North Carolina’s cap on noneconomic damages

What the cap is

North Carolina law limits noneconomic damages in medical malpractice actions (N.C. Gen. Stat. § 90-21.19). Claims against nursing homes, assisted living facilities, and hospitals are generally treated as medical malpractice actions, so the cap applies to most of the cases we handle.

As of January 1, 2026, the cap is $712,847. Unless a plaintiff can prove gross negligence, the most a North Carolina plaintiff can recover for noneconomic damages in a medical malpractice action, including claims against long-term care providers, is $712,847. The cap is the total for all claims arising from the same care, not a separate amount for each defendant.

What counts as noneconomic damages

For many families of nursing home and assisted living residents, most of the damages in a case are noneconomic. Older residents are often retired, so there may be little or no lost income. As a result, the cap often sets a practical ceiling on what a case can recover.

When the cap does not apply

The cap does not apply if the jury finds both of the following:

• The patient suffered disfigurement, loss of use of part of the body, permanent injury, or death; and
• The defendant’s conduct that caused the injury was grossly negligent, in reckless disregard of the rights of others, fraudulent, intentional, or malicious.

Proving gross negligence is a high bar. Whether it can be proven depends on the facts of each case, including staffing records, prior incidents, and what the facility knew.

How the cap changes over time

The cap began at $500,000 and is adjusted for inflation every three years by the North Carolina Office of State Budget and Management. The $712,847 figure took effect on January 1, 2026 (NC OSBM). The next adjustment is scheduled for January 1, 2029.

What this means for your family

Lawsuits against nursing homes, assisted living facilities, and hospitals are expensive and time-consuming. Because of the cap, we evaluate each case carefully and talk with families candidly about what a case can realistically recover before anyone commits to litigation. If you are unsure how the cap applies to your situation, tell us what happened and we will explain.

This page is general information about North Carolina law, not legal advice about your situation. The cap amount is current as of January 1, 2026.