Who Pays for Medical Bills After a Dog Bite?
May 29, 2025
Dog bites can result in serious physical, emotional, and financial consequences for victims. Determining who is responsible for paying medical bills after a dog bite involves traversing an intricate legal structure shaped by state statutes, common law principles, and insurance policies.
Understanding the various factors that influence liability for medical expenses following a dog bite incident, including North Carolina’s strict liability and negligence laws, the role of homeowners’ insurance, potential defenses, and practical steps victims can take to seek compensation are all important factors.
With an estimated 4.5 million dog bites occurring annually in the United States (CDC), understanding these issues is critical for both victims and dog owners in North Carolina. Reach out to our Raleigh personal injury attorney for more information.
Legality of Governing Dog Bites in North Carolina
North Carolina employs a combination of strict liability and negligence-based rules to determine liability for dog bite injuries. These legal principles establish who is responsible for covering medical bills and other damages. A personal injury attorney can help with this process.
Strict Liability for Dangerous Dogs
Under North Carolina General Statutes § 67-4.4, a dog owner is strictly liable for injuries caused by a dog that has been classified as a "dangerous dog." A dangerous dog is defined under § 67-4.1 as one that:
Has killed or inflicted severe injury on a person without provocation.
Is owned or harbored primarily for dog fighting.
Has been declared dangerous by a local authority due to prior aggressive behavior.
If a dog meets this definition and bites someone, the owner is automatically liable for damages, including medical bills, regardless of whether they were negligent or knew about the dog’s dangerous tendencies.
This strict liability rule simplifies the process for victims, as they do not need to prove the owner’s fault. However, the designation of a "dangerous dog" often requires prior incidents or formal classification, which may not apply in many first-time bite cases.
The “One-Bite” Rule and Negligence
For dogs not classified as dangerous, North Carolina follows a modified version of the "one-bite" rule, rooted in common law. This rule does not automatically hold owners liable for a dog’s first bite unless the owner knew or should have known that the dog had a propensity for aggression (referred to as "scienter").
To establish liability under negligence, the victim must prove:
Knowledge of dangerous propensities: The owner was aware, or reasonably should have been aware, that the dog was likely to bite or act aggressively. Evidence might include prior bites, complaints from neighbors, or the dog’s behavior (e.g., frequent growling or lunging).
Failure to take reasonable care: The owner failed to take reasonable steps to prevent the bite, such as restraining the dog, using a leash, or posting warning signs.
Causation and damages: The owner’s failure directly caused the bite, resulting in injuries and associated medical expenses.
For example, if a dog owner knows their pet has snapped at people before but allows it to roam freely, they could be held liable for negligence if the dog bites someone. Medical bills, along with other damages like lost wages or pain and suffering, may be recoverable under this theory.
Statutory Violations and Negligence Per Se
North Carolina also has laws that impose duties on dog owners, such as local leash laws or § 67-12, which prohibits dogs from running at large at night. If a dog bite occurs because the owner violated one of these statutes, the victim may argue negligence per se.
This doctrine holds that violating a safety statute is automatic evidence of negligence, making it easier to establish liability. For instance, if a dog bites someone while off-leash in a county with a leash ordinance, the owner’s violation could lead to liability for medical bills.
Who Pays for Medical Bills?
Once liability is established, the question becomes who is financially responsible for the victim’s medical expenses. Several parties may be involved, depending on the circumstances.
The Dog Owner’s Liability
In most cases, the dog owner is the primary party responsible for paying medical bills if they are found liable under strict liability or negligence. Victims can seek compensation for:
Emergency medical care (e.g., ambulance fees, ER visits).
Surgical procedures (e.g., stitches, reconstructive surgery).
Follow-up treatments (e.g., physical therapy, wound care).
Medications (e.g., antibiotics, pain relievers).
Mental health services (e.g., therapy for trauma or PTSD).
However, many dog owners lack the personal funds to cover these expenses, especially if the injuries are severe. This is where insurance often comes into play.
