Short Answer

Notify your health plan’s subrogation or recovery unit in writing as soon as you open your injury claim. Provide basic accident details, the at-fault insurer’s information, and your treatment dates, and request a written lien or reimbursement statement. In North Carolina, you must also account for statutory medical liens and any public plan repayment (Medicaid, Medicare, or the State Health Plan) before disbursing settlement funds.

Understanding the Problem

In North Carolina personal injury cases, you (or your lawyer) can and should open a subrogation claim with your medical benefits administrator so your plan can track what it paid and tell you what it will seek to be repaid from any settlement. Here, treatment is complete, so you want the plan’s itemized paid-claims ledger and current lien amount before negotiating with insurers.

Apply the Law

Under North Carolina law, health plans and certain payors can assert reimbursement or lien rights against injury recoveries. Medical providers can perfect statutory liens; Medicaid and the North Carolina State Health Plan have statutory recovery rights; Medicare must be reimbursed under federal law. Before settlement funds are disbursed, resolve all perfected liens and valid reimbursement claims. Provider liens against settlements are capped by statute; public plan reimbursement follows separate rules that are not subject to the provider-lien cap.

Key Requirements

• Notice and file opening: Send written notice to your plan’s subrogation/recovery unit with accident and coverage details; ask for a lien/reimbursement statement and periodic updates.
• Identify all payors: Determine if any payments were made by private health insurance, Medicaid, Medicare, or the NC State Health Plan, and if any provider liens were perfected.
• Statutory lien cap for providers: Perfected medical provider liens attach to settlements but are limited to a portion of the recovery after attorney’s fees.
• Public plan repayment: Medicaid and the NC State Health Plan have statutory recovery rights; Medicare must be reimbursed under federal rules. These are separate from provider liens.
• Settlement disbursement: Do not disburse funds until you obtain final lien amounts in writing and resolve them; keep documentation of all reimbursements.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider liens) - Allows providers who give proper notice to assert liens on personal injury recoveries.
• North Carolina Gen. Stat. § 44-50 (Distribution; lien limits) - Caps total provider liens to a portion of the recovery after attorney’s fees.
• North Carolina Gen. Stat. § 108A-57 (Medicaid liens) - Gives the State a lien on third-party recoveries for Medicaid-paid care.
• North Carolina Gen. Stat. § 135-48.37 (NC State Health Plan reimbursement) - Authorizes the State Health Plan to recover medical payments from liable third-party recoveries.

Analysis

Apply the Rule to the Facts: Because treatment is complete, your lawyer should request the administrator’s itemized ledger of paid claims and a current lien figure now. With the at-fault driver’s policy limits not yet confirmed, opening the subrogation file early preserves the plan’s rights and prevents surprises at disbursement. Since you may have MedPay and possible UIM, the administrator should be told about all coverages so the final reimbursement accounts for any first-party payments and any statutory limits.

Process & Timing

1. Who files: You or your attorney. Where: Your health plan’s subrogation/recovery unit (for Medicaid, the NC Department of Health and Human Services; for Medicare, the recovery contractor; for the NC State Health Plan, its recovery contractor). What: A written notice of claim including accident date/location, involved insurers, claim numbers, treatment dates, and a request for a lien/reimbursement statement. When: Send immediately after opening your injury claim and before any settlement negotiations conclude.
2. Ask for an initial lien letter and itemized paid-claims list within 2–6 weeks; update the administrator if new bills post, MedPay pays, or liability limits are confirmed. Request a “final demand” before disbursement.
3. At settlement, allocate attorney’s fees and costs, apply the provider-lien cap, satisfy public plan reimbursement as required, obtain written releases/zero-balance confirmations, then disburse the client’s net.

Exceptions & Pitfalls

• Self-funded ERISA health plans may enforce contractual reimbursement rights not limited by state provider-lien caps; review plan documents.
• Provider liens must be properly perfected to attach; if notice is deficient, you can challenge the lien.
• Medicaid and Medicare follow statutory/federal repayment rules; do not assume they are capped like provider liens.
• Do not double-pay: coordinate MedPay, liability, and UIM benefits so reimbursements account for all payors.
• Keep a paper trail: save every lien letter, ledger, and release; mismatches between bills and paid amounts can be negotiated.

Talk to a Personal Injury Attorney

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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.