How medical and chiropractic bills and liens affect injury settlements in South Carolina

Short answer: You will often see medical and chiropractor charges addressed before you receive your settlement funds. Which bills or liens are paid (and how much) depends on who paid or provided the treatment (private provider, health insurer, Medicaid/Medicare), whether the provider has a valid lien or subrogation claim, and the agreements your attorney negotiates. This page explains the common types of claims against a settlement in South Carolina and practical steps to protect the money you should receive.

Detailed answer — how settlement money is typically allocated

1. Gross settlement vs. net recovery

A settlement starts as a gross amount agreed with the defendant or insurer. From that amount, the following categories are commonly deducted (in this order, in practice):

• Attorney contingency fee and litigation costs (if your lawyer worked on contingency).
• Liens, subrogation, and reimbursement claims from health insurers, medical providers, Medicare, or Medicaid.
• Any outstanding medical bills not covered by insurance, if the provider has a right to be paid from the settlement.

The money left after these deductions is your net recovery.

2. Types of medical claims that can reduce a settlement

• Private medical providers (doctors, hospitals, chiropractors): If a provider has a written lien, contract, or a valid equitable claim against the recovery, they may demand payment from the settlement. Some providers will accept negotiated reductions.
• Health insurers and subrogation: If an insurer paid your medical bills, it commonly has a contractual right to be reimbursed from any third‑party settlement (subrogation). This can include private insurers and ERISA plans. Those liens can significantly reduce your net recovery unless negotiated.
• Medicaid and Medicare: Federal and state programs routinely seek repayment from settlements for medical care they paid. South Carolina Medicaid also enforces claims for reimbursement. See the South Carolina Department of Health and Human Services for program information: https://www.scdhhs.gov/.
• Liability vs. protective liens: Some providers file statutory or common‑law liens; others simply assert a claim and negotiate. The enforceability depends on the provider’s documentation and applicable law.

3. Chiropractor charges specifically

Chiropractors are medical providers and may bill you or your insurer for care. If a chiropractor provided treatment and either (a) asserts a lien, or (b) your health insurer paid those bills and seeks subrogation, those amounts can be collected from the settlement. Whether the chiropractor can directly place a lien on settlement funds depends on the provider’s actions, any signed agreement you made when treatment began, and applicable South Carolina rules.

4. Negotiation and reductions are common

Many medical providers and insurers accept less than the full billed amount when a settlement is imminent. An experienced attorney typically negotiates reductions for medical bills and subrogation claims to maximize your net recovery. Public programs (Medicaid/Medicare) often have specific procedures and timelines for asserting their claims and may or may not accept reductions.

5. What your attorney should do

• Obtain a full accounting of all medical bills, liens, and insurer reimbursement demands.
• Confirm which entities have a legal right to be paid from the settlement and the amount each claims.
• Negotiate lien reductions or obtain written releases from providers where possible.
• Hold settlement funds in trust or escrow until liens and subrogation demands are resolved, or obtain written proof that lien claimants will be paid so you can receive your portion safely.

South Carolina resources for law and reimbursement rules

For statutory language and to check specific rules that might affect liens and reimbursements in South Carolina, use the official South Carolina Code index: https://www.scstatehouse.gov/code.php. For Medicaid reimbursement and recovery policies, see the South Carolina Department of Health and Human Services: https://www.scdhhs.gov/.

Practical example (hypothetical)

Imagine you reach a $50,000 settlement after a car crash. Your attorney’s contingency fee is 33% ($16,500), litigation costs are $1,500, and medical providers and your insurer together claim $12,000 in bills/reimbursement. After negotiating, medical claims are reduced to $7,000. The settlement distribution might look like:

• Gross settlement: $50,000
• Attorney fee: $16,500
• Litigation costs: $1,500
• Medical liens after negotiation: $7,000
• Net to you: $24,000

Helpful Hints

• Ask your attorney for a written settlement worksheet showing gross recovery, each deduction, and the net amount you will receive.
• Request itemized bills and written lien statements from every medical provider and insurer who claims reimbursement.
• If you have health insurance, check your plan documents for subrogation language; ERISA plans often have strict rules and timelines.
• Contact Medicaid or Medicare early if they paid any bills; federal and state programs will want notice and may assert a claim.
• Do not sign releases or accept a settlement disbursement until your attorney confirms lien and reimbursement issues are resolved or funds are properly escrowed.
• Consider negotiating medical bills before settlement — providers frequently accept reduced payoffs to resolve their claims quickly.
• If you are a minor or otherwise need court approval for a settlement, confirm how liens will be resolved before final approval.

Next steps

Talk with your attorney about all medical payments, insurance payments, and any written or claimed liens. Good attorneys will identify potential claims early, try to negotiate reductions, and give you a clear, itemized explanation of the money flow so you know what to expect.

Disclaimer: This article provides general information about how medical and chiropractic bills and liens commonly affect settlements in South Carolina. It is not legal advice and does not create an attorney‑client relationship. For advice tailored to your situation, consult a licensed South Carolina attorney.