Short Answer

Yes. In North Carolina, valid medical provider liens—including chiropractor bills related to your injury—are usually paid from your personal injury settlement before you receive your portion. By law, after attorney’s fees are deducted, no more than half of the remaining settlement can go to these provider liens, and they share that amount proportionally. Separate reimbursement rights (like Medicaid, Medicare, or certain health plans) may also have to be resolved before any funds are disbursed.

Understanding the Problem

You want to know if North Carolina law requires payment of medical or chiropractic balances from your personal injury settlement. The decision point is simple: when your case settles, can your lawyer hold back money to pay providers and other claimants before you get paid? This matters because the answer affects how much you take home and when you receive it.

Apply the Law

North Carolina gives certain medical providers a lien against the proceeds of an injury claim for treatment related to the accident. Your lawyer must address these liens before disbursing settlement funds. The Clerk of Superior Court does not routinely oversee these distributions in a standard settlement, but a court can resolve disputes if needed. A key statutory cap limits how much of the recovery (after attorney’s fees) may be paid to medical provider liens.

Key Requirements

• Covered providers/treatment: The bills must be for accident-related treatment by a qualifying provider (for example, physicians, hospitals, and chiropractors).
• Notice and identification: The provider must assert the lien by notifying you or your attorney and providing an itemized statement so it can be verified and addressed at settlement.
• Distribution cap: After deducting attorney’s fees, no more than 50% of the remaining settlement can go toward medical provider liens; providers typically share this amount pro rata.
• Other statutory recoveries: Separate rules apply to Medicaid, Medicare, TRICARE, and certain health plans; those claims must be resolved before disbursement.
• Attorney trust duties: Your lawyer must hold settlement funds in trust and cannot release your portion until valid liens and statutory reimbursement claims are handled or resolved.

What the Statutes Say

• N.C. Gen. Stat. § 44-49 (Medical provider lien) — Allows certain providers to assert a lien on injury recoveries for related treatment.
• N.C. Gen. Stat. § 44-50 (Distribution and cap) — Limits the total paid to medical provider liens to 50% of the recovery after attorney’s fees, shared proportionally.
• N.C. Gen. Stat. § 108A-57 (Medicaid reimbursement) — Establishes Medicaid’s right to reimbursement from third-party liability settlements and related procedures.

Analysis

Apply the Rule to the Facts: With no specific facts provided, consider two brief examples. If your $20,000 settlement remains after attorney’s fees and your combined provider bills total $30,000, the medical provider liens cannot take more than 50% of the $20,000 remainder, and providers share that amount pro rata. If Medicaid paid some of your bills, Medicaid’s recovery must be addressed under its statute before any disbursement to you.

Process & Timing

1. Who files: Your attorney. Where: Funds are held in the attorney’s North Carolina trust account. What: Verify and obtain itemized statements from providers; request lien/recovery statements from Medicaid/Medicare/health plans; negotiate reductions; prepare a written settlement statement. When: Before any client funds are disbursed.
2. Your attorney issues payment to valid lienholders and statutory claimants, applying the 50% cap to medical provider liens after attorney’s fees. If a dispute arises, your attorney can hold the disputed portion in trust and, if necessary, ask a North Carolina Superior Court to resolve it.
3. After liens/recoveries are resolved and payments issued, your attorney disburses the remaining balance to you with a final settlement statement.

Exceptions & Pitfalls

• Some health plans (for example, certain self-funded ERISA plans) and government programs have separate reimbursement rights outside the medical provider lien cap.
• Providers who do not properly assert or document their lien may forfeit lien rights; however, undisputed debts can still be pursued directly from the patient.
• Failing to notify Medicaid or Medicare can delay or jeopardize disbursement; always verify and resolve these claims before paying out the client’s share.
• Do not assume every bill is lien-protected; only accident-related charges by qualifying providers fall within the medical provider lien statutes.
• If lien claims exceed the cap, pay them pro rata rather than in full to a single provider, unless a statute says otherwise.

Talk to a Personal Injury Attorney

If you’re settling an injury claim and need to understand which liens must be paid and how much, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 919-313-2737.

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.