Short Answer

In North Carolina, a medical provider generally must perfect a lien before your lawyer distributes settlement funds. That usually means giving written notice of the lien and an itemized statement of charges to your attorney or the liability insurer. If a provider did not perfect a valid lien in time, your lawyer is not required to withhold money for that provider, and you can typically keep that portion. The underlying bill may still be owed, and government payers (Medicaid, Medicare, State Health Plan) follow separate rules.

Understanding the Problem

In North Carolina personal injury cases, the key question is narrow: can you receive your settlement without paying a provider that did not file a valid lien before funds are distributed? Here, your matter includes one provider that did not present a lien. You want to know whether your share of the settlement can include that amount.

Apply the Law

North Carolina law allows certain medical providers (for example, EMS, hospitals, and doctors) to assert liens against personal injury recoveries. A lien attaches to settlement funds only if the provider follows the statute’s steps, which include timely written notice and sufficient documentation of the charges tied to your injury. Your attorney must honor perfected liens, but cannot pay more than the statutory cap, and can deposit disputed amounts with the Clerk of Superior Court if the parties cannot agree.

Key Requirements

• Who can lien: Providers of medical or ambulance services for the injury (e.g., EMS, hospitals, physicians) may assert a lien on the settlement.
• Notice and documentation: The provider must give written lien notice and an itemized statement of charges to your attorney or the liability insurer before funds are distributed; failure to do so typically defeats lien rights against the settlement.
• Reasonableness and relation to injury: Only reasonable charges that relate to the accident injury are lienable.
• 50% cap and pro rata sharing: Total payments to all medical lienholders cannot exceed 50% of the settlement after attorney’s fees; if multiple providers claim, they share that amount pro rata.
• Attorney duties and disputes: Your attorney must protect perfected liens. If there’s a dispute over validity or amount, the attorney may deposit the disputed funds with the Clerk of Superior Court while the dispute is resolved.
• Government and plan claims: Medicaid, Medicare, and the State Health Plan have separate statutory or federal reimbursement rights that can apply even when a provider does not file a lien.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider lien) - Creates medical provider liens on injury recoveries and requires notice/itemization.
• North Carolina Gen. Stat. § 44-50 (Payment; 50% cap) - Limits combined lien payments to 50% of the net recovery after attorney’s fees; pro rata if multiple liens.
• North Carolina Gen. Stat. § 44-50.1 (Disputed liens; deposit with Clerk) - Allows attorneys to deposit disputed lien funds with the Clerk of Superior Court.
• North Carolina Gen. Stat. § 108A-57 (Medicaid third-party recovery) - Sets Medicaid’s separate reimbursement process and limits.

Analysis

Apply the Rule to the Facts: Your firm identified valid liens for EMS and an insurer and negotiated the insurer’s reimbursement down, which fits the attorney’s duty to protect perfected liens and the 50% cap. A separate provider did not present a valid lien, so your lawyer was not required to hold back funds for that provider. You should receive a settlement statement and check that reflect payment to perfected lienholders only; the provider without a valid lien may still bill you directly, but it cannot force payment from funds already disbursed.

Process & Timing

1. Who files: Your attorney. Where: Clerk of Superior Court (North Carolina) if there’s a dispute. What: Deposit of the disputed lien amount under G.S. 44-50.1 with notice to the claimants; otherwise, pay perfected liens and disburse the balance. When: Before distributing settlement funds.
2. Your attorney requests itemized statements, verifies lien validity, applies the 50% cap, and negotiates reductions. If a provider fails to perfect its lien, your attorney documents the file and proceeds with disbursement.
3. If a lien dispute persists, the attorney deposits the disputed portion with the Clerk of Superior Court and notifies claimants. The court resolves entitlement, and the Clerk releases funds per order.

Exceptions & Pitfalls

• Government payers: Medicaid, Medicare, and the State Health Plan have separate statutory or federal recovery rights that can apply even if a provider does not file a lien.
• No lien doesn’t erase the bill: An invalid or missing lien means no hold on settlement funds, but the provider may still pursue the debt through normal billing or collections.
• Plan reimbursement: Health insurance and certain self-funded plans may assert reimbursement rights under plan documents; these are distinct from provider liens and should be reviewed carefully.
• Notice issues: If a provider sent timely written notice and itemization to your attorney or the liability insurer, your lawyer must address it before disbursing funds.

Conclusion

Under North Carolina law, medical providers must perfect liens—by timely written notice and itemized charges—before your lawyer distributes settlement funds. If a provider did not perfect a valid lien, your attorney generally need not withhold money for that provider, and you may keep that portion of the settlement, subject to the 50% cap for valid liens and separate government payer rules. Next step: review your final settlement statement and confirm that only perfected liens were paid; if a dispute lingers, ask your lawyer to deposit any disputed amount with the Clerk of Superior Court.

Talk to a Personal Injury Attorney

If you're dealing with disputed medical charges or lien questions tied to your settlement, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at [919-341-7055].

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.