What you need to know about medical expenses at trial
Medical bills are like the sticker price on a car—very few people pay the full amount. Yet, when your trucking company is sued, the full price of the medical bill is too often used as a barometer of the case’s value.
Plaintiff’s attorneys inflate the medical expenses by steering clients to favorable medical providers. Their clients proceed down an assembly line of treatment—initial exam, physical therapy, chiropractor, MRI’s, and injections with bills accumulating with each step.
They do it to “blackboard” the expenses at trial. They use these numbers as a starting point for their other damages such as “pain-and-suffering.” Plaintiff attorneys also know that insurance companies usually look at the medical expenses as a “given” that will be awarded by the jury.
Medical bills are not a “given”. You can fight back.
First, state laws often limit the amount of medical bills recovered, if not totally bar recovery. For example, in Pennsylvania a plaintiff may not recover the amount paid by their PIP carrier or by a health insurer that is not part of an ERISA plan. Other states similarly bar recovery of PIP paid medical bills.
Second, the law in many jurisdictions permit defendants to show the jury the amount actually paid to the medical provider rather than the amount billed. This is usually a substantial difference. The difference is the plaintiff’s insurance company’s negotiated rates or government programs at a fraction of the charge.
Third, you can fight the reasonableness of the amount of a medical bill. Usually plaintiffs support this evidence at trial by having one of their treating doctors testify that the bills of all of his treaters were “reasonable”.
How does that doctor know? What qualifies the doctor to give that opinion? Targeted questioning of the doctor can undermine the doctor’s qualifications and knowledge and challenge that evidence.
We can present evidence that the bills are not, in fact, reasonable. We do this with the testimony of a medical economist. This expert possesses real knowledge of medical pricing rather than doctor of one specialty lacking such knowledge.
A medical economist can access billing data bases within specific geographic areas. He can present data as to what the average charges are for specific medical procedures in that area. He can address hospital charges by analyzing data as to their costs and add an average profit margin.
This data-based evidence is stark contrast to the anecdotal testimony of a treating doctor who lacks the overview or information.
Using this methodology, medical economists can reduce amounts of the medical expenses by 40%-60%. This is big where the valuation of cases by plaintiff attorneys, insurers, and juries are driven by the amount of medical expenses.
Medical bills are a key item in personal injury lawsuits. You can—and must—challenge them.
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