Short Answer

In North Carolina, medical providers can assert statutory liens against your personal injury settlement, and those liens must be handled before you receive any net funds. If the insurer won’t coordinate payments, your attorney should collect itemized bills, verify or challenge any liens, and direct the settlement to an attorney trust account for proper disbursement. Do not sign a broad release until you know how valid liens will be paid and what (if anything) you will receive.

Understanding the Problem

In North Carolina, how do I protect myself when the insurer says it will pay my medical providers up to a set amount, but wants me to sign a full release and I’m not clear how my hospital and EMS bills will actually be handled? One key fact here: the bodily injury adjuster proposed covering bills up to a limit while requiring a release that surrenders all past and future claims.

Apply the Law

North Carolina law gives hospitals, physicians, and EMS providers a lien on your personal injury recovery if they supply an itemized statement and records upon request. Attorney’s fees come off the top, and there is a statutory cap on the total that medical lienholders can take from the recovery. Disputes about liens or disbursement can be resolved by negotiation or, if needed, in the Superior Court. Deadlines to bring an injury claim still apply even while liens are being sorted out.

Key Requirements

• Provider lien basics: A provider’s lien attaches only if the provider furnishes itemized charges and records on request; unreasonable or unproven charges can be challenged.
• Attorney’s fee comes first: A reasonable attorney’s fee (not more than one‑third of the recovery) is deducted before medical liens are paid.
• Global lien cap: The combined amount paid to all medical lienholders cannot exceed a statutory percentage of the recovery after attorney’s fees.
• Trust‑account disbursement: Settlements are typically issued to your attorney’s trust account so valid liens can be verified, reduced, and paid before you receive your net.
• Forum and disputes: If a provider refuses a reasonable reduction or asserts an invalid lien, the dispute can be brought in Superior Court for resolution.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical charges; lien and records) – Providers must furnish itemized bills/records to support any lien on your recovery.
• North Carolina Gen. Stat. § 44-50 (Enforcement; caps; attorney’s fee) – Attorney’s fee has priority (capped at one‑third), and total medical liens are capped as a percentage of the recovery after fees.
• North Carolina Gen. Stat. § 1-52 (Three‑year limitation) – Most personal injury claims must be filed within three years if settlement is not reached.

Analysis

Apply the Rule to the Facts: Because the adjuster wants a full release while “covering bills up to a limit,” you should insist that valid medical liens be verified, reduced as allowed, and scheduled for payment through an attorney trust account before you sign. Your attorney can demand itemized statements; any provider that does not furnish them cannot enforce a lien. After deducting a reasonable fee, the total paid to all medical lienholders cannot exceed the statutory cap, which helps protect your net recovery.

Process & Timing

1. Who files: You (through your attorney). Where: Directly with providers and the insurer; court only if there’s a lien dispute. What: Written requests for itemized bills and records, HIPAA authorization, and a proposed settlement disbursement plan that pays perfected liens. When: Before signing any release and before the insurer issues final settlement funds.
2. Insist the insurer sends the bodily injury settlement to your attorney’s trust account. Your attorney verifies each lien, negotiates reductions, and prepares a settlement statement. This phase commonly takes a few weeks; complex liens (Medicare/Medicaid/ERISA) can take longer.
3. If a provider refuses to reduce or asserts an improper lien, your attorney can hold the disputed portion and file a motion or action in Superior Court to resolve it. Final outcome: a signed release tailored to the bodily injury claim, paid lienholders, and a net check to you.

Exceptions & Pitfalls

• Medicare/Medicaid and some health plans: Federal/state reimbursement rights may override state caps and require formal payoff verification before disbursement.
• Unperfected or excessive charges: If a provider won’t supply itemized bills and records or charges are unreasonable, challenge the lien before paying.
• Release traps: Keep property damage and bodily injury releases separate. Do not sign a global release that extinguishes future claims before lien resolution is documented in writing.
• Joint checks and misdirected payments: If the insurer tries to pay providers directly or issues joint checks without a plan, you can request payment to your attorney’s trust account so liens are handled correctly.
• Traffic citation risk: A pending speeding ticket can affect liability arguments. Address the citation strategy with counsel before finalizing your bodily injury settlement.
• “Global billing” confusion: Ask for clear, itemized hospital and EMS statements; confirm what was written off or adjusted and whether health insurance should be billed first.

Talk to a Personal Injury Attorney

If you’re dealing with an insurer that won’t coordinate medical payments and you need a plan to resolve liens, 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.