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Proposed legislation to help at fault drivers: Billed vs. Paid

As the tort reform debate continues in the North Carolina Legislature, one of the most controversial and seemingly difficult to understand issues for legislators is the concept of bill vs paid. What that involves is a push by the major automobile insurance companies to not allow a hurt person to put on evidence of ALL of their medical expenses if they have some additional way to pay the same or if they would not all have to be paid back. One easy example is when a state employee is injured in a car collision and goes to the emergency room and to their primary physician for several visits they have “incurred” $2,500.00 in medical expenses. Under bill vs. paid, the amount the State Health plan has negotiated as a reduction with the hospital and the other providers in exchange for the provider getting paid by the health plan would come out of the amount. Of the $2,500.00 20% would be “paid” or owed by the state employee as a deductible and 80% would be the responsibility of the state health plan. Due to the amount of bills that are paid by the state health play the plan may only have to pay 50% of the 80% to satisfy that debt in full. Under bill vs. paid the state worker would not be able to present the 30% reduction to the jury as an incurred medical expense as it would not be actually “owed”, the state worker would STILL have to pay the state health plan back out of any recovery the 50% they “paid” for the medicals. Who benefits from the billed vs. paid option? Doesn’t it make sense not to pay for what is not actually “owed”? In reality the only one who benefits is the at fault party and their insurance company. The not at fault party – the victim–gives to the defendant (the one who caused the problem in the first place) their benefit in having purchased insurance or had a good enough job to purchase insurance in exchange for nothing… The drunk that ran head on into the family of four on the way home from the circus gets the benefit of the parents having good jobs? Who of the two of them should get that benefit? If there is no health insurance then the bill is owed in full. Why is a system that rewards those who are at fault good for us? The short answer is that it is not good for the victim and quite frankly the only benefit is for the insurance company who represents the drunk driver and whose identity in North Carolina is never mentioned during trial. Yes, that is correct, if the defendant drunk driver has auto insurance who will pay his bill, it is illegal to mention that during a trial, but the fact that the injured person is hard working and has purchased their own insurance is admissible…

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