What Usually Must Happen Before Payment
- Settlement terms confirmed: The parties usually confirm the key terms in writing (the amount, what claims are being resolved, and who is included in the release). If treatment is ongoing, the insurer may argue it cannot fairly evaluate the claim yet, which can affect both the offer and the timing.
- Documents signed: Most settlements require signing a release. A release typically ends the claim, even if symptoms change later, so it is important to understand what you are giving up before you sign.
- Liens/reimbursements addressed: Before money is distributed, any valid claims that must be paid from the settlement (like certain medical provider liens or certain benefit reimbursement claims) are identified and resolved. This step can affect both timing and take-home.
- Disbursement: After the settlement funds arrive, the disbursement process typically involves paying approved case costs, attorney fees (if you hired counsel), and any valid liens/reimbursement claims, then issuing the remainder to the client.
What Can Cause Delays
- Ongoing treatment or incomplete records: If your medical records and itemized bills are still coming in, the insurer may treat the claim as “unfinished” and keep the offer conservative.
- Disputes about what care is injury-related: Adjusters often challenge whether certain visits, imaging, or follow-up care were caused by the incident. That can slow negotiations and also affect lien resolution.
- Liability disputes (including contributory negligence): North Carolina’s contributory negligence rule can be a major pressure point. If the insurer argues you were even slightly at fault, it may use that to justify a lower offer or a denial. (Contributory negligence is generally raised as a defense, and the defense has the burden to prove it.)
- Paperwork issues: Missing signatures, incorrect payee information, or unclear release language can delay issuance of funds.
Liens and Reimbursement Claims (Plain English)
“Liens” and “reimbursement claims” are ways third parties may claim part of a settlement because they paid (or are owed) injury-related medical expenses. Two common examples in North Carolina are:
- Medical provider liens: North Carolina law can allow certain providers to assert a lien on personal injury recoveries for injury-related services, but the lien has to be properly supported (including providing required documentation and notice). These liens attach to settlement funds and can affect what gets paid out at the end. See generally N.C. Gen. Stat. § 44-49 and N.C. Gen. Stat. § 44-50.
- Medicaid reimbursement rights: If Medicaid paid for injury-related care, the State may have subrogation/reimbursement rights that must be addressed as part of settlement distribution, and North Carolina law sets out presumptions and a process for disputes in some situations. See generally N.C. Gen. Stat. § 108A-57.
Even when a settlement number increases, your net recovery can still be meaningfully affected by these items, plus case costs and attorney fees (if you hired a lawyer). That is why it is important to evaluate offers using a “net-to-client” lens, not just the headline number.
How This Applies
Apply to your facts: You have an open North Carolina injury claim, you are still treating, and a demand has already been sent—so you are in the negotiation stage where first offers are often used to test how well the claim is documented and how firmly you will support your demand. If treatment is ongoing, it is common for the insurer to argue it cannot fully value the claim yet, which can keep the first offer low. And because you are already thinking about liens and attorney fees, you should compare any offer to your likely take-home after valid medical/provider claims and reimbursement issues are resolved—not just the gross settlement figure.
Conclusion
The first settlement offer is often not the insurer’s final position, but there is no dependable “standard” increase because value depends on proof, defenses, and practical limits. In North Carolina, contributory negligence arguments can also heavily influence negotiation posture. When you evaluate any offer, look at the likely net amount after valid liens/reimbursement claims, case costs, and attorney fees (if any). One practical next step is to request a written breakdown of what documentation the insurer says it still needs to evaluate your demand.
