Short Answer

In North Carolina, a medical provider’s lien on your injury settlement is enforceable only if the provider followed the lien statute’s requirements. Your attorney must first pay agreed fees and then address valid medical liens from the remaining settlement. If a provider won’t withdraw or reduce a lien, you can challenge its validity (for example, if the provider won’t supply an itemized bill and records) or ask the court to decide and order a pro rata distribution. Some payors like Medicare/Medicaid have separate, must-pay rules.

Understanding the Problem

You’re settling a North Carolina personal injury claim and one medical lien remains. You want to know if you can get that lien removed or reduced so the case can close. The decision point is whether the remaining provider properly perfected its lien and, if so, whether you can negotiate rescission or reduction, or need a court order. One salient fact: the remaining lien is tied to a recent rehabilitation service date.

Apply the Law

North Carolina law gives certain medical providers a lien on personal injury recoveries if they comply with statutory requirements. The lien attaches to settlement or judgment proceeds related to the injury, but only after payment of your attorney’s fee. If proceeds are insufficient to pay everyone, compliant medical liens share pro rata. If a provider refuses to furnish an itemized statement and records upon request, its lien cannot be enforced. Disputes over lien validity or distribution can be brought to the Superior Court (often initiated through the Clerk of Superior Court) for resolution, and the clerk can order mediation in matters within the clerk’s jurisdiction. Medicare and Medicaid recoveries are governed by separate laws and can supersede these limits.

Key Requirements

• Provider compliance: The provider must, upon request and with proper authorization, furnish an itemized statement and relevant records. Failure to do so defeats lien enforcement.
• Scope and attachment: The lien reaches only the injury-related settlement/judgment proceeds, not your other assets.
• Priority of attorney’s fees: Your lawyer’s agreed fee is paid first; medical liens attach to the remaining funds.
• Pro rata sharing: If funds are insufficient to pay all compliant liens, they share proportionally from the net.
• Forum for disputes: If the provider won’t reduce or release, you can seek a court order determining validity and distribution; procedures can vary by county.
• Government program rights: Medicare and Medicaid have distinct, mandatory recovery rules that can override typical lien caps.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider liens) - Creates provider liens and conditions enforcement on furnishing itemized bills and records.
• North Carolina Gen. Stat. § 44-50 (Distribution and priorities) - Protects attorney fees first and provides for pro rata payment of compliant medical liens from the balance.
• North Carolina Gen. Stat. § 108A-57 (Medicaid lien) - Establishes Medicaid’s recovery rights from personal injury settlements.

Analysis

Apply the Rule to the Facts: Because your remaining lien ties to a recent rehab service, first confirm the provider furnished an itemized bill and the requested records; if not, the lien isn’t enforceable. If the provider complied, your lawyer must pay fees first and then address the lien from the net. With only one lien left and a moderate balance, you can negotiate a reduction or rescission; if the provider refuses, you can seek a court order for determination and distribution. If Medicare or Medicaid paid any of the bills, those must be resolved under their specific rules.

Process & Timing

1. Who files: You (through your attorney). Where: Clerk of Superior Court/Superior Court in the North Carolina county handling your claim or where the provider or settlement resides. What: Written demand for itemized bill and records; if unresolved, a petition or civil action to determine lien validity and distribution; deposit disputed funds with the court if needed. When: Before disbursing settlement funds; request records immediately and allow reasonable time for provider response.
2. Negotiate: Use the statutory limits (fees first, pro rata if short funds) and any compliance gaps to request reduction or withdrawal. This commonly takes 1–3 weeks, depending on provider responsiveness and county practices.
3. Court resolution: If no agreement, ask the court to determine lien validity/amount and order distribution. Expect several weeks to a few months for scheduling; some clerks can order mediation to expedite resolution.

Exceptions & Pitfalls

• Government payors: Medicare and Medicaid recoveries must be honored under their own statutes and can override typical lien caps.
• Noncompliance: If the provider won’t supply an itemized statement and records when properly requested, the lien is unenforceable—but the underlying bill can still be pursued against you.
• Pro rata traps: Do not prefer one provider over others if funds are short; use proportional payment after attorney fees.
• Wrongful death is different: If your matter is a wrongful death recovery, different statutory caps and allocation rules apply.
• Premature disbursement: Releasing funds before resolving liens can expose you and your attorney to claims and force a court dispute later.

Talk to a Personal Injury Attorney

If you’re dealing with a medical lien that’s holding up your North Carolina injury settlement, our firm has experienced attorneys who can help you understand your options and timelines. Call us today to get started.

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.