Short Answer

In North Carolina, you can be reimbursed for out-of-pocket medical and therapy bills from your settlement after attorney’s fees and any valid medical liens are paid. Send your lawyer clear proof of what you already paid and ask that a “Client reimbursement for out-of-pocket medical expenses” line be included on the settlement statement before you sign. Reimbursement is normally paid from your net settlement proceeds.

Understanding the Problem

You want to know how, in North Carolina personal injury cases, you can get paid back from your settlement for medical and therapy bills you already paid yourself. Here, you’ve reached a settlement and are about to e-sign a release, and you want to confirm that your out-of-pocket payments will be reimbursed.

Apply the Law

Under North Carolina law, settlement funds are disbursed by your attorney from the firm’s trust account. Attorneys’ fees come off the top. Then any valid medical liens are paid. Your reimbursement for bills you personally paid comes from your net recovery after those items. North Carolina statutes give medical providers a lien on settlement funds if they properly perfect it, and those liens are collectively capped at 50% of the recovery after attorney’s fees. Public benefits (like Medicaid) and some health plans may also have reimbursement rights that must be addressed before you receive your net.

Key Requirements

• Prove what you paid: Give your lawyer receipts, cancelled checks, or portal printouts showing the provider, date, service, and amount paid.
• Avoid double payment: Identify which providers you already paid so your lawyer does not also pay them from the settlement.
• Priorities apply: Attorney’s fees are paid first; perfected medical liens are next, subject to a 50% cap after fees; your reimbursement is taken from your net.
• List it on the settlement statement: Ask for a line item labeled “Client reimbursement – out-of-pocket medical/therapy expenses” before you sign.
• Resolve benefit plan claims: If Medicare/Medicaid or a health plan paid bills, those claims must be addressed before your net is finalized.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider liens) - Allows providers to assert a lien on settlement funds if they give proper notice and supply records.
• North Carolina Gen. Stat. § 44-50 (Amount and priority) - Attorney’s fees come first; valid medical liens are collectively limited to 50% of the recovery after attorney’s fees.
• North Carolina Gen. Stat. § 108A-57 (Medicaid reimbursement) - Describes Medicaid’s right to reimbursement from liability settlements.

Analysis

Apply the Rule to the Facts: You have a settlement and a release to sign. Before you sign, send your lawyer proof of every medical and therapy bill you paid yourself. Those amounts can be listed as a client reimbursement line on the settlement statement. Your attorney will first deduct fees and pay any valid liens; then your reimbursement will come from your net proceeds, and your check will be mailed to the address you provided.

Process & Timing

1. Who files: You (through your attorney). Where: No court filing; handled through your attorney’s trust account in North Carolina. What: Provide itemized statements and proof of payment; request a “Client reimbursement – out-of-pocket medical/therapy expenses” line on the settlement statement; complete the e-signature on the release. When: Do this before funds are disbursed and ideally before you sign the settlement statement.
2. After the insurer sends funds, your attorney deposits them, confirms lien amounts, and finalizes the settlement statement. This often takes 2–4 weeks depending on how quickly lienholders respond and funds clear.
3. Once liens and fees are paid, your attorney issues your net settlement. Your reimbursement will be included in that net or as a separate client reimbursement check mailed to your address.

Exceptions & Pitfalls

• If a provider has a perfected lien, it must be satisfied ahead of your reimbursement; your out-of-pocket amounts cannot jump the statutory priorities.
• If Medicaid, Medicare, or an ERISA health plan paid bills, their reimbursement rights can reduce your net; disclose those benefits to your lawyer early.
• Double-payment risk: If you already paid a bill that your insurer also paid, your lawyer needs that information to prevent duplicate payments and adjust reimbursements.
• Release timing: Once you sign and disbursements are made, changing the settlement statement can delay your payment; confirm all amounts up front.
• E-sign issues: If the portal glitches, ask for a secure email link or a PDF to sign and return so disbursement is not held up.

Talk to a Personal Injury Attorney

If you're dealing with a settlement and want to be repaid for medical bills you covered yourself, 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.