A reasonableness-only state for fees
Compare North Carolina to a state like New York, which applies a hard statutory sliding scale to medical malpractice attorney fees specifically. North Carolina has no equivalent figure anywhere in its rules for any type of personal injury claim, including malpractice — the fee simply can't be "clearly excessive" under Rule 1.5, assessed case by case.
Two separate things that sound related but aren't
It's worth being clear that North Carolina's medical malpractice damages cap — $712,847 for 2026 on noneconomic damages — has nothing to do with attorney fees. That cap limits what a patient can recover from a health care provider; the attorney's own percentage fee remains governed entirely by Rule 1.5's reasonableness standard, untouched by whatever the damages cap happens to be in a given case.
A strict fault rule that shapes practice differently
North Carolina's pure contributory negligence rule doesn't set or limit the fee percentage directly, but it does shape how attorneys approach case selection and risk. Because even 1% of fault on the claimant's part can eliminate an otherwise valuable claim entirely, contingency-fee attorneys in North Carolina factor that binary risk into which cases they take on and how they negotiate, differently than attorneys in a state where fault only ever reduces a recovery rather than eliminating it.
A distinctive addition, not a cap
North Carolina does have one fee-related statute worth knowing: N.C. Gen. Stat. § 6-21.1 lets a judge award a separate, court-paid attorney fee in small personal injury or property damage cases under $10,000, layered on top of the ordinary contingency arrangement. This is an addition available in a narrow category of smaller cases, not a limit on what can be charged more broadly.