Yes! You can Recover. However, that recovery may be limited depending on the facts of the treatment surrounding your personal injury case.

In a Car Crash or personal injury case in Indiana, the person making the claim (a.k.a. Plaintiff) is able to present evidence of the medical expenses when presenting their claim for Damages. Some Plaintiffs and Attorney never present medical bills as part of their claim for a host of reasons including concerns, they might reduce any possible jury verdict or confuse the issues for the jury. Every case is very different and when considering the reasonable value of the medical expenses in a personal injury case, a number of factors must be considered.

What does the Law Say?

When determining the value of medical services, plaintiffs can present the total billed amount of those expenses per Indiana Rule of Evidence 413, and defendants can present the total amount paid for those services without referencing insurance in any way. According to the common law collateral source rule, and as defined further in IC 34-44-1-2, defendants cannot introduce any evidence of payments made by a third party, or the United States government, or an insurance company. Defendants may, however, introduce reduced bills for the plaintiff so long as they do not mention the bills were reduced because of the payment of insurance premiums. This issue of reduced billing was litigated in the case Stanley v. Walker 906 N.E.2d 852.

However, how does one determine the reasonable value of these services when the plaintiff’s medical bills have been reduced not because of insurance, but through uninsured discounts, hardship adjustments, or charitable write-offs by medical providers?

Indiana courts have long litigated the issue of what constitutes a reasonable value of medical services provided. Under Indiana common law, as set out in the cases Herrick v. Saylor and Brosnan v. Sweetser, a plaintiff is entitled to recover the reasonable value of medical services provided as a result of the injury/injuries caused by the defendant, even if the medical services were provided gratuitously. In Herrick, the court stated that, “The measure of damages for medical services is not, therefore, the actual expenses incurred, nor is it the actual amount paid for such services.” Herrick v. Saylor 160 F.Supp. at 28.

In the case Brosnan v. Sweetser 26 N.E. 555, the plaintiff was treated by her brother and sister, both of whom were nurses with several years of experience. The doctor who had treated her initially testified to the reasonable value of the treatment provided by the siblings, even though they had not charged the plaintiff for their services. The court held that when the defendant is liable for the plaintiff’s injuries, it does not matter if the plaintiff did not have to pay for treatment at all or paid ten times the actual value of such services provided. The plaintiff can only recover the reasonable value of the services. The court further stated that plaintiff could have a doctor testify as to the reasonable cost of the services provided because the doctor had knowledge of the reasonable cost of those services.

Where the defendant is liable for the injuries to the plaintiff, the remedy for medical expenses is the reasonable value of such treatment provided for injuries related to the accident or occurrence. According to the collateral source rule, as defined by case law and further established by statute, collateral benefits received by the plaintiff are likely not admissible. An uninsured discount, write-off, or hardship adjustment would likely be a collateral benefit that the plaintiff received from a third party. If so, this would not be admissible to determine the reasonable value of the services provided. Defendants may introduce evidence to show what they believe the reasonable cost of medical services provided is, including what was actually paid for the services, but they cannot mention insurance, or any benefits provided to the plaintiff.

What does this all mean? How will it impact my case?

First, keep in mind that you are dealing with and insurance company on the other side. Their basic business model is to collect as much as they can in insurance premiums while simultaneously limiting the amount of money that they pay out in claims.  If they can limit their exposure with regards to medical expenses, then they will certainly take advantage of that.

Additionally, be ready for the Defense to raise this issue and argue that your medical bills should be less than what you are claiming they are. As a matter of fact, most insurance companies completely disregard the Law which states that both numbers (billed and paid) are admissible. The insurance companies then base all offers and settlements on the reduced medical bills because it again fits their business model.

Finally, you should retain an experienced litigator and trial lawyer to protect your rights as they pertain to the car accident or personal injury. Our Legal Team at Hurst Limontes LLC has years of experience handling these complicated legal questions. Please call us for a free consultation at 317-636-0808.