Can I recover my chiropractic and other medical bills if the insurer says I'm at fault?

Understanding the Problem

In North Carolina, can an injured person recover chiropractic and other medical bills from the at-fault driver’s insurer when the insurer denies the claim based on contributory negligence? Here, the insurer has denied the claim multiple times. The question is whether you can still get those treatment costs paid and what steps you can take to challenge the denial.

Apply the Law

North Carolina follows contributory negligence. If the other driver proves you were even 1% at fault, you cannot recover from that driver’s liability insurer unless a narrow exception applies. To recover medical and chiropractic bills, you must show the other driver’s negligence caused your injuries, and that your treatment was reasonable, necessary, and related to the crash. If the insurer denies, you may file a lawsuit in the General Court of Justice, and the court—not the insurer—decides fault. There is a general three-year deadline from the crash to file most personal injury claims.

Key Requirements

• Prove the other driver’s negligence: Show duty, breach, and that the breach caused the crash.
• Establish medical causation and necessity: Link your chiropractic and other care to the crash and show charges are reasonable and necessary.
• Defeat contributory negligence: Avoid any finding that your own negligence contributed to the crash, or fit a narrow exception (such as last clear chance or willful/wanton conduct by the defendant).
• Admit bills correctly: Use proper proof (records/affidavits) so medical charges can be considered.
• Meet the filing deadline: File your lawsuit within North Carolina’s general three-year limitation period for personal injury claims.

What the Statutes Say

• North Carolina Gen. Stat. § 1-52 (Three-year limitation) - General three-year deadline for personal injury claims.
• North Carolina Gen. Stat. § 8-58.1 (Medical records and bills; affidavits) - Allows medical records and itemized bills to be admitted with proper affidavits.
• North Carolina Rules of Evidence, Rule 414 (Amounts paid) - Limits evidence of medical expenses to amounts actually paid to satisfy the bills, not the full amounts billed.

Analysis

Apply the Rule to the Facts: The insurer’s denials based on contributory negligence do not end the matter; a court decides fault if you file suit. To recover your chiropractic and other medical bills, you’ll need evidence that the other driver was negligent and that your treatment was reasonable, necessary, and caused by the crash. If the defense raises contributory negligence, you must defeat it or fit a narrow exception. Meanwhile, consider MedPay under your policy and have health insurance process bills to avoid collections.

Process & Timing

1. Who files: The injured person (plaintiff). Where: File a Complaint and Civil Summons (AOC-CV-100) with the Clerk of Superior Court in the North Carolina county where the crash occurred or where the defendant lives. When: Generally within three years of the crash.
2. Serve the defendant (sheriff or certified mail), exchange evidence (medical records, bills, crash report, photos, witness statements), and attend a court-ordered mediated settlement conference. Timeframes vary by county and court calendars.
3. Resolve by settlement or trial. If you prevail, the judgment can include allowable medical expenses proven to be reasonable, necessary, and related, subject to evidentiary limits on amounts paid.

Exceptions & Pitfalls

• Narrow exceptions to contributory negligence: Last clear chance or willful/wanton conduct by the defendant can bypass the bar.
• MedPay and policy deadlines: MedPay under your policy can pay medical bills regardless of fault, but policy notice and proof requirements are strict.
• Proof gaps: Failing to link chiropractic care to the crash or to show necessity can sink recovery; obtain provider opinions and itemized records.
• Recorded statements/releases: Broad medical releases or statements to insurers can be used to argue fault; be cautious.
• Liens and subrogation: Health insurers and certain providers may assert reimbursement claims against your recovery; address them early.

Conclusion

In North Carolina, you can recover chiropractic and other medical bills only if you prove the other driver’s negligence caused your injuries and you avoid a contributory negligence finding, or a narrow exception applies. The insurer’s denial is not final; a court decides. To protect your claim, gather evidence, properly prove medical charges, and file your Complaint with the Clerk of Superior Court within three years of the crash.