Short Answer

In North Carolina, if the at-fault driver’s liability limits are not enough, you can look to your own coverages—medical payments (MedPay) and underinsured motorist (UIM)—to fill the gap. Before you sign any release with the at-fault insurer, give written notice to your UIM carrier and obtain its written consent (or allow time for it to advance the settlement). You must also resolve medical liens correctly before you receive funds.

Understanding the Problem

You’re asking, in North Carolina, how you can get fully compensated when the at-fault driver’s insurance may be too low to cover your medical treatment and other losses. You’ve completed treatment, so the main decision is whether and how to use your MedPay and any UIM coverage—and the timing for getting your UIM insurer’s consent—before you settle and sign a release with the at-fault carrier.

Apply the Law

North Carolina’s auto insurance rules allow you to recover first from the at-fault driver’s liability policy. If that is insufficient, you may use your own optional MedPay to reimburse medical bills and then make a UIM claim if you carry it. UIM claims generally require that the liability limits be exhausted and that you protect your UIM carrier’s subrogation rights by seeking its written consent to settle (or giving it the chance to advance the settlement amount) before you release the at-fault driver. Medical providers and certain payors may have statutory lien or reimbursement rights that must be handled from any injury recovery.

Key Requirements

• Applicable coverage: Confirm you have MedPay and/or UIM on an applicable North Carolina policy (as a named insured, resident relative, or covered occupant).
• Exhaustion/insufficiency: The at-fault driver’s liability limits are not enough to cover your damages and are tendered/exhausted.
• Consent to settle: Before signing a release with the liability insurer, give written notice to your UIM carrier; obtain written consent or allow time for the carrier to tender an advance to preserve subrogation.
• Liens/resolution: Identify and resolve statutory medical provider liens and any Medicaid/Medicare reimbursement claims from the settlement proceeds, within statutory caps.
• Forum and timing: Disputes are handled with your insurer or, if needed, by filing a civil action in the North Carolina General Court of Justice; key timing includes the UIM consent window and the general three-year personal injury limitation period.

What the Statutes Say

• North Carolina Gen. Stat. § 20-279.21 (Auto liability; UM/UIM coverage) - Sets rules for uninsured/underinsured motorist coverage, exhaustion, and consent/advance to preserve subrogation.
• North Carolina Gen. Stat. § 44-49 (Medical provider liens) - Creates liens for reasonable medical charges paid from personal injury recoveries.
• North Carolina Gen. Stat. § 44-50 (Enforcement and limits on liens) - Caps and pro‑rata distribution of medical liens, typically limited to a portion of the net recovery after attorney’s fees.
• North Carolina Gen. Stat. § 108A-57 (Medicaid third‑party recovery) - Medicaid reimbursement rights apply to injury recoveries.

Analysis

Apply the Rule to the Facts: Because treatment is complete, you can total your medical bills and other losses to gauge whether the at-fault limits will be insufficient. If they are, use MedPay to reimburse covered medical expenses regardless of fault. Before accepting and signing any release from the at-fault insurer, notify your UIM carrier in writing of the tentative settlement and request written consent; if it advances the funds within its response window, it preserves subrogation and you proceed against UIM for the shortfall. Be sure to resolve provider liens within the statutory caps before funds are disbursed.

Process & Timing

1. Who files: The injured person. Where: First with insurers (liability and your own UIM/MedPay); if needed, file a civil complaint in the General Court of Justice (District or Superior Court) in the county of the crash or defendant’s residence. What: Written UIM notice and consent-to-settle request; MedPay claim submission; civil Summons and Complaint if suit is required. When: Send the UIM consent request before signing any release; the UIM carrier typically has about 30 days to consent or advance under § 20-279.21.
2. After consent or advance, finalize the liability settlement and exhaust those limits. Then present your UIM claim for the uncompensated damages, supported by medical records, bills, wage loss proof, and the liability settlement documentation.
3. If the UIM claim does not resolve, pursue litigation against the at-fault driver and provide required notice to your UIM carrier; your UIM insurer may participate per statute and policy. The final outcome is memorialized in a judgment or settlement release, with lien distributions handled before client funds are disbursed.

Exceptions & Pitfalls

• Settling without UIM consent: Releasing the at-fault driver before consent (or advance) can forfeit UIM benefits.
• Ignoring liens: Medical provider liens must be paid from settlement proceeds within statutory caps; Medicaid/Medicare have separate reimbursement rules.
• Coverage stacking and multiple policies: In some situations, UIM coverage can be increased by stacking coverages; the details depend on policy language and facts.
• Late notice: Delay in notifying your own insurer or missing the personal injury limitations period can limit recovery.
• Documentation gaps: Keep treatment records, bills, and proof of lost income organized to support both liability and UIM claims.

Talk to a Personal Injury Attorney

If you’re facing medical bills that exceed the at-fault driver’s insurance and need guidance on MedPay, UIM, and lien resolution, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at .

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.