Homeowners’ or Renters’ Insurance
Most dog bite claims in North Carolina are covered by the dog owner’s homeowners’ insurance or renters’ insurance policy. These policies typically include personal liability coverage, which protects the policyholder against claims for injuries or property damage caused by their actions or pets. Standard policies may cover:
Medical bills for the victim.
Legal fees if a lawsuit is filed.
Settlements or judgments up to the policy’s liability limit (often $100,000 to $300,000).
However, there are important caveats:
Breed exclusions: Some insurance companies exclude certain breeds deemed high-risk (e.g., Pit Bulls, Rottweilers) from coverage. If the dog falls under an excluded breed, the owner may have to pay out of pocket.
Policy limits: If medical bills exceed the policy’s liability limit, the owner is responsible for the remainder unless they have additional coverage, such as an umbrella policy.
Negligence exclusions: Some policies may not cover bites if the owner was grossly negligent (e.g., intentionally allowing the dog to attack).
Victims should promptly notify the dog owner’s insurance company to file a claim.
The insurer will investigate the incident, assess liability, and negotiate a settlement. In 2023, the average insurance payout for dog bite claims nationwide was approximately $58,545, according to the Insurance Information Institute, reflecting the significant costs of medical care and other damages.
The Victim’s Health Insurance
If the dog owner is uninsured, cannot be identified (e.g., a stray dog), or refuses to pay, the victim’s own health insurance may cover medical bills. Most health insurance plans, including those under the Affordable Care Act, cover emergency and follow-up care for injuries like dog bites. However, victims may face:
Copays and deductibles: Out-of-pocket costs can be substantial, especially for high-deductible plans.
Subrogation: If the victim’s health insurer pays the bills, it may seek reimbursement from the dog owner’s insurance or the owner directly through a process called subrogation.
Victims should inform their health insurer and personal injury attorney about the dog bite and any potential liability claims to coordinate coverage and avoid disputes.
Other Potential Sources
In rare cases, other parties may be liable for medical bills:
Landlords: If the dog belongs to a tenant and the landlord knew about the dog’s dangerous behavior but failed to act (e.g., by evicting the tenant), the landlord could be liable under negligence principles.
Dog walkers or caretakers: If the bite occurs while the dog is under the care of a professional (e.g., a dog walker or kennel), the caretaker’s business liability insurance might cover the bills.
Government entities: If a stray dog maintained by a public shelter bites someone, the local government could potentially be liable, though such cases are rare and face immunity challenges.
Ultimately, the responsibility for a dog bite victim’s medical bills typically falls to the dog owner or their insurance, but victims may need to rely on their own health insurance or pursue other liable parties if coverage is unavailable or insufficient. If you have questions, contact the personal injury attorney at Life Law.
Defenses That May Affect Liability
Dog owners may raise defenses to avoid paying medical bills, which can complicate recovery for victims. Common defenses include:
Provocation: If the victim provoked the dog (e.g., by teasing or hitting it), the owner may not be liable. North Carolina courts interpret provocation narrowly, requiring clear evidence of intentional or reckless behavior by the victim.
Trespassing: If the bite occurred on the owner’s private property and the victim was trespassing, liability may be reduced or eliminated. However, this defense does not apply to children under the attractive nuisance doctrine, which holds property owners liable for injuries to children drawn to dangerous conditions (e.g., an unrestrained dog).
Contributory negligence: North Carolina follows a strict contributory negligence rule, meaning if the victim is even slightly at fault (e.g., ignoring a “Beware of Dog” sign), they may be barred from recovering damages. This rule makes it critical for victims to demonstrate they did nothing to contribute to the incident.
Dog owners may use defenses like provocation, trespassing, or contributory negligence to avoid liability, potentially barring victims from recovering medical expenses unless they can prove they were entirely faultless. Reaching out to a personal injury attorney can help traverse these defences.
Contact a Personal Injury Attorney
In North Carolina, responsibility for medical bills after a dog bite typically falls on the dog owner if liability is established under strict liability or negligence principles. Homeowners’ or renters’ insurance often covers these expenses, but victims may need to rely on their own health insurance or pursue legal action. Reach out to Life Law in Raleigh, North Carolina for more information. We serve Nags Head, Wake County, Johnston County, Franklin County, and Durham County.