Why These Records Matter
In most North Carolina personal injury claims, medical records and bills do two big jobs: (1) they help show causation (that your injuries are connected to the incident), and (2) they help prove damages (the financial and human impact of the injury).
When bills or records are missing, the insurer may say it cannot fairly evaluate the claim yet. Even if liability is clear, the claim can stall because the documentation is incomplete.
What to Request
- Core documents:
- Complete treatment records (office notes, exam findings, diagnoses, and discharge/closing notes)
- Itemized billing statements (showing dates of service and charges)
- Billing ledger/account history (payments, adjustments, and current balance)
- Helpful add-ons:
- Proof of payment (if any bills were paid by health insurance or out of pocket)
- Any written work restrictions or return-to-work notes (if wage loss is part of the claim)
- Referral notes (if the chiropractor referred you to another provider, or vice versa)
How to Request Them (General Steps)
- Identify the holder: Many “medical facilities” separate records (medical records department) from bills (billing office or an outside billing vendor). You often have to request both.
- Authorization: A signed medical authorization is commonly required before records/bills will be released to you or your attorney. North Carolina law also allows providers to charge copying fees within set limits in many situations.
- Follow-up: Keep a simple log of request dates, who you spoke with, what was promised, and what is still missing. If you resend a request, attach the prior request and ask for a status update in writing when possible.
What to Do If Records Are Delayed, Missing, or Incorrect
- Confirm what’s missing: Ask whether the delay is for records, bills, or both. Also ask whether the provider is waiting on a doctor’s sign-off or coding/billing finalization.
- Request an “itemized statement” and a “ledger”: Sometimes a single-page balance due is not enough for claim evaluation. An itemized bill and ledger often answer the insurer’s questions faster.
- Check for separate providers: A single visit can generate separate charges (facility charge vs. professional charge). If you only have one side, the file can look incomplete.
- Fix errors promptly: If dates, body parts, or accident history are wrong in the chart, ask about the provider’s process to request a correction or addendum. Insurers commonly point to inconsistencies when disputing causation.
- Attorney coordination: When a case is represented, it often helps for counsel to centralize requests and track what has been received, because each missing piece can delay a demand package or negotiations.
How Missing Records Can Affect “Value” (Not Just Timing)
- Medical expenses may be harder to prove: In North Carolina, presenting medical expense damages often depends on showing what was actually paid (for satisfied bills) and what is still necessary to satisfy bills that have been incurred but not yet paid. If the billing is incomplete, it can be difficult to present a clean, supported number.
- Causation can look weaker: If the records do not clearly document symptoms, exam findings, and progress over time, the insurer may argue the treatment was not related or not necessary.
- Gaps create leverage for the insurer: When the file is incomplete, insurers may delay evaluation or offer less while saying they are “waiting on documentation.”
How This Applies
Apply to the facts: Here, treatment with a chiropractor is complete, but the claim is waiting on remaining bills and records from a medical facility. That missing facility documentation can hold up the next step (often a demand/negotiation phase) because it may contain key proof of diagnosis, imaging, referrals, and the final billing totals. It can also affect how persuasively the claim ties the injury timeline together from the incident through the end of care.
What the Statutes Say (Optional)
- N.C. Gen. Stat. § 1-52 – lists several three-year limitation periods that commonly apply in injury cases (deadlines depend on the claim type and facts).
- N.C. Gen. Stat. § 90-411 – addresses fees a health care provider may charge for copying and providing medical records.
Conclusion
Missing medical bills and records usually delay a Durham injury claim because they are the backbone of proving treatment, cost, and how the injury connects to the incident. They can also affect claim value if the insurer argues the damages are not fully documented. The most practical next step is to identify exactly which records and billing items are missing (and who holds them) and push a complete, itemized set through one coordinated request process.
