If the negligence of another has injured you, it should be simple to recover the cost of your medical treatment, lost wages, and pain & suffering.
Unfortunately, this is rarely the case in NC Personal Injury cases. This post discusses what to do if the insurance company offers less than the cost of your medical bills and expenses.
The Bishop Law Firm represents personal injury victims in North Carolina. We do not get paid unless we win your case. Call us today for a free case review or start online now.
NC Personal Injury Law
In North Carolina, an injured victim can recover the cost of their accident-related medical expenses, lost wages, and pain and suffering. Most insurance adjusters do not want to pay pain and suffering and are reluctant to give money for lost income without comprehensive documentation.
Do not rely on an insurance adjuster to determine a fair settlement amount for serious injuries or to tell you what you are legally entitled to recover. This will not happen.
If the insurance adjuster offers you less than the cost of your medical bills, you are not alone. If the at-fault party's insurance company "thinks" that you have received too much medical treatment or if the medical bills are "too expensive", they will try to pay you less than the value of the medical bills.
How much are your medical bills?
The first step for an injured person or their personal injury lawyer in attaining a fair personal injury settlement is finding out the total amount of the medical bills and liens due in a case. Consider the following:
- Don't settle your case until you receive all necessary medical care or until you know the value of future medical costs.
- Once you are finished treating, ask your medical providers for the medical records and outstanding medical bills.
- Certain facilities (i.e., emergency room visits) bill separately for physicians and diagnostic testing (e.g., X-rays, MRIs), so you may have more than one bill for a single visit.
- Don't forget to get the bill from the ambulance ride!
- Ask your health insurer if they will put forth a medical lien on your personal injury settlement if you used your health insurance to pay for your accident-related medical expenses. Whether your health insurance company can put forth a lien is based on what type of insurance company they are (NC is an anti-subrogation state, but there are several exceptions).
- In North Carolina, you can be compensated for the amount your health insurance paid on your behalf, the amount you paid out of pocket, and the cost of the future medical treatment needed (future need will need to be documented by a physician) (See Rule 414).
- For the insurance adjuster to make a fair settlement offer, all expenses need to be included in a demand letter with proof of those expenses.
- Knowing how much your medical bills actually are can give you a line in the sand when dealing with the insurance adjuster.
Medical Bills More Than Personal Injury Settlement?
Why would an insurance company offer less than my medical expenses? Unfair as this may seem, adjusters want to pay as little as possible on accident victims' claims.
Many adjusters feel that they are not required by law to cover the cost of your total expenses and will attempt to make you settle for less than your costs.
An insurance adjuster will tell you that medical treatment is not related to your accident, when it clearly is.
We frequently have adjusters who object to medical treatment even though our client reported the symptom in their first medical treatment post-accident.
Adjusters will also say treatment is not related when there is a gap in treatment (even a week!), when it is well known that getting the appointment can take substantial time.
If you settle with the insurance for less than the cost of your expenses, you have effectively had to pay for someone else's negligence twice.
At my firm, we never recommend settling for less than the cost of our client's accident-related medical treatment, nor do we recommend accepting the insurance companies' first offer.
Please remember that if you accept the money from the insurance company (no matter how unfair), your case is done, and no further money can be obtained.
Do I have to pay medical bills out of my settlement?
Yes, you need to pay your medical bills out of your settlement. However, an experienced personal injury attorney can help weed out unrelated medical bills from healthcare providers while ensuring your settlement proceeds can pay all your medical bills.
Under North Carolina Law, the settlement funds are subject to liens from medical providers and certain health insurance providers (such as Medicare, Medicaid, and ERISA).
If you do not pay these liens, they can become judgments against you. Unpaid medical bills will result in calls from debt collectors and can affect your credit.
However, that does not mean you should accept and pay the bills at face value. Don't be afraid to negotiate! Negotiating medical bills can result in significant savings for accident victims.
Even a failed negotiation to reduce bills is better than no negotiation. In other words, you have nothing to lose by asking the medical provider to negotiate on their bills.
In addition, in North Carolina, pro-rata distribution can be used to negotiate medical bills and liens.
Is filing a court case the only way to get more money for my NC Personal Injury Claim?
It depends. For the adjuster to give you a decent offer, they must have all your medical records, medical bills, lien information, lost wage information, photographs, doctor's work notes, and other support for the amount of settlement that you are asking for.
Adjusters who do not have all the necessary documentation are reluctant to increase the value of their offer.
Sometimes, even with clear and complete evidence, the adjuster may not want to give you a fair offer. This can be based on the inexperience of the adjuster or on the fact that adjusters are often so busy that your case gets lost in a stack.
However, some adjusters will increase their offer when presented with all the evidence.
After providing the adjuster with all the evidence and making a demand, some adjusters still will not offer enough money to cover your accident-related expenses.
In these cases, you can settle with the adjuster and then contact your medical providers to attempt to reduce your medical bills due to the amount of your settlement.
Do I need an NC Personal Injury Attorney to file litigation?
Usually, the better option when a settlement offer is not enough to pay your accident-related bills is to file personal injury litigation in the county court where the accident occurred.
Filing litigation forces the insurance company to add the potential cost of litigation to your claim, which can increase the claim's value.
No, you can file a case independently, but you must keep up with dates and provide the requested information to the court and opposing counsel, or your case could be dismissed.
To start your personal injury litigation case, you must file a complaint, civil summons, and discovery in the District or Superior Civil court in the county of the accident before the NC Statute of Limitations runs out.
If you hire an NC Personal Injury Lawyer, they can help you with litigation and prelitigation. As mentioned above, some adjusters will offer more money if faced with more evidence during settlement negotiations.
A personal injury attorney can help you gather this evidence and present it to the adjuster.
If the adjuster refuses to offer more money for settlement, an attorney can discuss whether filing for litigation is the best option for recovery in your case.
If you find yourself in a situation where your NC Personal Injury Medical Bills are More Than the Settlement, just know that The Bishop Law Firm represents injured clients in North Carolina. We do not get paid unless you win, and we offer free case reviews. Call us today, (919) 615-3095, or start your free online case review now!
