Short Answer

In North Carolina, any provider or payer asserting a medical lien must give you an itemized statement of its claim when you ask in writing. Send a HIPAA-compliant authorization and a clear, dated request to the insurance administrator. If they do not respond, follow up in writing, escalate to certified mail, and—if litigation is pending—use a subpoena to obtain the lien statement before distributing settlement funds.

Understanding the Problem

You’re handling a North Carolina personal injury case and need lien statements so you can resolve and pay valid medical liens from settlement funds. The insurance administrator has not responded to your voicemail, and you want to avoid delaying the case. The core question is: how do you compel the administrator to provide the itemized lien statement your file needs?

Apply the Law

North Carolina law gives medical providers and some benefit programs lien rights against personal injury recoveries. A provider’s lien is enforceable only if the provider furnishes, upon request, an itemized statement of charges. Attorneys must identify, verify, and address valid liens before disbursing settlement funds. Most lien issues are handled out of court, but if a lawsuit is pending, you can use a subpoena to obtain documents. While the statutes do not set a fixed response time, you should secure lien statements before settlement distribution.

Key Requirements

• Written request and authorization: Send a dated, written request to the administrator with a HIPAA-compliant authorization and proof of representation.
• Itemized statement duty: A provider claiming a lien must furnish, upon request, an itemized statement; failure to do so can affect enforceability.
• Attorney’s distribution duty: Identify and resolve statutory liens before releasing settlement funds; hold disputed funds in trust until resolved.
• Allocation limits: North Carolina caps the total payable to medical lienholders from the recovery after attorney’s fees; public program liens (Medicaid, State Health Plan, Medicare) have separate rules.
• Forum and tools: Out-of-court requests first; if a case is filed, use a subpoena duces tecum under the North Carolina Rules of Civil Procedure to compel production.

What the Statutes Say

• N.C. Gen. Stat. § 44-49 (Medical provider liens; itemized statement) - Creates provider liens and requires furnishing an itemized statement upon request.
• N.C. Gen. Stat. § 44-50 (Distribution and limits) - Sets priorities and limits on total medical lien payments from the recovery after attorney’s fees.
• N.C. Gen. Stat. § 108A-57 (Medicaid liens) - Governs Medicaid reimbursement from third-party liability recoveries.
• N.C. Gen. Stat. § 135-48.37 (State Health Plan recovery) - Authorizes the State Health Plan to assert and recover its paid benefits.

Analysis

Apply the Rule to the Facts: Because you already left a voicemail, send a written, HIPAA-compliant demand for the lien statement to the administrator, referencing North Carolina’s lien framework and your need for an itemized statement. Give a short response window and offer secure delivery options. If no response, send a certified follow-up and, if the case is in litigation, issue a subpoena to the administrator. Do not disburse settlement funds until you verify and account for all valid liens.

Process & Timing

1. Who files: Plaintiff’s counsel. Where: To the insurance administrator (and any known providers). What: Written request for an itemized lien statement with HIPAA authorization and proof of representation. When: Send immediately and request a response within 10–14 days.
2. If no response: Send a second written request by certified mail and email/fax to all available addresses; document delivery and set a shorter deadline (for example, 7 days). If a lawsuit is pending, prepare a subpoena duces tecum under Rule 45 using the North Carolina subpoena form available on nccourts.gov.
3. Final step: Upon receipt, reconcile charges, apply statutory limits and program-specific rules (e.g., Medicaid/State Health Plan/Medicare), negotiate if appropriate, and document the final payoff before issuing disbursements from the trust account.

Exceptions & Pitfalls

• Public program liens vary: Medicaid and the State Health Plan follow their own statutes; Medicare is governed by federal law. Confirm the program and follow its process.
• HIPAA issues: Without a valid authorization, administrators may refuse to release itemized information. Use a current, properly executed authorization.
• Enforceability: A provider’s failure to furnish an itemized statement upon request can undermine lien enforceability—keep written records of your requests.
• Trust accounting: Do not distribute client funds until liens are resolved; hold disputed sums in trust to avoid exposure.
• Wrong address or entity: Send requests to the correct plan administrator, TPA, or recovery vendor; verify claim and policy identifiers.

Talk to a Personal Injury Attorney

If you're dealing with unresponsive administrators and unresolved medical 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.