Short Answer

In North Carolina, you prove past medical expenses with what was actually paid or what you still legally owe, not the full sticker price on bills. To strengthen your claim, gather itemized bills, explanation-of-benefits (EOBs), receipts, and provider balance statements, plus medical records tying each charge to your injury. Track and resolve any healthcare liens before settlement. Keep copies organized and consistent across all providers and dates of service.

Understanding the Problem

You’re negotiating with an insurance adjuster in North Carolina and want to show solid proof of your medical and diagnostic costs so your injury claim (including pain and suffering) is taken seriously. What, exactly, should you collect and present to document those costs now?

Apply the Law

North Carolina allows recovery of the reasonable value of necessary medical care caused by the injury, but the evidence you can present focuses on amounts actually paid or still owed, not undiscounted list prices. The main forum at this stage is your pre-suit negotiation with the insurer, but the same evidentiary rules matter if you end up in District or Superior Court. A key timing rule is the three-year statute of limitations for most negligence-based injury suits, which runs from the date of injury; procedures and deadlines can change, so confirm specifics for your situation.

Key Requirements

• Itemized bills: Obtain detailed statements for each provider and date of service that show CPT/HCPCS codes, charges, and adjustments.
• Proof of payment and balances: Collect EOBs, receipts, and current balance statements to show what was paid (by you or insurance) and what remains owed.
• Link to the injury: Include medical records (e.g., visit notes, radiology reports) that tie each billed charge to the accident-related diagnosis and treatment plan.
• Lien documentation: Identify and track healthcare liens (e.g., hospitals, physicians, Medicaid/Medicare/ERISA plans) and keep correspondence about claimed amounts and any reductions.
• Affidavits/records readiness: Where helpful, secure custodian affidavits or certifications that will let you authenticate bills and records efficiently if litigation becomes necessary.

What the Statutes Say

• N.C. R. Evid. 414 (Amounts paid or owed) - Limits evidence of past medical expenses to sums actually paid or necessary to satisfy outstanding charges.
• N.C. Gen. Stat. § 8-58.1 (Medical bills evidence) - Allows itemized medical bills to serve as prima facie evidence of reasonableness and necessity, subject to other evidence rules.
• N.C. Gen. Stat. § 44-49 (Healthcare provider lien) - Creates liens for medical providers on personal injury recoveries for services related to the injury.
• N.C. Gen. Stat. § 44-50 (Lien enforcement/limits) - Addresses enforcement and limits for healthcare liens against injury recoveries.

Analysis

Apply the Rule to the Facts: Because you’re negotiating a settlement, present a package that proves what was actually paid and what is still owed, not just billed totals. Match each itemized charge to records that show it treats your accident-related injuries. Include EOBs and receipts to document payments and write-offs, plus current balances to show what remains due. Identify any provider liens early and show the adjuster you are addressing them.

Process & Timing

1. Who files: Your attorney on your behalf. Where: Liability insurer’s claims department handling your North Carolina claim. What: A demand package with itemized bills, EOBs, receipts, current balance statements, key medical records, lien notices, and a HIPAA authorization; affidavits may be collected for later use if suit is filed. When: After treatment stabilizes or you reach maximum medical improvement, while monitoring the three-year filing deadline.
2. The insurer reviews your documentation, may request clarifications or additional records, and may evaluate liens; allow several weeks for provider records and updated balances, as response times vary by provider.
3. If the case settles, you’ll sign a release and resolve liens before disbursement; if not, your attorney files suit in the proper North Carolina court based on the amount in controversy.

Exceptions & Pitfalls

• Submitting billed totals without EOBs/receipts can backfire because evidence focuses on amounts paid or still owed.
• Gaps in treatment or missing records weaken causation; keep care and documentation consistent.
• Unresolved liens can delay or reduce your net recovery; address reductions and obtain lien releases before disbursement.
• Contributory negligence remains a complete defense in North Carolina; accurate, consistent medical proof helps counter causation disputes.

Talk to a Personal Injury Attorney

If you’re negotiating an injury claim and need to document medical and diagnostic costs the right way, 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.