North Carolina General Statute 44-49 and 44-50
N.C. Gen. Stat. 44-49 creates medical provider liens upon recoveries for personal injuries stating, in pertinent part, that:
(a) from and after March 26, 1935, there is hereby created a lien upon any sums recovered as damages for personal injury in any civil action in this State. This lien is in favor of any person, corporation, State entity, municipal corporation or county to whom the person so recovering, or the person in whose behalf the recovery has been made, may be indebted for any drugs, medical supplies, ambulance services, services rendered by any physician, dentist, nurse, or hospital, or hospital attention or services rendered in connection with the injury in compensation for which the damages have been recovered... .
(b) Notwithstanding subsection (a) of this section, no lien provided for under subsection (a) of this section is valid with respect to any claims whatsoever unless the physician, dentist, nurse, hospital, corporation, or other person entitled to the lien furnishes, without charge to the attorney as a condition precedent to the creation of the lien, upon request to the attorney representing the person in whose behalf the claim for personal injury is made, an itemized statement, hospital record, or medical report for the use of the attorney in the negotiation, settlement, or trial of the claim arising by reason of the personal injury, and a written notice to the attorney of the lien claimed. N.C. Gen. Stat. 44-49(a)-(b) (2007).
N.C. Gen. Stat. 44-50 creates a lien against settlement proceeds, stating in pertinent part, that:
A lien as provided under G.S. 44-49 shall also attach upon all funds paid to any person in compensation for or settlement of the injuries, whether in litigation or otherwise. If an attorney represents the injured person, the lien is perfected as provided under G.S. 44-49. Before their disbursement, any person that receives those funds shall retain out of any recovery or any compensation so received a sufficient amount to pay the just and bona fide claims for any drugs, medical supplies, ambulance services, services rendered by any physician, dentist, nurse, or hospital, or hospital attention or services, after having received notice of those claims. N.C. Gen. Stat. 44-50 (2007).
In Smith v. State Farm Mut. Ins. Co., 157 N.C. App. 596, 580 S.E.2d 46 (2003), the Court, in considering N.C. Gen. Stat. 44-49 and 44-50, held that "a lien against the settlement proceeds received by a pro se injured party arises by operation of law, and is perfected when the insurer has 'received notice' of the 'just and bona fide claims' of the medical service provider." Smith, 157 N.C. App. at 602-03, 580 S.E.2d at 51.
The Court further held that the "submission of the health insurance claim form to the defendant was sufficient to validate the medical service provider lien asserted by the plaintiff". Id. at 604, 580 S.E.2d at 51.