How can I get medical records from a hospital in another state when the death happened in a different state? – North Carolina

Short Answer

In most situations, an out-of-state hospital will release a deceased person’s medical records only to someone with legal authority to act for the estate—usually a court-appointed personal representative. In North Carolina, that authority is typically proven with certified Letters of Administration (for an intestate estate) issued by the Clerk of Superior Court, along with a certified death certificate and the hospital’s HIPAA form. If no estate is open yet (or the estate is very small), the practical next step is often opening a simple NC estate file so the Clerk can issue the needed letters.

Understanding the Problem

When a North Carolina family member needs a decedent’s medical records from a hospital located in another state, the key question is: who has the legal authority to request and receive those records after the patient has died? Hospitals commonly require “court papers” because medical records remain confidential after death, and the hospital must confirm that the requester has the right to act for the decedent’s estate. This issue often comes up when the records are needed for litigation and the decedent died without a will and with little to no assets, so no probate case has been opened yet.

Apply the Law

Under North Carolina probate practice, the person with authority to act for an intestate estate is the court-appointed personal representative (usually called the administrator). That authority is issued by the Clerk of Superior Court (Estates Division) in the form of Letters of Administration. Even if the hospital is in another state, hospitals commonly accept certified letters as proof that the requester is the estate’s authorized representative, along with proof of death and a compliant HIPAA authorization or court order.

Key Requirements

• Proof of death: A certified death certificate (or other acceptable evidence of death) is commonly required to start probate and to complete third-party requests.
• Authority to act for the estate: Certified Letters of Administration (intestate) or Letters Testamentary (testate) show that the Clerk has appointed a personal representative.
• A proper records request: Most hospitals require their own HIPAA-compliant form, identification, and a clear description of what records are requested and where to send them.

What the Statutes Say

• N.C. Gen. Stat. § 8-36 (Authenticated copy of record of administration) – Allows properly certified out-of-state letters/administration records to be used as evidence in North Carolina, which is one reason certified “letters” matter when proving authority across state lines.
• N.C. Gen. Stat. § 130A-374 (Security of health data) – Reflects North Carolina’s general rule that individual medical records are confidential and not open public records, which is consistent with why hospitals require formal authority before releasing records.

Analysis

Apply the Rule to the Facts: Here, the hospital is asking for a court-issued letter/authority because the request involves a deceased patient’s confidential medical records. Since the decedent reportedly died without a will and little to no assets, there may not be an open estate file yet—meaning no one currently has Letters of Administration to prove authority. In practice, opening an intestate estate in North Carolina so the Clerk can appoint an administrator (and issue certified letters) is often the cleanest way to satisfy an out-of-state hospital’s documentation requirements for release.

Process & Timing

1. Who files: A person with priority to serve (often a spouse or heir) seeks appointment as administrator. Where: The Clerk of Superior Court (Estates) in the North Carolina county tied to the decedent’s domicile (or otherwise appropriate venue under NC probate practice). What: An application to qualify as administrator and supporting documents; the Clerk then issues Letters of Administration if approved. When: As soon as the records are needed; delays can occur if required heirs must sign renunciations/waivers or if the Clerk requires additional proof of death.
2. Request certified copies: After appointment, obtain certified Letters of Administration (not just photocopies). Many institutions will only accept certified letters, and some will require a recently dated certification.
3. Submit the hospital packet: Send the hospital its HIPAA authorization/request form, a certified death certificate, certified letters, and any litigation-related documentation the hospital requires (for example, a subpoena or court order if the hospital insists on one under its state’s rules). The hospital then releases records to the authorized recipient or the law office designated in the request.

Exceptions & Pitfalls

• “Small or no assets” does not always mean “no probate needed”: Even when the decedent had little property, a hospital may still require letters showing who has authority to receive records.
• Wrong person signing: A family member may not have legal authority to obtain records without being appointed by the Clerk (or without another legally recognized authorization). Hospitals often reject requests that lack proof of authority.
• Out-of-state rules can add steps: Some hospitals will not accept letters alone and may require a subpoena, court order, or specific HIPAA language based on the hospital’s state law and internal compliance policies.
• Certification details: Institutions commonly require certified copies of letters and may reject scans that are not clearly certified or are missing the Clerk’s seal.

Conclusion

To obtain a decedent’s medical records from an out-of-state hospital for litigation, the request usually must come from a legally authorized representative of the estate. In North Carolina intestate cases, that typically means qualifying an administrator with the Clerk of Superior Court and using certified Letters of Administration (plus a certified death certificate and the hospital’s HIPAA form) to prove authority. The most important next step is to file for Letters of Administration with the Clerk promptly so the records request can be made before litigation deadlines.

Talk to a Probate Attorney

If you’re dealing with an out-of-state hospital that will not release records without court authority, our firm has experienced attorneys who can help explain the North Carolina probate steps and the timelines that often matter in active litigation. 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.