Short Answer

Yes—an insurance company can try to deny or reduce a North Carolina car-accident claim if there is no medical treatment yet, because it gives them an argument that your injuries are not serious or not related to the crash. That said, a delay caused by real access problems (like needing a referral or records transfer) is different from simply choosing not to treat, and it can often be explained and documented. The key is to create a clear paper trail showing you reported symptoms promptly and made reasonable efforts to get care.

Understanding the Problem

In North Carolina, can the at-fault driver’s insurer use the fact that you have not started medical treatment yet—because providers require a hospital referral and imaging/records transfer—to argue that your car-accident back and hip pain is not connected to the crash or is not severe enough to pay?

Apply the Law

Under North Carolina personal injury law, you generally must prove (1) the other driver was legally at fault, (2) the crash caused your injuries, and (3) the amount of your damages. A treatment gap does not automatically erase a valid claim, but it can make causation and damages harder to prove and gives the insurer room to argue that something else caused your symptoms or that you failed to act reasonably to limit your losses (often called “mitigation”).

Separately, you must still file any lawsuit on time. For most negligence-based injury claims from a car wreck, North Carolina’s general three-year limitations period is the main deadline to keep in mind.

Key Requirements

• Proof the crash caused the injury: Medical records are one of the main ways insurers and juries connect back/hip complaints to the collision. No treatment yet means less documentation.
• Reasonable efforts to get care (mitigation concept): If you are trying to get an appointment but are blocked by referral/records requirements, that can help show you acted reasonably.
• Consistent symptom reporting: Early, consistent reports of pain (to EMS, the ER, urgent care, primary care, or even through written messages to providers) reduce the “you weren’t really hurt” argument.
• Clear timeline: Dates matter—when symptoms began, when you first sought care, and what barriers delayed treatment.
• Preserving the right to sue: Even if treatment is delayed, you cannot miss the filing deadline and expect the claim to survive.

What the Statutes Say

• N.C. Gen. Stat. § 1-52 (Three years) - Sets a three-year limitations period for many negligence-based personal injury claims.
• N.C. Gen. Stat. § 1-139 (Burden of proof of contributory negligence) - Places the burden on the party asserting contributory negligence as a defense.

Analysis

Apply the Rule to the Facts: Because you have significant back and hip pain but no treatment records yet, the insurer’s letter is a predictable move: they are signaling they currently see little documentation tying your symptoms to the crash or showing the extent of your injuries. Your stated reason for the delay (providers requiring a hospital referral and imaging/records transfer) is the kind of real-world barrier that can be documented and used to explain the gap. The goal is to reduce the insurer’s ability to argue “no treatment = no injury” or “delay = unrelated condition.”

Process & Timing

1. Who acts: You (and your attorney, if you hire one). Where: With medical providers and the insurance adjuster handling the claim in North Carolina. What: Start a documented care pathway (for example, ER/urgent care/primary care visit if appropriate, then referral-based follow-up) and gather proof of your attempts to schedule. When: As soon as reasonably possible, and do not wait until the claim “heats up” to start building the record.
2. Document the access problem: Keep screenshots, portal messages, call logs, and written notes showing you requested appointments, were told you need a referral, and are waiting on imaging/records transfer. Ask each office for the earliest available appointment date in writing if possible.
3. Respond strategically to the insurer letter: If you are represented, provide the letter to your attorney as it instructs. If you are not represented, you can respond with a short, factual update that you are actively seeking care and explain the referral/records barrier—without guessing diagnoses or overstating anything.

Exceptions & Pitfalls

• “Gap in treatment” arguments: Insurers often argue that a delay means the injury was minor, healed quickly, or came from something else. A well-documented explanation (referral requirement, records transfer, scheduling backlog) helps blunt that argument.
• Waiting too long to create any medical record: If you never get evaluated, it becomes much harder to prove causation and damages. Even a basic evaluation that documents your complaints can matter.
• Inconsistent histories: Be consistent about what hurts, when it started, and how it affects you. Inconsistent statements across providers can be used to reduce credibility.
• Over-sharing with the adjuster: Giving recorded statements or speculating about diagnoses before you have records can create problems. Keep communications factual and limited.
• Missing the lawsuit deadline: Negotiations with an insurer do not stop the statute of limitations from running in most situations.

Conclusion

In North Carolina, not starting treatment right away can give the insurer an opening to deny or reduce your claim because it weakens proof of causation and the extent of your injuries. A delay caused by referral and records-transfer requirements can often be explained if you document your efforts and get evaluated as soon as you reasonably can. Next step: provide the insurer’s letter to your attorney (or, if unrepresented, start building a written timeline and seek an initial medical evaluation promptly), while keeping the three-year filing deadline in mind.

Talk to a Personal Injury Attorney

If you’re dealing with an accident claim where treatment has been delayed by referral requirements or appointment backlogs, our firm has experienced attorneys who can help you understand your options and timelines. Reach out today. Call [CONTACT NUMBER].

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.