Does tn law require that the medical bills be paid from a settlement in a personal injury case if it is settled prior to going to court?

I would need a little more information since I am not sure what you mean by "the medical bills be paid" in your summary  because there are a variety of different ways that this can be handled. Sometimes when a person is injuried by the fault of another and incurrs medical bills, the medical provider will want to be paid our of the settlement since sometimes the injured person might not pay the medical provider from the settlement/judgment proceeds. In cases like this, the medical provider will request and obtain an assignment form where the injured person authorizes his/her attorney to withhold any money from the settlement and pay that money directly to the medical provider. This will be enforced whether it is obtained by settlement or judgment ("going to court").