Short Answer

In North Carolina, a liability insurer does not have to pay medical bills as they come in. It pays damages at settlement or after a judgment for treatment that is reasonable, necessary, and caused by the crash. A “maximum medical improvement” note is not a legal cutoff. To get resumed care considered, submit updated medical records tying the new treatment to the original injury, explain any treatment gap, and preserve your right to sue within three years if the insurer refuses.

Understanding the Problem

You want to know if you can make the insurer pay for chiropractic treatment you restarted after being told you were at maximum medical improvement in North Carolina. You are the injured person seeking payment from an auto liability insurer that has already made an initial bodily injury offer, and the key issue is whether care after a break can still be covered as part of your claim.

Apply the Law

Under North Carolina personal injury law, you can recover the cost of medical care that is proximately caused by the at-fault party’s negligence, so long as the care is reasonable in charge and necessary in kind. “Maximum medical improvement” (MMI) is a clinical milestone, not a legal bar to damages. Insurers commonly question treatment after a break, so you need clear medical opinions connecting resumed care to the original injury and explaining why the additional treatment was needed. The claim is typically handled by the at-fault driver’s insurer pre-suit; if unresolved, you file in state court. The general deadline to file a personal injury lawsuit is three years from the crash.

Key Requirements

• Causation: A treating provider must link the resumed treatment to the original crash injury and rule out new, unrelated causes.
• Medical necessity: Records should explain why additional care was needed after MMI, including the reason for any treatment gap and clinical findings supporting more care.
• Reasonable charges: Provide itemized bills and proof of amounts actually paid or owed to show the charges are reasonable.
• Coverage source: Liability insurers reimburse in settlement or judgment; optional medical payments (med‑pay) under your own auto policy may pay ongoing bills per the policy.
• Timeliness: Preserve your claim by filing suit within the three‑year statute of limitations if negotiations fail.

What the Statutes Say

• N.C. Gen. Stat. § 1-52(16) (Three-year limit for personal injury) - sets the general deadline to file suit.
• N.C. Gen. Stat. § 8-58.1 (Proof of medical expenses) - allows medical bills and records to show reasonableness and necessity.
• N.C. R. Evid. 414 (Amounts actually paid) - limits evidence of medical expenses to amounts paid or necessary to satisfy charges.
• N.C. Gen. Stat. § 58-63-15(11) (Unfair claim settlement practices) - identifies prohibited insurer practices; you can complain to the Department of Insurance.

Analysis

Apply the Rule to the Facts: Because you resumed chiropractic care after a break, the insurer will focus on causation and necessity. Ask your provider to write an addendum tying the later treatment to the original injury, explaining the clinical change after MMI, and addressing why the gap occurred. Submit updated records and itemized bills to show necessity and reasonable charges. If you have med‑pay under your own auto policy, submit those bills there too; otherwise, preserve your right to sue within three years if the liability insurer will not include the resumed care.

Process & Timing

1. Who files: You (the injured person). Where: With the at‑fault insurer’s adjuster; med‑pay claims go to your own auto insurer. Court filings go with the Clerk of Superior Court in the proper North Carolina county. What: A written demand package with updated medical records, a provider letter of medical necessity, and itemized bills; if filing suit, a Complaint and Civil Summons (AOC‑CV‑100). When: Aim to send the supplemental demand promptly and file any lawsuit within three years of the crash.
2. After submission, expect the adjuster to review within a few weeks; response times vary by insurer and county practices. If denied or undervalued, consider a North Carolina Department of Insurance complaint and prepare for litigation.
3. For litigation, serve the defendant, engage in discovery, and seek a settlement or trial judgment. The final outcome is a settlement release or a court judgment addressing your medical damages, including post‑MMI care if proven.

Exceptions & Pitfalls

• Settlement release finality: Do not sign a release while you are still treating unless the settlement accounts for future care; releases are typically final.
• Contributory negligence: If the insurer reasonably claims you were also at fault, North Carolina’s contributory negligence rule can bar recovery.
• Treatment gaps/new events: Long gaps or a new incident can break causation unless your provider explains why the original injury still required more care.
• Proof of charges: Keep itemized bills and proof of amounts paid; under Rule 414, recoverable medical expenses focus on amounts actually paid or owed.
• Policy differences: Med‑pay is optional and contract‑specific; check your policy for notice and proof‑of‑loss requirements.

Talk to a Personal Injury Attorney

If you're dealing with an insurer refusing to cover care you resumed after MMI, our firm has experienced attorneys who can help you understand your options and timelines. Reach out today. Call (919) 341-7055 or email us to get started.

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.