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How Does Compensation for My Medical Bills Work in My Motorcycle Accident Case?

  • Last Updated: December 27th, 2022
  • By: Mike Grossman
  • Motorcycle

Compensation for medical bills following a motorcycle accident.

The typical car accident collision will leave the occupants of the vehicles relatively unharmed, especially with the litany of safety features available today. But, motorcycles are a whole different story. Even minor collisions can leave a motorcycle rider with severe injuries and gigantic medical bills. Our attorneys know what negligent drivers have done to affect the lives of motorcycle riders all too well, and have the experience to get you the compensation you deserve.

In this article, we'll explain how our attorneys can help you to get your medical bills covered following a motorcycle accident.

Questions answered in this article:

  • How does compensation for my medical bills work in my motorcycle accident case?
  • What are some hurdles to getting my compensation for my bills?
  • Am I paid the full amount of my medical bills, even with insurance?
  • How will an attorney help me get compensation for medical bills in my motorcycle accident case?

How compensation for medical bills works.

Rather than rattle off legal statutes and case law, we'll explain in general terms how compensation for medical bills works. The best way to explain this is to cover two hypothetical scenarios. One scenario we'll explore is when the insurance coverage of the negligent driver is more valuable than the your medical bills, and another where your injury costs are more than insurance money available. Also, for simplicity, we'll pretend that medical bills are only thing you can sue for under Texas law, when in fact, there are many other damages you can sue for.

Scenario One: When the insurance coverage is more than the injuries.

Imagine than Bob is riding motorcycle and a car pulls out of a driveway and cuts him off, resulting in him running into the side of the car. He ends up suffering major injuries as a consequence. Imagine that driver has $10 million in insurance and Bob has $150,000 in medical bills. Again, pretend Bob is only suing for medical bills. So Bob just calls up the negligent driver's insurance carrier and they give him the full $150,000 right? Not exactly. $150,000 may be the total market value for Bob's bills, but it doesn't mean it is the court value for his medical bills.

There are a few different reasons why the court's value may differ:

  • First, liability insurance carriers are allowed to argue that the person that their client injured got more medical treatment than was needed or that they were charged too much. In Texas, the plaintiff has something called "duty to mitigate damages". This duty says that you'll get the medical attention you need and not overpay for that medical attention. So, if an insurance carrier suspects Bob of foul play by seeking treatment from most expensive doctor in town, or getting unneeded treatments, the insurance companies can argue that Bob failed to mitigate damages and refuse to pay. The chances are that the insurance company will argue that even if the medical bills are actually reasonable.

    The second reason is due to court procedure. Imagine if Bob took the case to trial but left all of his evidence (bills) at home. You can imagine that a jury would have no idea what to award him because he can't prove how much his bills were. It is much like trying to return an item to the store without a receipt. You may be thinking,"Well that's not a problem, as long as Bob brings medical bills".

    Well, under Texas law, the only evidence allowed to be brought into court is that which is deemed admissible. How are medical records deemed admissible? In order to keep people from bringing in fraudulent medical records into the courtroom, Texas law requires that all medical bills be proved up with an accompanying affidavit from the medical provider. In this affidavit the medical provider swears under penalty of perjury that all amounts shown in the bill are true and accurate and the recipient of the treatment required that treatment.

    So, in other words, there is only one right way and an infinite number of wrong ways to submit your bills to the court. So, if Bob is not familiar with Texas court procedure and the rules of evidence and he therefore neglects to properly prove up his medical bills, it has the same effect as if he had just left his medical bills on the kitchen counter. The jury will never know that those medical bills exist unless they are deemed admissible. Most people are unfamiliar with court proceedings. So when they choose to represent themselves, they don't go through this step and the insurance carrier gets a telltale sign you don't know what you're doing off the bat.

  • The "Paid and incurred rule":

    The the case of Haygood v. Escobedo, a jury paid Escobedo for his full medical bills that he presented the jury as evidence. But, it was later determined his health insurance carrier already paid half of his bills, which would mean that Escobedo was actually personally responsible for half of that amount and had been compensated for the full medical bill amount.

    The Texas Supreme Court determined that it is unfair for the defendant to pay for the full market value for Escobedo's medical expenses, when he was only financially obligated to pay for half after insurance.

    This is an important thing to keep in mind: Any compensation for medical bills is subject to reduction based on the paid and incurred rule.

    Let's go back and apply this rule to Bob's case.

    His medical bills may be $150,000, but, there are ways that insurance companies can pick it apart. Perhaps his medical insurance picked up $75,000 of his medical bills and under the paid and incurred rule, his compensation would likely be closer to $75,000 due to him being financially responsible for paying only that amount out of pocket after insurance.

Scenario Two: When insurance coverage is less than the injuries.

In the above scenario, we explained that even if the negligent driver had all the insurance money in the world, the court can still can still restrict his damages if he doesn't know how to navigate through the case. Things get even more dire when there is a limited amount of insurance available.

Let's say that the negligent driver had only $100,000 worth of coverage, leaving Bob searching for a way to pay for the other $50,000. Bob is not totally out of options here. We can look into finding different insurance policies or look into the bad guy's assets to get Bob the compensation he deserves. We could also negotiate reductions for Bob's medical bills from the medical provider, meaning more of the settlement money will go into his pocket. Even if there isn't enough insurance to cover Bob's medical costs, there is still a lot an attorney can do so he can get the most compensation under his circumstances.

Our attorneys have the experience needed to fight big insurance companies.

We go out of our way to carefully negotiate for medical bills, because they usually are the largest financial burden on our clients. This means that we'll go to bat against the negligent driver's insurance company and even negotiate with your health care provider to lower your bills if they've gotten out of hand. Call: (855) 326-0000. If we don't win your case, you don't owe us a cent.

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