Burlingame, CA Personal Injury Blog

Tuesday, January 13, 2015

Recoverable Medical Expenses

 Accident and Injury Lawyer Helping Victims Get Compensation for Medical Expenses in San Francisco Bay and Burlingame

Suppose you are injured from an accident which is someone else's fault.   One of the categories of compensatory damages which the law allows you to recover is past medical expenses.  The treatment has to be reasonably necessary and the amount has to be reasonable.  So you go to a doctor or hospital and they produce a bill for their services.  How much can you recover for the medical expense?  This probably seems like a rhetorical question.  The amount of the bill of course.  This is the answer you would arrive at using common sense.  In the old days, before 2011, you would have been right almost all the time.  However now the courts in California have held that the amount of a medical bill is irrelevant.  That's right.  The amount of the bill and the amount of your recoverable medical expense are two different things.  How much can be recovered is not set at the time of the billing.  It can change depending on how the bill is paid.

If you have health insurance you have probably paid for it.  You paid for perhaps years in case you were injured.  Now you are hurt and you use your health insurance.  They pay a reduced negotiated rate with your health care provider.  The amount of the reduction now benefits whom?  The person who injured you.  That's right.  The person who is responsible for your injury now benefits by paying the lower amount paid instead of the higher amount billed.  So says our Supreme Court in Howell v. Hamilton Meats, Inc. (2011) 52 Cal.4th 541.  In fact, in these circumstances the amount of the original bill itself will likely never be known by the jury.  This is not to say you should not use your health insurance.  This is certainly preferable to paying the bill yourself.  But the law does increase the benefit of having and using a medical payment provision on an auto policy unless such benefits are needed for co-pays or services not covered by health insurance.  In short, this is a complicated area and professional expertise may be helpful.  If you or a loved one wants to know how payment options will affect their case call Shapiro Legal Group for a free consultation.

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