If an insurance payout is more than you expect, do you have to repay it?

You don't say what kind of insurance payment it is.

Is it a life insurance, car insurance, home or what?

There could be some explanations; such as interest, accidental death, additional damage that was overlooked, etc.

It's hard to answer a question when there is not much info to go on.

If this happened back in July, and liability is not in dispute, I'm guessing the property damage claim has already been settled. You either collected through your collision coverage, or directly from the at fault party. (Oregon allows some diminished value on property damage liability, but as long as that is already settled we do not need to be concerned about it.) I assume your car rental has also been resolved. Oregon is a No-Fault PIP state, so that means your medical bills have already been paid, and now your insurance company is seeking reimbursement for the medical bills paid. I assume they will deal directly with your insurance carrier for the reimbursement. You may be entitled to some pain and suffering compensation. How much can you expect? We would have no way to determine that without knowing more about the extent of your injuries and treatment. Regarding your medical bills, we do not know how much was for diagnostic verses treatment, etc. It sounds like you may have had a sprain/strain type injury. This is the kind of thing that typically heals up without any medical treatment at all. And it usually heals on its own in about 3 to 6 weeks. If you treated from July to December, then it appears you may have over-treated. This is a common error. Chiropractors try to get you to keep coming back because they want to make some money off you. But this does not mean you really NEEDED this treatment. Some people think if they get a bunch of unnecessary treatment that it will result in a bigger bodily injury settlement. But most claims adjusters see right through that scheme. Let them make the first offer. ================== (added) Whatever they offer you, just double that, and say you had figured your claim was worth this much. So if they offer, for example, $2,500, you thank them for the offer, and counter at $5,000. But in a subtle way you convey that you have some room to move. Wait for them to increase their offer a little. And then you probably settle for somewhere in between, like maybe $3,500. Or if they offer $5,000, you counter at $10,000, but probably settle between $6,500 to $7,500. (I am not suggesting your claim is worth that much, I am just using these numbers to show the dynamics of negotiating.) In some rare cases, their first offer is their final offer, but that is the exception. Usually, they have a little room to move. But not a lot of room on these smaller cases. So it doesn't make any sense to counter at $50,000. (When people do that to me, I just tell them we have nothing to talk about, and we will wait for your lawsuit. Goodbye.) So keep your negotiations in the ball park. And whatever you do, be nice to the claims adjuster. It would be foolish to insult the claims adjuster, or treat them rudely. Do not give the claims adjuster any reason to dislike you.

they may have had to seperate policies maybe a smaller one that you didn't know about. I would cash the check that you know abuot and hold the other for a little while .

Whatever amount you agreed on is what the check should be for...if you got more (2 checks) they will probably want one back.