Understanding the Problem

If you were hurt in a North Carolina crash and the other driver’s insurance company denies the claim or offers too little, you are usually asking: “Can I still recover money, and what do I have to do next before time runs out?” This often comes up when you were taken by ambulance and the insurer questions the injury, the treatment, or who caused the wreck.

Apply the Law

In North Carolina, the at-fault driver (not the insurer) is legally responsible for injuries caused by negligence, and the insurer’s job is to evaluate and pay covered claims up to the policy limits. If the insurer denies liability, disputes the amount of damages, or denies coverage, you can still pursue the underlying claim by building proof and, if necessary, filing a civil lawsuit in North Carolina trial court. You must also watch the filing deadline: most personal injury claims must be filed within three years.

Key Requirements

• Liability (fault) proof: You must be able to show the other driver was negligent and that negligence caused the crash and your injuries.
• Medical causation and documentation: Your medical records need to connect the collision to your symptoms and treatment, including follow-up care if symptoms continue.
• Damages proof: You need evidence of your losses (medical bills/records, missed work documentation, and how the injury affects daily life).
• Deadline compliance: You must file suit on time even if the insurer is still “reviewing” the claim.
• Careful settlement paperwork: A signed release can end your claim, even if you later learn your injury is worse than expected.
• Coverage pathway awareness: If the insurer denies coverage or the available liability limits are not enough, other coverages (like UM/UIM in certain situations) may become important.

What the Statutes Say

• N.C. Gen. Stat. § 1-52 (Civil actions—three years) - Sets a three-year limitations period for most personal injury claims.
• N.C. Gen. Stat. § 20-279.21 (Motor vehicle liability policy; UM/UIM provisions) - Includes rules about required auto coverages and when uninsured/underinsured motorist coverage can apply, including when a liability insurer denies coverage.
• N.C. Gen. Stat. § 7A-38.3A (Prelitigation mediation of insurance claims) - Allows a process for pre-suit mediation in certain insurance-claim situations and provides tolling rules once a request is filed.

Analysis

Apply the Rule to the Facts: Here, the claim value and the insurer’s position will likely turn on (1) proving the other driver caused the intersection crash, (2) documenting that the ambulance transport, hospital visit, imaging, and prescriptions were reasonable and tied to the collision, and (3) showing ongoing back pain and missed work with follow-up medical support. Because you have ongoing symptoms but have not yet followed up with another doctor, the insurer may argue your condition is not serious or not clearly related—so timely medical follow-up and complete records often matter. Since you were driving a work vehicle and have discussed workers’ compensation, you also need to coordinate the injury claim carefully so you do not create avoidable disputes about what benefits apply and when.

Process & Timing

1. Who files: The injured person (or their attorney). Where: Typically with the at-fault driver’s liability insurer first; if suit is needed, in North Carolina District Court or Superior Court (depending on the amount in controversy) in a county where venue is proper. What: A documented demand package (medical records/bills, wage loss proof, and a clear liability summary) and, if necessary, a civil Complaint and issuance of a Summons. When: Do not wait past the statute of limitations—most injury cases must be filed within three years.
2. Negotiation and dispute narrowing: If the insurer denies the claim or offers too little, you (or your attorney) typically respond by addressing the stated reasons for denial/low valuation—often by supplying missing records, clarifying causation, and correcting liability arguments. If the issue is coverage (not just “value”), you may need to pursue other coverage paths, including UM/UIM in the situations allowed by North Carolina law.
3. Litigation if needed: If the insurer still will not pay fairly, the next step is usually filing suit against the at-fault driver before the deadline, then using the court process (discovery, motions, mediation, and potentially trial) to prove fault and damages. Many cases resolve during litigation, but you should prepare as if the case could go to trial.

Exceptions & Pitfalls

• “Denial” may mean different things: An insurer can deny liability (fault), deny damages (amount), or deny coverage (policy doesn’t apply). Each requires a different response, and a coverage denial can change whether UM coverage becomes relevant under North Carolina law.
• Gaps in treatment can be used against you: If you have ongoing back pain but do not follow up, insurers often argue you were not really hurt or that something else caused the symptoms. Getting appropriate medical follow-up helps document what is going on.
• Do not sign a release too early: A quick settlement can close the case before you understand the full medical picture. Once you sign, reopening the claim is usually very difficult.
• Work-related crash coordination issues: Because the crash happened while driving for work, workers’ compensation may pay certain benefits, and there can be lien/repayment issues that affect the net recovery. Coordination mistakes can delay settlement or reduce what you keep.
• Property-damage settlement confusion: Settling vehicle damage does not automatically settle the injury claim unless the written settlement documents say it does. Read all settlement paperwork carefully.