Medical Billing, Insurance Write-offs and the Collateral Source Rule

[DGUtley]

Medical Billing, Insurance Write-Offs and the Collateral Source Rule

This has become a monster issue in personal injury litigation. Here's how it works:

Mr. Jones is injured in an accident but has a great recovery. His medical bills are: Billed: $136,000 but b/c of the insurance contractual-adjustment provisions, the providers accept $21,000 for the medical charges in complete satisfaction. What is his element of damages? Nobody has paid the $115,000 that's been eliminated. In Ohio, I'm allowed to introduce the lower amount as 'evidence of the value of the services rendered' according to the OHSC. This is important b/c emotional distress / pain and suffering is generally limited to 3x's economic loss, creating quite a difference.

This article discusses this issue.

[Kacper]

Medical Billing, Insurance Write-Offs and the Collateral Source Rule

This has become a monster issue in personal injury litigation. Here's how it works:

Mr. Jones is injured in an accident but has a great recovery. His medical bills are: Billed: $136,000 but b/c of the insurance contractual-adjustment provisions, the providers accept $21,000 for the medical charges in complete satisfaction. What is his element of damages? Nobody has paid the $115,000 that's been eliminated. In Ohio, I'm allowed to introduce the lower amount as 'evidence of the value of the services rendered' according to the OHSC. This is important b/c emotional distress / pain and suffering is generally limited to 3x's economic loss, creating quite a difference.

This article discusses this issue.

You left off a link to an article.

A lot of medical providers in our area won't bill health insurance if it is related to an automobile accident because they don't want to take the write-offs even though they allege it is due to subrogation issues. It gets more complicated on the other side because some liability companies increasingly offer such low settlements that they now have their own law firms (as they own the law firm) to represent them they are in litigation so much (Yes I'm talking about you GEICO and Nationwide) because they don't even offer enough to cover damages and legal fees outside litigation. "Not our fault your client hired a lawyer" and "Not our fault your client doesn't have other insurances to mitigate his losses" are frequent refrains from them.

[DGUtley]

It's there -- click it. "medical billing..." will click.

[Common]

Another point to be made is that if you dont have insurance they will bill the entire amount and not accept less, thats just absurd

[Peter1469]

Another point to be made is that if you dont have insurance they will bill the entire amount and not accept less, thats just absurd

They accept less from insurers because they have long term business relationships.