How do I show the insurer that I need additional funds for future medical treatment?

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How do I show the insurer that I need additional funds for future medical treatment? - North Carolina

Short Answer

In North Carolina, you show the insurer you need more money for future medical care by providing clear medical proof that your crash injuries will likely require specific treatment and what it will cost. Ask your treating provider to put in writing the diagnosis, how the crash aggravated your condition, the recommended future care, frequency and duration, and itemized cost estimates. Package this with updated records, bills, and a concise supplemental demand before you sign any release.

Understanding the Problem

You want to convince a North Carolina auto insurer to increase a settlement because you will need treatment going forward. The core issue: can you show, through your medical providers, that the crash caused or aggravated your injuries and that future care is reasonably likely and reasonably priced? Here, one key fact is your prior neck surgery and chronic back pain, which the insurer may point to in lowering value unless you document aggravation.

Apply the Law

Under North Carolina law, an injured person may recover the reasonable value of necessary medical care caused by the crash, including future treatment, if it is more likely than not needed. Adjusters (and courts, if you sue) look for medical opinions that tie your need for future treatment to the collision, describe the recommended care, and give a reasonable cost estimate. Negotiations happen with the insurer, but if settlement fails, claims are filed in District Court (generally up to $25,000) or Superior Court (more than $25,000). A three-year statute of limitations usually applies to personal injury from a motor-vehicle crash.

Key Requirements

  • Causation and aggravation: A provider links your ongoing problems and future care to the crash (including aggravation of a preexisting condition).
  • Medical necessity: A provider states the specific treatments you will likely need, with expected frequency and duration.
  • Reasonable cost: Itemized estimates (e.g., CPT-coded quotes, fee schedules, pharmacy costs) that show reasonable pricing.
  • Documentation: Updated medical records, imaging, and a provider narrative summarizing diagnosis, prognosis, and future plan.
  • Timing and forum awareness: Negotiate before signing a release and keep the three-year filing deadline in mind; file in the proper trial division if negotiations fail.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Because you have prior neck surgery and chronic back pain, the insurer will likely argue your current needs are unrelated. Ask your treating physician to explain how the front-end collision aggravated your neck and back and why additional care is more likely than not. For strains to the neck, back, and hip, have the provider outline specific future therapy, medications, injections, or follow-ups and give itemized cost estimates. Submit a supplemental demand with these materials to justify additional funds.

Process & Timing

  1. Who files: You or your attorney. Where: To the liability adjuster (and to your UIM carrier if applicable). What: A supplemental demand letter with a provider narrative, updated records/bills, imaging, work restrictions, and itemized future care cost estimates. When: Before signing any release and before the three-year statute of limitations to file suit.
  2. Request a written narrative and future care estimate from your treating provider; allow 2–4 weeks (some offices take longer). Follow up to confirm the necessity, frequency, and cost of projected care.
  3. Negotiate with the adjuster using the new documentation. If the offer still does not reflect future care, consider filing suit in the appropriate North Carolina trial division and use your treating provider’s opinion as testimony.

Exceptions & Pitfalls

  • Signing a broad release too soon waives claims for future care; finalize documentation first.
  • Gaps or inconsistent treatment can undercut future-need opinions; keep follow-up appointments.
  • Provider statements that you “might” need care are often too speculative; ask for “more likely than not” language.
  • Preexisting conditions can reduce offers unless your provider explains aggravation versus baseline.
  • If UIM coverage may be needed, give your UIM carrier written notice and consent-to-settle opportunity before resolving with the liability insurer.

Conclusion

To obtain additional funds for future medical treatment in North Carolina, you need a treating provider’s written opinion that the crash caused or aggravated your injuries, the specific future care you will likely need, and reasonable cost estimates. Send a supplemental demand with these materials before signing any release. If negotiations stall, preserve your rights by filing in the correct court within three years of the crash. Next step: request a provider narrative and itemized future care estimate, then deliver your supplemental demand to the adjuster.

Talk to a Personal Injury Attorney

If you're dealing with an insurer that won’t account for future medical care, our firm has experienced attorneys who can help you understand your options and timelines. Call us today to discuss your case.

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.

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