The National Trial Lawyer - Top 100
Super Lawyers
AV Preeminent - Martindale-Hubbell
Top 10 attorneys and firms - American Institute Of Legal Counsel
North Carolina Advocates for Justice

When the Hospital Won’t File Your Health Insurance…

Matt Richardson

When you have suffered a serious personal injury as a result of someone else’s negligence, you will most likely find yourself in a hospital for your initial medical treatment. In our neck of the woods (Fayetteville, NC), the hospital is most likely a facility owned by Cape Fear Valley or First Health. When you check into the E.R., you will be asked to disclose your health insurance information on the intake forms. Most people assume that any bills they incur will be filed with their health insurance carrier and paid accordingly.

Who Really Pays the Bill?

A problem arises when the hospital refuses to file your balances with your health insurance carrier. If there is another source of payment available, like the liability insurance of the person who caused your injury, the hospital may decide not to file your health insurance and instead receive payment from the other source.

This frustrates most people, and unfortunately, as attorneys practicing personal injury law in Fayetteville, we see it often. It is especially common in motor vehicle collisions, where hospitals will seek payment from the liability coverage of the at-fault driver or even the Med Pay, Uninsured, or Underinsured motorist coverage of your auto policy. The end result: it can be months, even years, before your hospital bills are paid. To make matters worse, if you have a personal injury claim, the hospital will put a lien on any money you receive in a settlement or judgment.

Follow the Money

Why wouldn’t a hospital simply file your health insurance instead of waiting? The answer is simple: the hospital often gets paid more money by not filing. Most health insurance companies have contracted rates with medical providers. This means the health insurance carrier only has to pay a percentage of your total bill. The remainder is often “written off.” Look at any medical bill your health insurance paid in the past, and you will see these “adjustments” in the margins.

By seeking payment from a 3rd party source like liability insurance, the hospital can be reimbursed for your entire bill, not the lesser percentage it would receive by filing your bill with your health insurance. It’s a money game, and injured victims are caught in the middle!

Unfortunately, North Carolina courts have held that hospitals can choose not to file your health insurance. It’s their choice. In addition, the hospital can put a lien on any money you receive for your injuries from another source (typically the at-fault party’s insurance). This is all well and good until you begin to deal with the liability insurance company. There you may find that a settlement offer isn’t large enough to pay your hospital bill and compensate you for other damages like pain and suffering or lost wages.

What it Means for You

This article only touches on one of many issues that arise in our complex game of medical billing in personal injury claims. If you’ve stumbled on this post, you probably have additional questions that relate to your particular case. Our attorneys will be happy to provide you with a free consultation to see if we can help.

Client Reviews

“The Richardson law firm is outstanding! From their courteous and efficient office staff to their knowledgeable lawyers. Both in accident injury and criminal disputes, we were lucky to have them represent our family. Their kindness and...”

Gloria D.

“I highly recommend this firm if you're looking for an attorney in Cumberland County. My traffic matter was handled within one week of receiving my citation. You just cannot beat that. Attorney Patrick Anstead is really good at his job and Melissa is very...


“If you are looking for an Attorney for handling Military reasons for your loved one, I Highly recommend The Richardson Law Firm. I cannot not thank Attorney Kris Poppe and staff enough for handling matters for my son. May my review show my forever...”

Elaine M.

I was facing a serious felony charge looking at 20 years. As soon as I stepped in the office, the staff were very polite and professional and took care of my case as if it was their own. I ended up walking away with a misdemeanor and a year probation. This law...

Smooth O.

This law firm is the best! Thank you Mr. Poppy & his assistant Melissa for handling my case with compassion and kindness. I could always call Melissa and Kris was there anytime I needed to see him. It was a very serious case, thank God I had someone on my side...

Penny B.

Being in need of legal representation, I contacted Mr. Matthew Richardson after he was recommended to me by a friend. Mr. Richardson and his paralegal, Ms. Codia DiTarana-Evans were pleasant to work with and did an excellent job taking care of my legal needs.

Karen B.

Matt Richardson was extremely helpful in giving legal advice. He had our best interest in mind. He was detail oriented, and made us a priority. I highly recommend his practice for all legal matters big or small.

Elizabeth T.

Contact Us

Fill out the contact form or call us at (910) 488-5050 to schedule your consultation.

  • No-Fee_2x.png Most Consultations Free
  • Language_2x.png Quick Response Time
  • Experience_2x.png Client Focused

Call Us at (910) 488-5050