Short Answer

In North Carolina, uninsured motorist (UM) insurers can rely on policy language that prevents paying the same medical expense twice if another source, like workers’ compensation, already paid it. You should verify the insurer’s offsets line-by-line, identify every lien (including the workers’ compensation lien), and focus negotiations on losses that are not already paid, such as pain and suffering, lost income not covered by comp, and documented mileage. Your attorney can also seek lien reductions where allowed to increase your net recovery.

Understanding the Problem

In North Carolina personal injury cases, you can make a UM bodily injury claim after a crash. The insurer says it will not duplicate payments for medical expenses that workers’ compensation already covered. Can you still settle fairly, and what should you do when the insurer applies these offsets? One key fact here is that workers’ compensation already paid your hospital and emergency bills.

Apply the Law

North Carolina allows first-party auto policies, like UM coverage, to include anti-duplication provisions so the carrier does not pay the same medical charges twice. Separate from that contract rule, North Carolina law gives a workers’ compensation carrier a statutory lien on an injured worker’s recovery from responsible third parties and often treats UM recoveries as standing in for the at-fault driver. Health care providers may also assert statutory medical liens, but those are capped. The typical forum for a disputed UM claim is the Superior Court (or contractual arbitration if the policy requires it). Most personal injury claims must be filed within three years of the crash; your policy may also impose earlier notice or arbitration deadlines.

Key Requirements

• Anti-duplication applies only to the same expense: The carrier may offset medical charges already paid by workers’ comp or another source, but it must still evaluate uncompensated losses (e.g., pain and suffering, uncovered wage loss, reasonable mileage).
• Workers’ compensation lien: The comp carrier typically has a statutory lien on third-party/UM recoveries and must be reimbursed from settlement proceeds, subject to court-approved reductions in some cases.
• Medical provider liens: Providers can assert liens for accident-related treatment, but the total enforceable amount is limited by statute and cannot exceed a set portion of the recovery after attorney fees.
• Allocation matters: The written release and settlement paperwork should allocate damages to avoid labeling the same medical charge twice and to show what is truly uncompensated.
• Deadlines and forum: Observe the general three-year filing deadline for injury claims and any contractual UM notice/arbitration requirements; litigation is generally filed in Superior Court if negotiations fail.

What the Statutes Say

• North Carolina Gen. Stat. § 20-279.21 (Motor vehicle liability policies; UM/UIM) – Requires UM coverage and permits policy terms that affect payment of damages.
• North Carolina Gen. Stat. § 97-10.2 (Workers’ compensation subrogation/lien) – Establishes the employer/insurer lien and allows court involvement in distribution and reductions.
• North Carolina Gen. Stat. § 44-49 (Medical provider liens) – Gives providers a lien for reasonable charges for accident-related care.
• North Carolina Gen. Stat. § 44-50 (Limitations on medical liens) – Caps total enforceable medical liens to a portion of the recovery after attorney fees.

Analysis

Apply the Rule to the Facts: Because workers’ compensation already paid your hospital and emergency bills, the UM carrier can apply its anti-duplication clause to those same medical charges. That does not bar recovery for items not already paid, like pain and suffering, any wage loss not covered by comp, and documented mileage. Your lawyer should verify the insurer’s offset math, obtain a current workers’ comp lien statement, and ensure any medical liens comply with the statutory cap before finalizing numbers.

Process & Timing

1. Who files: The injured person (through counsel). Where: Submit a detailed demand to the UM insurer; if needed, file a civil action in Superior Court in the proper North Carolina county (or follow policy arbitration). What: Provide medical itemizations, wage proof, mileage logs, and proof of workers’ comp payments and liens. When: Observe policy notice/arbitration deadlines and the general three-year injury filing deadline.
2. Request a written offset breakdown from the UM adjuster and a current lien statement from the workers’ comp carrier; reconcile all medical charges to avoid counting the same bill twice. Seek reductions of the comp lien or provider liens where the law allows.
3. Document the final settlement with clear damage allocation language, obtain lien releases, and disburse funds consistent with statutory lien priorities and caps.

Exceptions & Pitfalls

• Medicare/Medicaid or ERISA plan reimbursements can apply and are separate from provider lien caps; failing to resolve them can delay payment.
• Not challenging improper offsets—ensure the insurer only deducts charges actually paid and related to this crash.
• Overpaying provider liens—confirm they fall within statutory caps and that providers gave proper notice and itemization.
• Release language—avoid broad releases that inadvertently surrender claims unrelated to the UM settlement or mischaracterize damages.

Talk to a Personal Injury Attorney

If you’re dealing with a UM insurer refusing to duplicate medical payments after workers’ comp has paid, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at [919-341-7055].

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.