In North Carolina, the practical next steps are to (1) confirm whether the health plan actually asserts a reimbursement/subrogation claim, (2) obtain a written, itemized payoff (or written confirmation of a $0 balance), (3) resolve any disputes and get the plan’s written release/satisfaction, and (4) document your settlement disbursement so you can show how any lien/reimbursement was handled. If the plan is Medicaid or the State Health Plan, there are specific notice and timing rules that can create fast deadlines after settlement.
If your North Carolina personal injury case has already settled and you still have not received confirmation that the health plan’s subrogation vendor even opened a file, the real question is: can you safely disburse and close the case, or must you keep funds back until the plan confirms whether it wants reimbursement? Here, one key fact is that your office sent referral materials multiple times but received no response.
“Subrogation” (and “reimbursement”) is the health plan’s attempt to be paid back from the injury settlement for medical bills it paid that were related to the accident. In North Carolina, the rules depend heavily on what kind of payor it is. Some payors have clear statutory rights and timelines (for example, Medicaid and the State Health Plan). Other health plans (including many employer plans) rely on contract terms in the plan documents and, sometimes, federal law. Separately, North Carolina also has statutes that create medical-provider liens on personal injury recoveries and impose duties on the person receiving settlement funds once proper notice is given.
Apply the Rule to the Facts: Because your office has already sent referral materials to the health plan’s subrogation vendor multiple times with no response, the immediate risk is closing the file and disbursing without knowing whether the plan will later assert a reimbursement claim. The safest path is to create a clear paper trail showing (1) you gave notice and requested confirmation, (2) you requested an itemized statement/payoff, and (3) you held back an appropriate amount if you had notice of a valid lien/reimbursement claim. If the payor is Medicaid or the State Health Plan, you also need to treat post-settlement notice and timing rules as hard deadlines.
To close out a health insurance subrogation claim after a North Carolina settlement, you typically must confirm in writing whether the plan asserts reimbursement, obtain an itemized payoff tied to the injury, resolve any disputes, and secure a written release before final disbursement. If you have notice of a valid medical lien claim, you generally need to retain enough funds to satisfy it. Next step: send a trackable written demand to the plan (not just the vendor) requesting a written payoff and release, and calendar the 30-day Medicaid dispute deadline if Medicaid is involved.
If you’re dealing with a post-settlement health plan reimbursement issue and the subrogation vendor is not responding, our firm has experienced attorneys who can help you identify the payor type, protect the settlement during the close-out, and work toward a written payoff and release so you can finish the case. Call undefined today.
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.
