Short Answer

In North Carolina, keep the complete ER medical record and the itemized ER bill, plus proof of any payments. Ask for certified copies or a custodian affidavit so the records can be used without live testimony. Because only amounts paid or still owed are generally admissible for medical expenses, also save pharmacy receipts, insurance explanations of benefits (if any), and any discounts or financial assistance letters.

Understanding the Problem

If you were hurt in a North Carolina crash and went to the emergency department, what exactly should you collect from that visit to prove your injuries and medical costs? Here, the driver was rear-ended, had ER x-rays that showed no fractures, received medication, and has no health insurance. The goal is to gather the right ER records and billing documents so an insurer—or a court—can consider them.

Apply the Law

Under North Carolina law, medical records are typically hearsay unless you authenticate them and fit a hearsay exception. Certified hospital/ER records or a custodian affidavit usually satisfy both. For medical expenses, North Carolina limits what juries can hear to the amounts actually paid or still owed, not the gross sticker price. If you plan to prove medical charges without live witnesses, advance notice and a records custodian certification are commonly used.

Key Requirements

• Relevance: The ER records must relate to your crash injuries and treatment that day.
• Authentication: Use certified copies or a records custodian affidavit so the records can be admitted without a witness.
• Hearsay exception: Medical records are typically admitted as business records when properly certified.
• Medical expense limits: Evidence of bills is limited to amounts actually paid or still owed, not write‑offs.
• Notice/affidavits: If you plan to use medical-bill affidavits at trial, serve the required advance notice and include the custodian certification.
• Link to the incident: ER notes should identify the crash as the injury mechanism to connect treatment to the collision.

What the Statutes Say

• N.C. R. Evid. 803(6) (Business records exception) - Allows properly kept and certified business records, including medical records, to be admitted.
• N.C. R. Evid. 414 (Medical expenses) - Limits admissible evidence of medical charges to amounts paid or necessary to satisfy the bills.
• N.C. Gen. Stat. § 8-58.1 (Proof of medical expenses) - Permits itemized medical bills and affidavits to show the reasonableness and necessity of expenses.
• N.C. Gen. Stat. § 8-44.1 (Copies of hospital records) - Allows certified copies of hospital records to be used in evidence.

Analysis

Apply the Rule to the Facts: Your ER imaging showed no fracture, but the records still document crash-related evaluation and treatment. Ask for the complete ER encounter record (triage, history, exam, orders, imaging reports, medication administration, discharge instructions) and a custodian certification to satisfy authentication and hearsay rules. Because you have no health insurance, keep the itemized ER bill and any payments or discounts—those documents show the amount you actually owe, which is what Rule 414 allows the jury to consider.

Process & Timing

1. Who files: You (or your attorney). Where: The hospital’s Health Information Management/Medical Records department in North Carolina. What: Request the “complete ER encounter record,” “itemized ER bill,” “radiology report,” and “radiology images on CD,” plus a “records custodian certification/affidavit.” When: Request as soon as possible; if litigation is filed, serve any required notice and affidavits before trial per the applicable rules.
2. Follow up with hospital Billing for an account ledger, proof of payments, and any charity/financial-assistance letters. Turnaround can take a few weeks; modest copy fees may apply.
3. For court use, organize certified records, the custodian affidavit, itemized bills, and proof of payment/amounts owed. Serve any advance notice required so the records can be admitted without live witnesses.

Exceptions & Pitfalls

• Gross charges vs. paid/owed: Do not rely on a summary balance. Use the itemized bill, explanations of benefits (if any), and receipts—Rule 414 focuses on amounts paid or still owed.
• Missing foundation: Make sure the ER notes state the crash as the mechanism of injury to connect treatment to the incident.
• Hearsay within records: Statements about who caused the crash may be redacted or ignored; focus on diagnosis, treatment, and cost.
• Uncertified records: Ask for certified copies or a custodian affidavit; uncertified printouts can draw objections.
• Radiology: Get both the radiology report and the actual images; reports summarize findings—images can assist your treating provider or expert later.
• No insurance: Keep any self-pay discounts or financial-assistance documentation; they affect what you still owe and what evidence is admissible.

Talk to a Personal Injury Attorney

If you're dealing with crash-related ER records and medical bills and want to understand what evidence helps under North Carolina law, our firm has experienced attorneys who can help you understand your options and timelines. Call us 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.