Short Answer

There is no central North Carolina registry to check subrogation. You verify it by contacting each likely lienholder or recovery unit (medical providers, the client’s health plan, Medicaid, Medicare, or the State Health Plan) and asking if a recovery/subrogation file is open for the accident. Send a letter of representation with key identifiers and request written confirmation and a current lien ledger before disbursing any settlement funds.

Understanding the Problem

In North Carolina personal injury cases, you need to know whether any insurer or provider has opened a subrogation or lien file tied to your client’s accident so you can resolve it before distributing settlement funds. Here, a billing administrator said no file was open and asked you to fax a letter of representation. The question is: how do you confirm file status with the right entities and document it?

Apply the Law

North Carolina law recognizes statutory medical provider liens on personal injury recoveries and gives certain payors (like Medicaid and the State Health Plan) statutory recovery rights. These claims attach to settlement proceeds and must be addressed before distribution. Verification is done directly with the potential lienholder’s recovery/subrogation unit; courts are not the clearinghouse for these inquiries. A common threshold is that medical provider liens are subject to statutory limits and priorities, and government health benefit programs have separate rules and processes.

Key Requirements

• Identify potential lienholders: Treat medical providers, the client’s health insurer (including ERISA/self-funded plans), North Carolina Medicaid, Medicare, and the State Health Plan as candidates.
• Give proper notice and data: Send a letter of representation, accident date, client identifiers (DOB, member ID), and a HIPAA authorization if needed so the lien unit can locate or open a file.
• Get written confirmation: Request written proof of whether a file exists, a reference number, and an itemized lien ledger showing paid accident-related charges and claimed recovery.
• Reconcile and cap as required: Apply North Carolina’s medical lien limits and priorities to provider liens, and follow separate statutory recovery rules for Medicaid and the State Health Plan.
• Do not disburse before resolution: Hold settlement funds until you receive final written lien amounts/demands and resolve them in compliance with statute.

What the Statutes Say

• N.C. Gen. Stat. § 44-49 (Medical provider lien) - Creates a lien in favor of providers for accident-related services on personal injury recoveries.
• N.C. Gen. Stat. § 44-50 (Amount/distribution of medical liens) - Addresses lien amounts, priorities, and caps relative to the recovery.
• N.C. Gen. Stat. § 108A-57 (Medicaid lien and recovery) - Authorizes state recovery of Medicaid payments from third-party liability proceeds.
• N.C. Gen. Stat. § 135-48.37 (State Health Plan subrogation) - Grants the State Health Plan subrogation, lien, and recovery rights.

Analysis

Apply the Rule to the Facts: Because the billing administrator reports no open file, your next step is to fax/email a letter of representation with the client’s identifiers and accident date and ask for written confirmation and a claim/lien ledger. Do the same for your client’s health plan and, if applicable, North Carolina Medicaid, Medicare, and the State Health Plan. Do not disburse settlement funds until you receive final written demands and apply the statutory limits and priorities to any provider liens.

Process & Timing

1. Who files: Plaintiff’s attorney. Where: Directly with each potential lienholder’s subrogation/recovery unit (medical providers, health insurer, North Carolina Medicaid/Division of Health Benefits, Medicare’s recovery contractor, State Health Plan). What: Letter of representation and request for lien/claim status; include accident date, client DOB, plan/member ID, and HIPAA release if requested. When: As soon as you’re retained and learn of accident-related treatment; follow up if no response.
2. Request written confirmation that a subrogation/recovery file is open (or not), a reference number, and an itemized ledger. Typical response times vary; calendar a follow-up in 2–4 weeks and again before settlement.
3. Before disbursement, request a final demand, evaluate reductions under applicable North Carolina lien caps and priorities, pay the lienholder from trust, and obtain a satisfaction/release letter for your file.

Exceptions & Pitfalls

• Self-funded ERISA health plans may assert contractual reimbursement rights not governed by the state medical lien caps; confirm plan status early.
• The State Health Plan’s recovery rights are statutory and separate from provider lien caps; treat it as its own lienholder.
• Provider liens attach only to accident-related charges; scrutinize ledgers for unrelated care and request corrections.
• Do not rely on phone calls—obtain written confirmation of file status, reference numbers, and final demands.
• Missing identifiers (member IDs, claim numbers) or not sending a HIPAA authorization can delay confirmation; include them up front.

Talk to a Personal Injury Attorney

If you're dealing with medical liens or insurer reimbursement after an accident, 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.