Why These Records Matter
When an auto insurer evaluates a settlement offer, it often focuses on what medical charges were actually paid or still need to be paid. In North Carolina, proof of medical expenses commonly centers on the amounts paid to satisfy bills that were paid and the amounts necessary to satisfy bills that are still owed. That is why an adjuster may ask for confirmation that you did not have health insurance and that the bills remain outstanding.
What to Request
- A signed affidavit from you: A short sworn statement saying you did not have health insurance coverage on the dates of treatment and identifying what bills remain unpaid (in general terms). The insurer may provide a template.
- Itemized bills for accident-related care: Bills that show dates of service and charges.
- Account statements/ledgers showing the current balance: A “patient balance due” statement or billing ledger is often more helpful than a bill that only shows the original charge.
- Proof of payment status (if any payments were made): Receipts, “payment history,” or a ledger showing partial payments and the remaining balance.
- Written confirmation of no coverage (if available): For example, an eligibility/coverage denial letter, a termination letter, or a letter/email stating you were not enrolled on the relevant dates.
- Health plan/benefits verification (if you had a job): A benefits summary showing you were not enrolled, or that coverage started after the treatment dates (if that’s true).
How to Request Them (General Steps)
- Identify the holder: Billing records may come from a hospital billing department, a separate physician group, imaging services, EMS billing, or a third-party billing vendor. Each may have its own statement and balance.
- Ask for the right format: Request (a) an itemized statement and (b) a current balance statement or billing ledger showing what is still owed as of today.
- Use the insurer’s affidavit language carefully: Make sure the affidavit matches reality. If you had coverage for part of the time, or only certain services, the affidavit should say that plainly rather than using an absolute statement.
- Keep a paper trail: Save copies of what you send and note the date you sent it. If you email or upload documents, keep the confirmation page or sent email.
What to Do If Records Are Delayed, Missing, or Incorrect
- If a bill doesn’t show a balance: Ask for a “patient account ledger” or “balance verification” showing the amount currently owed.
- If a provider says insurance was billed by mistake: Ask the provider to confirm in writing whether any health insurer paid anything and what the remaining patient responsibility is.
- If you can’t get a “no insurance” letter: Use what you can get (affidavit + billing ledgers). Many people simply do not have a formal “proof of no insurance” document unless they applied and were denied or coverage was terminated.
- If you had any coverage at all: Be precise. Overbroad statements can create credibility problems and slow negotiations.
How This Applies
Apply to these facts: Here, the insurer says it may increase the offer if you provide an affidavit confirming no health insurance and that bills remain owed. A practical response is to provide (1) the affidavit the insurer requested and (2) billing ledgers or current statements for each accident-related provider showing the unpaid balances. If you have any written proof you were not covered on the dates of service (such as a coverage termination or denial notice), include that as supporting documentation.
What the Statutes Say (Optional)
- N.C. Gen. Stat. § 8-58.1 (medical charges evidence) – In civil cases, medical charges are commonly proven with records showing what was paid or required to be paid, and the injured person can testify to those amounts when supported by the records.
Conclusion
To support an insurer’s request in a Durham-area car accident claim, focus on two things: a clear affidavit that matches the truth, and billing documents that show what is still owed. If you can also provide written confirmation that you were not covered on the treatment dates, that can help, but it is not always available. A good next step is to gather current balance statements/ledgers from each provider before you sign and submit any affidavit.
