Dec212025
Probate Q&A Series

Can I request a hospital to update or settle outstanding medical bills in an estate administration? – North Carolina

Short Answer

Yes. In North Carolina estate administration, the personal representative (executor or administrator) can contact a hospital or other healthcare provider to verify, dispute, and arrange payment of a deceased person’s outstanding medical bills, as part of collecting debts and paying valid claims. The provider will usually require proof of death and proof of authority, such as certified Letters Testamentary or Letters of Administration (or another court-recognized document), before discussing account details or accepting instructions. Payment or settlement still must follow North Carolina’s estate-claim rules and the required order of payment of debts.

Understanding the Problem

In North Carolina probate, a common question is whether the estate’s decision-maker can ask a hospital to correct a final balance, apply insurance or adjustments, and then accept payment or a settlement on a deceased patient’s account. The issue usually turns on whether the caller has authority to act for the estate and whether the request involves account information that the provider will only release to an authorized person. Timing can matter because creditors must present claims within the estate’s creditor-claims window, and the estate typically tries to confirm balances before paying.

Apply the Law

Under North Carolina law, the personal representative (PR) manages estate administration through the Clerk of Superior Court in the county where the estate is opened. Part of that job is identifying debts, giving legally required notice to creditors, reviewing claims, and paying valid claims in the statutory priority order. A hospital bill is typically a general unsecured claim unless it is tied to a specific lien or another higher priority by statute. Even when a hospital agrees to adjust or settle a bill, the PR should document the agreement and ensure the payment fits within the estate’s claim process and payment priorities.

Key Requirements

  • Proof of authority: The hospital usually requires documentation showing the caller can act for the estate (commonly certified Letters Testamentary or Letters of Administration, and often a death certificate). Some providers may accept a sworn statement for limited purposes, but many insist on the court-issued letters.
  • Proper claim handling: Medical bills are handled as creditor claims. The PR should determine whether the bill is valid, whether adjustments apply, and whether the claim was timely presented in the estate process.
  • Pay in the required order: The PR must pay allowed claims using North Carolina’s statutory order of priority, and must avoid paying lower-priority claims ahead of higher-priority claims when estate funds are limited.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Here, a firm representative acting for the executor contacted a healthcare provider’s billing department to address a deceased patient’s account and asked what documentation was needed. That fits the PR’s role of identifying and resolving creditor claims before paying them. Because the provider requested verification of the decedent’s identity and confirmation of the executor’s authority, the next step is to provide acceptable proof of authority (often certified letters) and any supporting documents the provider reasonably needs to locate and discuss the account. If the provider agrees that a sworn letter from the executor is sufficient, the PR should still keep that written confirmation and ensure any adjustment or settlement is documented for the estate accounting.

Process & Timing

  1. Who files: The personal representative (executor/administrator). Where: The estate is administered through the Clerk of Superior Court in the county where the estate is opened in North Carolina. What: After qualification, the PR typically publishes a Notice to Creditors and sends notice to known creditors; an affidavit of mailed notice is filed with the Clerk. When: Notice to certain known creditors is commonly handled early in the administration; practice often tracks a 75-day mailing window for some notices, and the published notice gives creditors at least three months from first publication to present claims.
  2. Provider contact and documentation: The PR (or the PR’s attorney) contacts the hospital billing office, requests an itemized statement and a final balance, and submits the provider’s required proof (commonly a certified death certificate and certified letters). If the provider will accept a letter of testimony or other sworn statement, confirm the provider’s requirements in writing and keep a copy for the estate file.
  3. Review, resolve, and pay properly: The PR reviews whether the bill is correct, whether insurance, charity-care review, or contractual adjustments apply, and whether the claim is properly presented. If the hospital agrees to reduce or settle, the PR documents the agreement and pays the allowed amount in the proper priority order, recording the payment for the final account.

Exceptions & Pitfalls

  • Authority mismatch: A power of attorney usually ends at death, and many providers will not discuss details with anyone other than the court-appointed PR (or the PR’s attorney) without certified proof of appointment.
  • Paying out of order: If the estate is short on funds, paying a hospital bill before higher-priority items (like administration expenses or certain taxes) can create personal risk for the PR. North Carolina uses a statutory priority system for payment.
  • Medicaid recovery issues: If the decedent received certain Medicaid benefits, a state agency claim may be involved and should be handled carefully within the creditor-notice and claims rules.
  • Weak documentation for “settlements”: A phone-only agreement can cause problems at accounting time. A written confirmation of any adjustment, write-off, or settlement helps support the PR’s final accounting.
  • Late or incomplete creditor notice: Errors in creditor notices or missing affidavits can extend exposure to claims and delay closing the estate.

Conclusion

In North Carolina, a personal representative can ask a hospital to update, correct, and resolve outstanding medical bills during estate administration, but the provider typically requires proof of authority (most often certified letters) before releasing account details or accepting instructions. Any settlement or payment should be documented and handled as a creditor claim, then paid in the statutory priority order. The next step is to provide the hospital the requested proof of appointment and death, then confirm the final balance in writing before paying within the claims period stated in the estate’s creditor notice.

Talk to a Probate Attorney

If a deceased person’s medical bills need to be confirmed, corrected, or resolved as part of a North Carolina estate administration, an attorney can help document authority, manage creditor claims, and avoid payment-order mistakes that delay closing the estate. 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.

Category: Probate Q&A Series

Author: jpierce

Attorney Jared Pierce is the founder of Pierce Law Group in Raleigh, North Carolina, a firm he established with a dedicated focus on probate administration and estate planning across North Carolina. Born and raised in the Republic of South Africa, Jared moved to Durham with his family in 2001, bringing with him a rich cultural background and a distinctive accent that often serves as a conversation starter.