Medical Bills (Past And Future)

As stated above, medical bills are a component of the compensatory damages claim in any personal injury case. The bills represent an out of pocket expense which should be reimbursed by the defendant's insurance company. There is no provision in the law requiring the liability insurer to pay the medical bills as they are incurred. The bills should be totaled in a "demand letter" when the treatment is concluded. It is also critical that the attorney assess the need for future treatment and secure an estimate from the treating physician as to the lifetime costs of the future medical bills. Many physicians will need to be educated about the need to estimate the future medical expenses. You must advise the physician that so long as he can state that the future medical expenses are "more likely than not" or "50.1% probable", the testimony is admissible.

Practice Pointer: Do not expect the defendant's liability insurer to pay for

medical bills one by one as they are incurred and submitted. While occasionally a claims adjuster will offer an unrepresented (pro se) party a few thousand dollars for the compensatory damages and agree to pay another few thousand dollars for future medical bills, this is a very bad idea and unless the injuries are very minor, any such offer should be rejected. This presents the problem of what to do if the client does not have health insurance or significant medical expense coverage through his own motor vehicle insurer to pay his medical bills as they are incurred. First, try to find a doctor who will accept the case on an "Assignment" which results in the bills being paid from the settlement or verdict. It is becoming more difficult to find physicians willing to take cases without up-front payment. The attorney accepting such cases must be willing to devote the necessary time to find proper treaters for the injured client.

The method of calculating a settlement by multiplying the medical bills x 3 is a thing of the past. You must understand the injury to interpret the significance of the medical bills. For example, a single trip to the emergency room with several scans and tests and an overnight stay for observation can run up a medical bill of nearly $10,000.00. But if all the tests and scans are negative and if the client is discharged with no significant injury, the liability insurer will argue the medical bills do not represent much beyond dollar for dollar reimbursement. This analysis of case value by the insurance company may be countered by pointing out that human beings have fears and emotions for which compensation must be provided. On the other hand, a rib fracture can cause pain every time you exert yourself, even when you take a deep breath, cough or sneeze. Unfortunately, once diagnosed, there is little to offer in the way of treatment beyond prescription pain relief medication. Therefore, this very painful injury will have few medical bills to present in settlement. In both cases you can counter the claims adjuster's contentions, but only if you have interviewed the client about how the treatment and injury have affected him both emotionally and physically.

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