Short Answer

In North Carolina, medical malpractice cases often require significant out-of-pocket case expenses (especially for medical record collection, expert review, and expert testimony), even when attorney fees are handled through a contingency fee agreement. Most clients do not pay hourly attorney fees up front in a contingency arrangement, but they may still be responsible for litigation costs depending on the contract. The exact cost and fee structure depends on what experts are needed, whether a lawsuit is filed, and how far the case has to be litigated.

Understanding the Problem

If you are pursuing a North Carolina medical malpractice claim and you have already sent a case summary to a lawyer for review, a key question is whether you must pay money up front for the investigation and whether the lawyer’s fee comes out of any settlement or verdict.

Apply the Law

In North Carolina, attorney fees in injury cases are usually set by a written fee agreement between the client and the lawyer. In medical malpractice matters, the biggest practical driver of “what it costs to pursue the case” is often not the lawyer’s time, but the case expenses required to properly investigate, file, and prove the claim—especially the need for qualified medical review and testimony. Many firms handle malpractice cases on a contingency fee, meaning the attorney fee is a percentage of the recovery, but the client and lawyer still need to decide (in writing) how case costs are paid and reimbursed.

Key Requirements

• Written fee agreement: The attorney fee arrangement (contingency or hourly) should be in writing and should clearly explain the percentage (if contingency), when it applies, and how costs are handled.
• Case expenses are separate from attorney fees: Costs like records, filing fees, depositions, and expert work are typically not the “fee” and are usually tracked separately.
• Medical review and expert work are often necessary: Malpractice cases commonly require early medical review and later expert testimony to prove the standard of care, breach, and causation.
• Costs usually increase after a lawsuit is filed: Once a case enters litigation, expenses often rise because of formal discovery, depositions, and motion practice.
• Reimbursement usually comes from the recovery: In many contingency arrangements, costs are advanced by the law firm and reimbursed from any settlement or verdict, but the contract controls.
• Fee-shifting is limited: North Carolina generally follows the rule that each side pays its own attorney fees unless a statute allows a fee award in a specific situation.

What the Statutes Say

• N.C. Gen. Stat. § 6-21.1 (Attorneys’ fees in certain personal injury/property damage cases) - Allows a judge, in limited situations and with specific findings, to award a capped attorneys’ fee as part of costs in certain smaller-damages cases.
• N.C. Gen. Stat. § 7A-314 (Witness and expert witness compensation) - Addresses witness fees and allows court-authorized compensation for expert witnesses in appropriate situations.

Analysis

Apply the Rule to the Facts: Because you are at the consultation stage (you sent a case summary and are confirming the lawyer received it), the immediate “cost” question usually turns on (1) whether the lawyer will do an initial screening without charge, (2) whether the case needs paid medical record collection and an early medical review, and (3) whether the lawyer proposes a contingency fee agreement that explains how expenses are handled. In a medical malpractice claim, the need for qualified medical review and later testimony is often the main reason these cases can be expensive to pursue even when attorney fees are contingent.

Process & Timing

1. Who files: The injured patient (plaintiff), through counsel if represented. Where: North Carolina Superior Court in the county with proper venue (often where the care occurred or where a defendant resides). What: A civil complaint and related filings; the fee agreement is signed with the law firm (not filed with the court). When: Before filing, most malpractice cases require meaningful pre-suit investigation; timing depends on medical record availability and the need for medical review.
2. Investigation stage: The lawyer typically gathers medical records, consults appropriate medical professionals for review, and evaluates whether the claim can be supported. This stage can take weeks to months depending on record volume and provider response times.
3. Litigation stage (if filed): After filing and service, the case moves into discovery (written discovery, depositions, expert disclosures). Costs often increase here because depositions, transcripts, and expert work become more intensive.

Exceptions & Pitfalls

• Not all “contingency” agreements treat costs the same way: Some agreements make the client ultimately responsible for costs even if there is no recovery; others may limit or waive certain costs. You should ask for a plain-English explanation of what happens if the case does not settle or does not win.
• Medical malpractice often requires expensive expert involvement: If the case needs multiple specialists (for example, one to address the standard of care and another to address causation), expenses can rise quickly.
• Confusing “fees” with “costs”: Attorney fees pay for legal work; costs pay for building and proving the case (records, filing fees, depositions, experts). Ask for both in writing.
• Waiting too long to consult counsel: Even if you are unsure you want to file suit, delays can make it harder to obtain records, locate witnesses, and complete the pre-suit review needed to responsibly file a malpractice case.

Conclusion

In North Carolina, pursuing a medical malpractice case can involve substantial case expenses—especially for medical records, medical review, and expert testimony—even when attorney fees are handled through a contingency fee agreement. The key is to separate (1) the attorney’s percentage fee from (2) the litigation costs, and to confirm in writing how both are paid and reimbursed. Next step: ask for a written contingency fee agreement that clearly explains who pays costs and when.

Talk to a Personal Injury Attorney

If you’re dealing with a potential North Carolina medical malpractice claim and you’re trying to understand the real-world costs, the role of medical experts, and how contingency fees and expenses are handled, our firm has experienced attorneys who can help you understand your options and timelines. Reach out today by calling (704) 343-4713.

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.