When you are injured because of someone else’s negligence, you have a right to recover compensation the full amount of all of your medical bills actually billed by the providers, provided that the amount billed is reasonable.
This right is subject to two limitations:
• The amount you can collect is the amount actually billed.
• The amount must be reasonable. Over-billing or excessive treatment is not recoverable. This usually is not an issue, as most doctors and hospitals do not over-bill or perform excessive treatment. But often there is a fine line between what is and is not reasonable and your personal injury attorney will be your advocate and show how and why the charges are reasonable.
Understanding Your Rights
As mentioned earlier, your right to obtain payment for all of your medical bills incurred is subject to two restrictions. First, it is limited to the amount actually billed. Second, the amount must be reasonable. Even if all you paid were co-pays because you had health insurance, you are still entitled to recover all of the medical bills because you may have an obligation to reimburse your health insurance provider. Even if you did not have insurance and are prohibited from recovering compensation for pain and suffering, you are still entitled to recover your medical bills.
The Amount Actually Billed
You may have had a brain surgery that ordinarily would run upwards of $200,000 after accounting for a one week stay in the hospital. However, if you had health insurance, your insurer likely has contracted discounted rates that the hospital can charge for your treatment and the amount actually billed might be only $50,000. If you had Medicare or Tricare (health insurance for members of the military), the amount billed would be closer to $25,000. Whatever the amount billed, that is the amount you are entitled recover.
Of course, you will often have an obligation to reimburse your insurer, but an experienced personal injury lawyer will be able to employ a variety of legal methods to reduce the amount you must reimburse, often cutting the amounts in half, thereby creating additional funds that can be paid to you. For example, a brain injury lawyer at our firm would typically be able to collect the entire $200,000 billed (in the previous example), settle with the hospital for $100,000, creating an additional $100,000 from which you can be compensated.
Your right to collect medical bills is limited to an amount that is reasonable. For example, your attorney may send you to a doctor who charges double or triple what another doctor of equal experience would charge, there is accidental duplicate billing, or there is excessive, unnecessary treatment. In such a case, the amounts charged would not be reasonable and you would be limited to recover a reasonable amount.