Can I start treatment with a chiropractor or doctor if I don’t have money upfront, and have it paid from a settlement later?
Can I start treatment with a chiropractor or doctor if I don’t have money upfront, and have it paid from a settlement later? - North Carolina
Short Answer
Yes—sometimes you can start treatment in North Carolina without paying upfront if a provider agrees to wait and be paid from your injury settlement later. But it is not automatic: the provider must agree to that arrangement, and North Carolina law can give medical providers a lien on your recovery once proper notice and documentation requirements are met. If your case settles for less than expected (or you lose), you can still be responsible for the bill.
Understanding the Problem
If you were hurt in a North Carolina crash and you have not seen a doctor yet, can you get care now (including chiropractic care) without paying cash upfront, and have the bill paid later out of the settlement? That question usually comes up when the at-fault driver’s insurer has not accepted liability yet, or you cannot wait for the insurance company to decide what it will pay.
Apply the Law
In North Carolina, there is a difference between (1) a private payment arrangement where a provider agrees to delay collection and (2) a legal “lien” that can attach to money you recover for your injuries. North Carolina’s medical lien statutes can allow certain medical bills related to the injury to attach to settlement or judgment proceeds, but the lien is not valid unless the provider gives required notice and documentation to the injured person’s attorney when requested. If you hire a lawyer and the provider properly asserts a lien, the lawyer generally must address valid lien claims before disbursing settlement funds.
Key Requirements
A willing provider: A chiropractor or medical office must agree to treat you without upfront payment. Many offices still require co-pays, deposits, or periodic payments even if they will wait on the balance.
Injury-related services: The charges must be for medical services connected to the injury for which you later recover damages.
Proper lien notice (if a lien is claimed): For a statutory lien, the provider must give written notice of the lien claimed to the injured person’s attorney (and, if the attorney requests it, provide an itemized statement/records/report within the statutory time window).
Settlement funds can be “encumbered”: Once notice is received, the person holding settlement funds (often the attorney) may have a duty to hold back enough to pay just and bona fide medical claims before distributing the rest.
Limits and priority issues: North Carolina law limits the total medical lien amount (exclusive of attorney’s fees) to a portion of the recovery, and some governmental reimbursement rights can take priority over private provider claims.
Disputes must be handled: If the amount of a medical claim is disputed, the statutes provide that payment is not compelled until the claim is established and determined through the proper legal process.
Apply the Rule to the Facts: You reported lower-back pain after being T-boned in a North Carolina parking lot, but you have not started treatment yet and want the other driver’s insurance to cover care, possibly through a lien arrangement. Under North Carolina law, you may be able to treat now without paying upfront if a chiropractor or doctor agrees, but that agreement is voluntary and does not guarantee the insurer will pay. If you later recover a settlement, properly asserted medical lien claims can attach to that recovery and may need to be paid (or resolved) before you receive the remaining funds.
Process & Timing
Who sets it up: You (often through your attorney). Where: Directly with the chiropractor/doctor’s billing office in North Carolina (not the court). What: A written agreement that explains whether the provider will bill health insurance, whether you remain personally responsible, and whether the provider will assert a lien under North Carolina law. When: Before or at the first visit, so expectations are clear.
During treatment: Keep appointments and follow medical advice. Make sure the provider’s records accurately describe how the injury happened and what symptoms you report, because those records often become key evidence in settlement negotiations.
At settlement: If you have an attorney and a provider has properly asserted a lien, the settlement proceeds are typically handled through the attorney’s trust account and disbursed only after addressing valid lien claims and any disputes.
Exceptions & Pitfalls
“Paid from settlement” is not the same as “the insurer will pay.” A lien or delayed-billing arrangement does not force the other driver’s insurer to accept liability or pay your bills as you go.
You may still owe the bill if the case underperforms. If the claim settles for less than expected (or does not settle), the provider may still pursue you for payment under the treatment agreement.
Multiple claims can compete for the same settlement dollars. Health insurers, government programs, and certain state plans may have reimbursement/subrogation rights that can reduce what is left to pay providers and you.
Disputed charges need a plan. If you disagree with the amount billed or whether services were related/necessary, raise it early. North Carolina law has specific rules for disputed medical lien claims.
Overtreatment and documentation gaps can hurt the claim. Large gaps in care, inconsistent complaints, or treatment that is hard to tie to the crash can create settlement problems and billing disputes.
Conclusion
In North Carolina, you can sometimes start treatment with a chiropractor or doctor without money upfront if the provider agrees to wait for payment from a later settlement. If you recover money, North Carolina’s medical lien statutes can allow properly noticed medical claims to attach to the settlement, and your attorney may have to address those claims before distributing funds. A key timing issue is that, if your attorney requests documentation to support a lien, the provider generally must respond within 60 days. Next step: get the payment terms in writing before you begin treatment.
Talk to a Personal Injury Attorney
If you're dealing with a crash injury and need treatment but can’t afford to pay upfront, our firm has experienced attorneys who can help you understand your options and timelines. Reach out today. Call [CONTACT NUMBER].
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.
