Short Answer

In North Carolina, a creditor’s claim must state the amount and the basis for the claim, and you may require the nursing home to verify it by sworn affidavit. Send a written demand for an itemized, verified statement and insurance adjustments; if they do not comply, you may reject the claim, which forces the creditor to sue within three months or be barred. If documents are needed, you can file an estate proceeding with the Clerk of Superior Court and use subpoenas to obtain billing and insurance records.

Understanding the Problem

As the personal representative in North Carolina, can you make a nursing home provide an itemized bill and explain insurance payments for a claim it filed without details? A nursing home submitted a claim that lacks itemized charges and insurance information. You need to decide how to obtain documentation before allowing or paying the claim.

Apply the Law

North Carolina law requires creditor claims to be in writing and to state the amount and the basis. You may insist the creditor verify the claim by affidavit that it is due and unpaid, with payments and offsets shown. If the claim remains unsupported, you can reject it, which starts a three-month window for the creditor to file suit; otherwise the claim is barred. You may also initiate an estate proceeding before the Clerk of Superior Court to resolve the claim’s validity and use subpoenas to obtain records. Nursing home charges for the decedent’s last illness are generally treated as medical services near death and prioritized accordingly when paying claims.

Key Requirements

• Proper claim content: The nursing home’s claim must state the amount and the basis; bare totals without explanation are not enough.
• Right to verification: You may require a sworn, itemized affidavit showing what is owed, what insurance paid, and any credits or offsets.
• Rejection triggers deadline: If you reject the claim in writing, the nursing home has three months to sue or the claim is barred.
• Court tools are available: You can file an estate proceeding with the Clerk of Superior Court and use subpoenas to compel billing and insurance documents.
• Payment priority matters: Medical services in the last 12 months of the decedent’s final illness have a specific payment priority; do not pay until you know where the claim fits.

What the Statutes Say

• N.C. Gen. Stat. § 28A-19-1 (Form and manner of claims) – Claims must state amount and basis; how they are presented.
• N.C. Gen. Stat. § 28A-19-2 (Verification by affidavit) – PR may require a sworn, itemized verification, including payments and offsets.
• N.C. Gen. Stat. § 28A-19-16 (Actions on rejected claims) – Creditor must sue within three months after written rejection.
• N.C. Gen. Stat. § 28A-19-6 (Order of payment of claims) – Sets priority classes, including last-illness medical services.

Analysis

Apply the Rule to the Facts: Because the nursing home filed a claim without itemization, you may demand a verified, itemized statement showing dates of service, charges, payments by Medicare/Medicaid or private insurance, adjustments, and net patient responsibility. If they do not provide this, issue a written rejection; they then have three months to file suit. If you still need records (e.g., insurance EOBs), file an estate proceeding with the Clerk of Superior Court and use subpoenas to obtain the documents before deciding whether to allow or pay the claim.

Process & Timing

1. Who files: Personal representative. Where: Start with a written demand to the nursing home; if needed, the Clerk of Superior Court in the North Carolina county where the estate is pending. What: Demand for a verified, itemized claim under the verification statute; if needed, a verified petition to determine/compel claim documentation with an Estate Proceeding Summons (AOC‑E‑102). When: Send the demand promptly; if unsupported, serve a written rejection and note the three‑month litigation window for the creditor.
2. If no cooperation: After rejection or if documents are withheld, file the estate proceeding, request a hearing, and issue Rule 45 subpoenas for itemized bills, ledger histories, and EOBs. Timeframes vary by county; many clerks set hearings within weeks.
3. Final step: After you obtain and review records, allow, reduce, or disallow the claim and pay it only in the correct statutory priority when sufficient funds are available. Keep invoices, EOBs, and your decision in the estate file for accounting.

Exceptions & Pitfalls

• Notice-to-creditors timelines: Claims must be presented by the date in your published notice (or within 90 days of personal notice, if later). Late claims are generally barred.
• Payment priority: Do not pay until you confirm class and solvency. Paying out of order can create personal liability.
• Your reimbursement claims: Funeral expenses are preferred only up to $3,500; gravestone up to $1,500 typically requires clerk approval for any excess as a lower‑priority claim. Landscaping may be an administration expense only if it preserved or prepared estate property for sale—document necessity and invoices.
• Real estate sale records: If you lack the sale price or net proceeds, request the settlement statement and disbursement ledger from the closing attorney or broker. Use subpoenas in an estate proceeding if needed.
• Accounting hygiene: Open a dedicated estate checking account using the estate EIN. Keep monthly bank statements and receipts for annual accounts. Avoid holding estate funds in a law firm trust account unless necessary, and never commingle.

Talk to a Probate Attorney

If you’re dealing with a nursing home claim and need itemized billing and insurance justification, our firm has experienced attorneys who can help you understand your options and timelines. Call us today.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.