal Category

When someone says there is a medical lien, identify the legal source.

statute;
insurance contract;
assignment;
subrogation provision;
government benefit program;
provider agreement; or
another recognized legal right.

Provider Assignments Can Affect Settlement Distribution

An injured person may sign an agreement assigning settlement proceeds to a medical provider for payment of outstanding treatment.

A valid assignment known to the attorney or other person distributing the settlement proceeds cannot simply be ignored.

Wyoming Medicaid

Wyoming Medicaid has statutory recovery rights when Medicaid pays accident-related medical expenses and the recipient later obtains recovery from another responsible source.

Settlement notice and reimbursement requirements must be handled before final distribution.

Do Not Disburse First and Ask Medicaid Later

Wyoming’s Medicaid statutes contain specific rights and notice requirements surrounding third-party settlements.

Identify Medicaid involvement and obtain the appropriate recovery information before final settlement distribution.

Workers’ Compensation

A worker injured in a motor-vehicle crash may receive workers’ compensation while also pursuing a legally responsible third party.

Wyoming law then provides a statutory reimbursement structure when the worker obtains a third-party recovery.

This calculation should be performed under the current workers’ compensation statute rather than treating the State’s interest as an ordinary health-insurance lien.