Short Answer

Yes. In North Carolina, valid medical provider liens attach to your personal injury recovery and must be paid from the settlement before you receive your share. Your attorney’s fee (up to one-third) is paid first, then valid medical liens are paid—often on a pro rata basis—and provider recoveries are capped by statute. Government program liens (like Medicaid, Medicare, or the State Health Plan) follow separate rules and must also be resolved.

Understanding the Problem

If you settled a North Carolina personal injury case, can medical liens take part of your settlement before you get your check? Here, your case has recently settled and your attorney is requesting final medical lien amounts. This is the right time to understand how liens work, what must be paid, and how those payments affect what you take home.

Apply the Law

North Carolina law gives healthcare providers a statutory lien on personal injury recoveries for reasonable charges related to the injury. To enforce that lien, providers must follow specific steps, and your lawyer must distribute settlement funds in a particular order from the law firm trust account. If the liens are larger than the amount subject to liens, providers are paid proportionally, and statutory caps limit how much of your settlement can go to medical providers.

Key Requirements

• Valid medical lien: The charges must be for treatment of the injury at issue and asserted under North Carolina’s medical lien statutes.
• Perfection/notice: On request, providers must promptly give your lawyer an itemized bill and related records at no charge and provide notice of their lien; failure can defeat the lien.
• Attorney’s fee priority: Your lawyer’s reasonable fee (capped at one‑third of the settlement) is paid before medical provider liens.
• Caps and prorating: Provider liens are limited by statute and, if funds are insufficient, are paid pro rata from the amount available for liens.
• Government program liens: Medicaid, Medicare, TRICARE, and the State Health Plan have separate statutory/federal reimbursement rights and timelines that must be honored.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider liens) - Creates provider liens and requires free itemized bills/records on request.
• North Carolina Gen. Stat. § 44-50 (Priority and limits) - Gives attorney’s fee priority (up to one‑third) and limits/prorates provider liens.
• North Carolina Gen. Stat. § 108A-57 (Medicaid lien) - Authorizes the State’s Medicaid lien and allocation process on third‑party recoveries.
• North Carolina Gen. Stat. § 135-48.37 (State Health Plan reimbursement) - Establishes the State Health Plan’s reimbursement/subrogation rights.

Analysis

Apply the Rule to the Facts: Because your case has settled and your lawyer is gathering final lien amounts, North Carolina law requires payment of the attorney’s fee first (up to one‑third), then payment of valid medical provider liens from the amount available for liens. If the total of valid provider liens is higher than the available amount, they are reduced and paid pro rata under the statutory cap. After those payments, your lawyer disburses the remaining balance to you.

Process & Timing

1. Who files: No court filing is required. Where: Your attorney resolves liens and disburses from the law firm trust account in North Carolina. What: The attorney requests itemized statements/records and written lien notices; then calculates distributions per statute. When: After settlement, before any client disbursement.
2. Your attorney negotiates reductions where appropriate (especially with large balances or overlapping coverage) and confirms Medicaid/Medicare/State Health Plan amounts. Response times vary by provider/agency.
3. Final disbursement: costs and court charges (if any), attorney’s fee (≤ one‑third), valid liens (pro rata if needed), then the client’s check with a written closing statement.

Exceptions & Pitfalls

• Wrongful death is different: If the recovery is for wrongful death (not a personal injury claim), separate caps and allocation rules apply. See G.S. § 28A-18-2.
• Unperfected liens: If a provider does not supply itemized bills/records when requested or fails to give lien notice, its lien may be unenforceable.
• Government program liens: Medicaid, Medicare, TRICARE, and the State Health Plan have separate statutory/federal rules; ignoring them can delay payment and risk penalties.
• Health plan reimbursement: Private/ERISA plans are not medical provider liens; enforceability depends on plan language and law separate from §§ 44‑49/50.
• Disbursement order: Releasing funds to the client before resolving liens can jeopardize your recovery and your lawyer’s obligations under the lien statutes.

Talk to a Personal Injury Attorney

If you’re dealing with medical liens on a North Carolina personal injury settlement, our firm can help you understand what must be paid, what can be reduced, and how fast you can be paid. Call us today to discuss your options and timelines.

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.