Short Answer

In North Carolina, medical providers have a statutory lien on your personal injury settlement even if they never “file” anything. To enforce it, they must furnish an itemized bill and make records available after a written request, attorney’s fees are paid first, and provider payments are capped and shared pro rata when funds are short. If a provider will not respond, your lawyer may reserve funds or ask the court to resolve the dispute before disbursing your money.

Understanding the Problem

In North Carolina personal injury cases, can a doctor or hospital still get paid from your settlement if they never sent a lien before the case resolved? You’ve settled, and your attorney is requesting the final lien amount from a provider after treatment for a broken arm. You need to know whether the provider’s delay changes what must be paid and how.

Apply the Law

North Carolina law gives healthcare providers a lien on any personal injury settlement for the reasonable value of their services, but the lien is enforceable only if the provider cooperates by furnishing an itemized statement and making records available upon written request. Attorney’s fees have priority, and the total paid to all medical providers from the settlement is capped; when there isn’t enough to pay all bills, providers share proportionally. Disputes about who gets what can be resolved by holding funds in trust or asking the court to decide.

Key Requirements

• Statutory lien attaches: A provider’s lien arises by statute on your settlement; no court filing is required to create it.
• Cooperation condition: The provider must, after a written request, furnish an itemized statement and make records reasonably available to enforce the lien.
• Attorney’s fees first: Your lawyer’s reasonable fee and case costs are paid before any provider liens.
• Cap on medical payouts: The total paid to all medical providers from the settlement is limited by statute and is shared pro rata when funds are insufficient.
• Dispute handling: If a provider will not respond or parties disagree, your lawyer may reserve funds in trust or ask the court to allocate the money.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider liens) - Creates a lien on personal injury recoveries and requires providers to furnish itemized charges and make records available upon request.
• North Carolina Gen. Stat. § 44-50 (Payment and limits) - Gives attorney’s fees priority and limits the total paid to providers, with pro rata sharing if funds are insufficient.
• North Carolina Gen. Stat. § 108A-57 (Medicaid reimbursement) - Separately authorizes state recovery of certain medical payments, outside the provider-lien rules.

Analysis

Apply the Rule to the Facts: Your case has settled, and your attorney has asked the provider for a final, itemized lien amount. The lien exists by statute regardless of whether the provider “submitted” it before settlement. But if the provider does not furnish an itemized statement and reasonably make records available after a written request, they may not be able to enforce their lien. Your lawyer should still prioritize attorney’s fees, apply the statutory cap, and, if there are multiple providers, use a pro rata split of the capped amount.

Process & Timing

1. Who files: Your attorney. Where: No filing is needed to create a lien; disputes are filed in the Superior Court (often with the Clerk of Superior Court handling deposits). What: Send a written request for an itemized statement and records to each provider; document attempts. When: Do this promptly after settlement and before disbursing funds.
2. Your attorney pays attorney’s fees and case costs first, then calculates the statutory cap for medical liens and proposes pro rata payments among responding providers. If a provider will not respond, your attorney may reserve a reasonable amount in trust and continue to follow up.
3. If disagreement remains, your attorney can file an interpleader or similar action, deposit the disputed amount with the Clerk of Superior Court, and request the court to allocate funds. Expect county-by-county variation in process and timing.

Exceptions & Pitfalls

• Government payers (Medicare, Medicaid, TRICARE/VA) have separate reimbursement rights that are not waived by a provider’s failure to “submit” a lien.
• Failure to get an itemized bill: A provider who will not furnish itemized charges or make records available after a written request risks losing the ability to enforce a lien.
• Pro rata mistakes: When funds are short, do not overpay one provider; apply a proportional split within the statutory cap.
• Unresolved disputes: Do not disburse disputed funds; hold them in trust or ask the court to decide. Keep written proof of all requests and notices.

Talk to a Personal Injury Attorney

If you’re navigating medical liens after a North Carolina injury settlement, our firm can help you understand what must be paid, how caps and pro rata rules work, and how to resolve unresponsive providers. Contact us today to discuss your options and timelines.

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.