Short Answer

Yes. In North Carolina, a personal injury settlement can include money for future medical care if the future treatment is reasonably expected and tied to the injury from the incident. The practical issue is proof: insurers typically want medical records and a doctor’s opinion showing what care you will likely need and why. A change in health insurance may affect what you pay out of pocket, but it does not automatically change what the other side must pay without supporting documentation.

Understanding the Problem

If you have an ongoing North Carolina personal injury claim and your back condition is getting worse while settlement talks are underway, you may be asking whether you can include the cost of future doctor visits and medications in the settlement even though your insurance coverage changed and those items are no longer covered.

Apply the Law

North Carolina personal injury damages are meant to compensate an injured person for losses caused by the incident. That can include medical expenses you have already incurred and medical expenses you are reasonably likely to incur in the future because of the injury. In settlement negotiations, the “rule” matters less than the evidence: future medical expenses usually need to be supported by medical documentation showing (1) the need for future care and (2) that the need is connected to the injury at issue.

Even when future care is appropriate to include, the defense and insurer commonly scrutinize whether the treatment is medically necessary, whether it relates to the incident (rather than a preexisting condition or a new event), and whether the projected costs are grounded in real-world billing and frequency of care.

Key Requirements

• Reasonably expected future treatment: You generally need a medically supported basis to say you will likely need ongoing care (not just a possibility).
• Causation: The future care must be tied to the injury from the incident, not a separate condition or a later aggravation unrelated to the claim.
• Reasonable value of the care: The projected costs should be based on actual charges/fee schedules and typical frequency, not guesswork.
• Medical support in the record: Treatment notes, imaging, referrals, and a provider’s opinion often carry more weight than a self-reported estimate.
• Clear time horizon: A settlement demand is stronger when it explains how long the future care is expected to last and what triggers changes (improvement, surgery, discharge from care).
• Consistency: Gaps in treatment, missed follow-ups, or inconsistent complaints can make future-care claims harder to negotiate.

What the Statutes Say

• N.C. Gen. Stat. § 8-58.1 (Proof of medical charges) - Allows an injured person to testify about amounts paid or required to be paid for medical charges (with records) and creates rebuttable presumptions about reasonableness in certain situations.
• N.C. Gen. Stat. § 44-49 (Medical provider liens) - Creates a lien on personal injury recoveries for certain medical-related debts connected to the injury, which can affect how settlement funds are distributed.
• N.C. Gen. Stat. § 130A-13 (State medical payment program reimbursement) - Addresses reimbursement/assignment issues when certain state-administered medical payment programs paid for care, which can impact net settlement.

Analysis

Apply the Rule to the Facts: Because your back condition is worsening during settlement discussions, future care may be a legitimate part of the settlement value if your medical records support that you will likely need continued visits and medications and that those needs are related to the injury being claimed. Your insurance change and increased out-of-pocket costs can help explain why future expenses matter to you, but the key negotiation point is still medical support for the need, duration, and cost of the future treatment. Your attorney can use updated treatment records and provider opinions to connect the worsening symptoms to the original injury and to justify a future-care component in the demand.

Process & Timing

1. Who gathers and submits: Your attorney (with your help). Where: Typically exchanged directly with the insurance adjuster/defense counsel (not filed with a court unless the case is in litigation). What: Updated medical records, itemized billing/ledger, pharmacy records, and a provider narrative or treatment plan addressing future care. When: As soon as there is a medically supported future-care plan and before you sign any release.
2. Valuation step: The parties usually negotiate based on documented past medical expenses plus a supported estimate of future care (frequency, duration, and expected services/medications). If the condition is still changing, it may be premature to “lock in” a number without updated medical guidance.
3. Resolution step: If a settlement is reached, you will be asked to sign a release. In most cases, that release ends the claim permanently, meaning you generally cannot come back later for more money if your condition worsens.

Exceptions & Pitfalls

• “Worsening” must still be connected to the incident: If the defense argues your decline is from degeneration, a prior condition, or a new injury, future medical expenses become harder to recover without strong medical support.
• Insurance changes do not automatically set damages: A switch in coverage may increase your out-of-pocket costs, but you still need evidence that the treatment is necessary and related, and you should be careful about assuming the other side must pay whatever your new plan does not cover.
• Incomplete documentation: Future-care claims often fail in negotiation when there is no clear treatment plan, no provider opinion about future needs, or no realistic cost basis.
• Liens and reimbursement: Medical provider liens and certain reimbursement rights can reduce what you take home from a settlement, so future-care planning should be coordinated with lien resolution. See, for example, N.C. Gen. Stat. § 44-49.
• Settling too early: If your condition is actively changing, settling before your doctors can reasonably project future needs can leave you undercompensated for care you later require.

Conclusion

Yes—future medical expenses can be included in a North Carolina personal injury settlement when the future care is reasonably expected and medically supported as related to the injury. The key is documentation: your settlement demand should be backed by updated records and a provider-supported plan that explains the likely future treatment and its reasonable cost. Next step: work with your attorney to obtain updated medical records and a written treatment plan before you sign any settlement release.

Talk to a Personal Injury Attorney

If you're dealing with a worsening condition during settlement talks and you’re worried about paying for future care, our firm has experienced attorneys who can help you understand your options and timelines. Reach out today by calling (800) 000-0000.

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.