Short Answer

In North Carolina, you can usually use your health insurance to get treatment paid while your injury claim is pending, but that does not automatically mean the at-fault driver’s insurer is “off the hook.” Health insurance often creates a repayment issue (a lien or reimbursement/subrogation claim) that must be addressed out of any settlement or judgment. The practical impact is that health insurance can reduce your out-of-pocket costs now, but it can also reduce what you take home later if the insurer has a valid reimbursement right.

Understanding the Problem

If you were hurt in North Carolina and you have health insurance, you are probably asking whether you should run your ER visit and follow-up care through your health plan after a crash where another driver hit you. In your situation, you went to the ER a couple days after the wreck and your imaging was clear, but you still have neck/back pain and were referred to a chiropractor. The key issue is how using health insurance affects (1) what bills get paid now and (2) whether someone must be paid back if your injury claim later resolves.

Apply the Law

North Carolina injury claims typically seek compensation for medical expenses and other losses caused by the crash. When health insurance pays accident-related treatment, two legal questions commonly come up: (1) what amount of medical charges can be proven in the case, and (2) whether a health plan or medical provider has a right to be reimbursed from your recovery (often called “subrogation” or a “lien”). Medical providers can also have statutory liens on personal injury recoveries for certain accident-related services, and those liens can affect settlement disbursement.

Key Requirements

• Use health insurance correctly: Your providers usually bill your health plan first (subject to deductibles/copays). You still need to tell providers the care is accident-related so billing and records are accurate.
• Track what was actually paid (not just billed): In North Carolina, the amount “paid or required to be paid in full satisfaction” of medical charges can matter when proving medical expenses.
• Identify reimbursement/subrogation rights early: Many health plans claim a right to be repaid from a settlement. Whether that right is enforceable depends on the plan type and its terms.
• Watch for provider liens: North Carolina law can create a lien in favor of providers for accident-related medical services that attaches to settlement funds, especially once proper notice is given.
• Follow notice and documentation rules: Liens and reimbursement claims often require specific notices, itemized statements, and proof tying charges to the crash.
• Plan for settlement disbursement: If a valid lien exists, the settlement can’t simply be paid out without addressing it; the disbursing attorney may have duties to hold and pay certain claims from the recovery.

What the Statutes Say

• N.C. Gen. Stat. § 8-58.1 (Medical charges evidence) - Allows testimony and records about the amount paid (or required to be paid) to satisfy medical charges and creates rebuttable presumptions about reasonableness.
• N.C. Gen. Stat. § 44-49 (Medical provider lien) - Creates a lien on personal injury recoveries for certain accident-related medical services, with requirements including providing an itemized statement and notice.
• N.C. Gen. Stat. § 44-50 (Lien attaches to settlement funds; disbursement duties) - Extends the lien to settlement funds and addresses retention/disbursement obligations and limits (including a 50% cap on the lien amount, exclusive of attorney’s fees).
• N.C. Gen. Stat. § 108A-57 (Medicaid subrogation) - Gives the State subrogation rights for Medicaid payments and sets presumptions and deadlines for disputing the Medicaid portion of a recovery.

Analysis

Apply the Rule to the Facts: Because you have health insurance and you went to the ER and were referred for chiropractic care after a T-bone collision, using your health plan can help keep treatment moving while the liability claim is investigated. At the same time, you should assume that someone may later ask to be reimbursed from any settlement for accident-related payments (depending on the plan and the type of coverage). You also need clean documentation showing what amounts were actually paid/accepted for your ER visit and follow-up care, because that can affect how medical expenses are presented and negotiated.

Process & Timing

1. Who files: Usually nobody “files” anything at the start; you (or your attorney) gather information. Where: With your health insurer, medical providers, and the at-fault driver’s auto insurer. What: Request itemized bills, EOBs (explanations of benefits), and medical records; confirm whether any provider is asserting a lien. When: Start as soon as treatment begins so billing mistakes and missing records do not pile up.
2. Confirm reimbursement/lien status before settlement: Before you sign a release, identify all accident-related payments and any claimed liens or reimbursement rights so the settlement can be structured and disbursed correctly.
3. Resolve liens and reimbursements at disbursement: After settlement funds arrive, the disbursing attorney typically resolves valid liens/reimbursement claims and then disburses the remainder to the client.

Exceptions & Pitfalls

• Not all “health insurance” reimbursement works the same: Some plans have strong reimbursement rights, while others may be limited by plan language or other rules. Do not assume you can keep the full settlement without checking.
• Billing the wrong payer can create delays: If providers bill auto insurance when they should bill health insurance (or vice versa), you can end up with collections notices or gaps in treatment documentation.
• Confusing “billed” vs. “paid/accepted” amounts: Negotiations often turn on what was actually paid or accepted as full satisfaction, not just the sticker price on the first bill.
• Ignoring provider lien notices: North Carolina’s medical lien statutes can require holding back settlement funds after notice; paying the client first can create problems later.
• Medicaid has its own rules: Medicaid reimbursement is governed by specific North Carolina statutes and presumptions, and missing the dispute deadline can limit your options.

Conclusion

In North Carolina, using health insurance after a car wreck often helps you get care paid while your injury claim is pending, but it can also create a reimbursement or lien issue that must be handled out of any settlement. You should track what amounts were actually paid or accepted for your ER and follow-up treatment and identify any liens before you sign a release. Next step: request your itemized bills and EOBs now so any reimbursement claims can be confirmed before settlement.

Talk to a Personal Injury Attorney

If you're dealing with accident-related medical bills and you’re unsure how your health insurance, liens, and reimbursement claims affect your settlement, our firm has experienced attorneys who can help you understand your options and timelines. Reach out today. Call (919) 704-0000.

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.