Short Answer

In North Carolina, your lawyer prepares a detailed settlement statement showing the gross settlement, attorney’s fees and costs, all medical liens/repayment claims, and your net amount. Before you sign, your attorney should confirm final lien figures, apply North Carolina’s lien limits and priorities, and give you copies of the lien ledgers and bills so you can verify items like your deductible were not paid twice. After funds clear and liens are resolved or reserved, your lawyer disburses your check.

Understanding the Problem

You want to know how, in North Carolina personal injury cases, you sign off on the settlement statement and get your check. You (the injured client) must review and approve a final, itemized statement before your lawyer can disburse funds. Because you have medical liens from a health insurer, two hospitals, and EMS, you also want to confirm your out-of-pocket deductible isn’t paid twice before you sign.

Apply the Law

North Carolina law requires injury settlements to honor perfected medical provider liens and certain government or plan reimbursement rights. Providers perfect liens by giving proper written notice before disbursement. Total provider liens are limited by law, with a key 50% cap after attorney’s fees, and competing liens typically share pro rata within that cap. Government-related claims (like Medicaid) and some health plans have separate statutory or federal rights that must be satisfied according to their rules. The lawyer’s trust account is the forum for receiving settlement funds and making compliant disbursements; there’s no routine court filing for an adult’s PI settlement.

Key Requirements

• Final, itemized statement: You receive a written breakdown of the gross settlement, attorney’s fees, case costs, each lien/repayment claim, and your net.
• Perfected medical liens only: Providers must give proper written notice to create a lien; unperfected balances are handled by agreement, not by automatic lien.
• 50% cap and pro rata sharing: After attorney’s fees, medical provider liens cannot take more than 50% of the remaining recovery; when liens exceed that, they share proportionally.
• Government/plan claims: Medicaid has a statutory lien, and Medicare must be reimbursed; North Carolina’s State Health Plan has specific recovery rights that can differ from provider caps.
• Your review and consent: You can ask for lien ledgers, bills, and EOBs to confirm accuracy and prevent duplicate deductible payments before signing.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical liens: creation and notice) - Providers obtain a lien by furnishing services and giving proper written notice.
• North Carolina Gen. Stat. § 44-50 (Enforcement and 50% cap) - Caps total provider liens at 50% of the recovery after attorney’s fees; requires pro rata sharing when over-subscribed.
• North Carolina Gen. Stat. § 108A-57 (Medicaid lien) - Authorizes the State’s Medicaid recovery from third-party liability settlements.
• North Carolina Gen. Stat. § 135-48.37 (State Health Plan subrogation) - Grants recovery/subrogation rights to the State Health Plan.

Analysis

Apply the Rule to the Facts: Your lawyer should verify which providers/insurers have perfected liens and obtain each final lien amount. The statement must apply the 50% cap after attorney’s fees and allocate any overage pro rata among providers. Because government and plan rights can be different, your lawyer should incorporate the final Medicaid/Medicare or State Health Plan demands. Before you sign, you can compare lien ledgers and your EOBs to ensure your deductible wasn’t already credited so it isn’t paid twice.

Process & Timing

1. Who files: No court filing is typically required for an adult PI settlement. Where: Your attorney’s North Carolina law firm (trust account). What: You receive a draft settlement statement, the release(s), and a proposed disbursement sheet; you may also receive HIPAA authorizations to confirm balances. When: After settlement funds clear and final lien/repayment amounts are confirmed (government or plan demands can add time).
2. Your attorney pays approved fees and case costs, then satisfies perfected liens within the 50% cap and pro rata rules, and resolves Medicaid/Medicare/State Health Plan claims as required. If any lien is disputed, the disputed portion is held in trust until resolved.
3. Once you review and sign the final settlement statement, the firm issues your net disbursement (check or wire) and provides copies of the paid lien receipts/releases and the lien/billing ledgers you requested.

Exceptions & Pitfalls

• Unperfected provider balances: If a provider did not give proper written notice, they may not have a statutory lien; your lawyer can address those balances by agreement rather than paying them from lien funds.
• Government and plan differences: Medicaid and Medicare have distinct recovery rules; the State Health Plan’s rights can differ from provider caps. These must be honored before disbursement.
• Duplicate deductible risk: Compare insurer EOBs and provider ledgers; if your deductible was already credited, ask to remove any duplicate line item before you sign.
• Over-subscribed liens: When total liens exceed the 50% cap (after fees), expect pro rata reductions among providers. Signing before this math is finalized can delay your check.
• Disputes hold funds: If you dispute a lien, your lawyer will typically hold only the disputed amount in trust and disburse the rest; unresolved disputes can slow final payment.

Conclusion

To receive your disbursement in North Carolina, you first review and sign a final settlement statement that itemizes the gross recovery, fees/costs, all perfected liens, and your net. Your attorney must confirm and apply North Carolina’s lien rules, including the 50% cap after attorney’s fees with pro rata sharing, and satisfy Medicaid/Medicare/State Health Plan demands. Next step: ask for the draft settlement statement plus lien ledgers and bills, confirm no duplicate deductible payment, then sign for prompt disbursement.

Talk to a Personal Injury Attorney

If you're dealing with finalizing a settlement, medical liens, and disbursement math, 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.