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Medical Expenses in Automobile Cases: New Law

On Behalf of | Nov 11, 2011 | Civil Trial, Legally Speaking, Personal Injury

As of October 1, 2011 many citizens of North Carolina will no longer be able to recover the full value of their medical expenses if they are injured in an automobile collision.  The North Carolina General Assembly has passed HB542 and SB 586 and it is now the law in North Carolina.  Rule 414 Evidence of medical expenses. Evidence offered to prove past medical expenses shall be limited to evidence of the amounts actually paid to satisfy the bills that have been satisfied, regardless of the source of payment, and evidence of the amounts actually necessary to satisfy the bills that have been incurred but not yet satisfied. This legislation hurts the average middle class citizens who works and has health insurance by giving any negotiated write-off between their health insurance company and their doctor to the at-fault party.  This change allows an injured person to only put on evidence of the actual amounts PAID on the bill regardless of who paid.  If the victim of any negligence is hard working and has as a result of their job health insurance the at fault person such as a drunk driver gets the benefit of this hard work and is allowed to reduce the amount submitted to the jury by the amount of the insurance reduction. 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.  The unreasonable portion of this bill is that those without health insurance recover the full amount of the bill with no reductions.  In reality the only one who benefits is the automobile insurance company.  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 against the evidence rules to mention that during a trial, but the fact that the injured person is hard working and has purchased their own insurance is admissible…  Thus, if you or a close friend or relative has the misfortune of being injured in North Carolina after October 1, 2011 the one who injured you will be granted some of your benefits.


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