What steps can I take if the other driver’s insurance refuses to reimburse my treatment costs?: Answered for North Carolina

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What steps can I take if the other driver’s insurance refuses to reimburse my treatment costs? - North Carolina

Short Answer

In North Carolina, a third-party insurer is not required to pay your medical bills until liability and damages are resolved by settlement or judgment. If the insurer will not reimburse treatment costs, use your health insurance or any medical payments coverage on your auto policy, send a formal demand with documentation, and be prepared to file a lawsuit against the at-fault driver within three years. If the other driver is uninsured or underinsured, evaluate uninsured/underinsured motorist coverage through your own policy.

Understanding the Problem

You are in North Carolina and were hurt in a car crash. You want to know what you can do when the other driver’s insurer refuses to pay your treatment costs and has stopped responding. Here, the insurer paid for vehicle damage but denied medical expenses. The question is what steps you can take now to protect your claim and address unpaid bills.

Apply the Law

Under North Carolina law, the other driver’s liability insurer generally does not pay medical bills as they come in. You must prove the other driver was negligent and that the crash caused your injuries. North Carolina follows contributory negligence, which can bar recovery if you were even slightly at fault, though narrow doctrines may apply in specific scenarios. Bodily injury claims are typically pursued against the at-fault driver in the General Court of Justice, not directly against the insurer. The basic deadline to file a negligence lawsuit for personal injury is three years from the crash. If the other driver is uninsured or there is not enough liability coverage, your uninsured/underinsured motorist benefits may apply through your policy. Medical providers may assert liens against a settlement, and those liens have statutory limits and documentation requirements.

Key Requirements

  • Fault: Show the other driver breached a duty of care (e.g., unsafe driving) and is legally responsible.
  • Causation and damages: Link the crash to your injuries with medical records and bills.
  • Contributory negligence risk: Any fault assigned to you can bar recovery; liability disputes drive many denials.
  • Timely action: File suit within the three-year statute of limitations for personal injury.
  • Proper parties: Sue the at-fault driver; add your own insurer only when required for uninsured/underinsured motorist claims.
  • Medical liens: Providers may claim a lien on settlement funds, but lien amounts and distributions are capped by statute.

What the Statutes Say

Analysis

Apply the Rule to the Facts: The insurer covered property damage but denied medical costs, suggesting a liability or causation dispute. Because you reportedly blacked out and crossed into oncoming traffic, the insurer may be asserting that you were at fault under North Carolina’s contributory negligence rule, which would bar recovery. To move forward, assemble medical proof tying injuries to the crash, use health insurance or any medical payments coverage to keep bills current, and prepare to file suit within three years if the insurer will not resolve the claim.

Process & Timing

  1. Who files: The injured person. Where: File a civil action in the General Court of Justice in the county where the crash occurred or where the defendant resides (through the Clerk of Superior Court). What: Civil Summons (AOC-CV-100) and a Complaint stating negligence and damages; for UM/UIM, follow your policy’s notice requirements and add the carrier when required by statute. When: File within three years of the crash.
  2. Before suit, send a written demand with medical records, bills, and a clear response deadline; allow reasonable time (often 30 days). If there is no response or denial continues, proceed with filing and service under North Carolina Rules of Civil Procedure.
  3. After filing, expect an Answer within weeks, followed by discovery and mediation. If you obtain a settlement or judgment, resolve any valid medical liens before distributing funds.

Exceptions & Pitfalls

  • Contributory negligence can bar recovery; evaluate any facts suggesting the other driver had the last clear chance to avoid the crash.
  • Do not wait on adjuster silence; missing the three-year statute of limitations ends the claim.
  • Notify your insurer promptly about potential UM/UIM claims; policies may have notice and consent-to-settle requirements.
  • Use health insurance and any medical payments coverage to prevent collections; later reimburse valid liens per North Carolina law.
  • Avoid quick releases that waive injury claims when only property damage was paid.
  • Serve the defendant correctly; bad service can delay or derail the case.

Conclusion

In North Carolina, the other driver’s insurer does not have to pay medical bills before liability is resolved. If they refuse, document fault and injury, use health insurance or medical payments coverage to manage bills, and be ready to file a negligence lawsuit against the at-fault driver in the proper county within three years of the crash. The next step is to send a complete demand with a firm response deadline and, if there is no resolution, file suit before the three-year limit.

Talk to a Personal Injury Attorney

If you’re facing unpaid medical bills after a North Carolina car crash and the insurer won’t respond, our firm can help you evaluate fault, insurance options, and filing timelines. Reach out today for guidance on your next steps. Call (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.

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