Personal Injury Settlements - Are Medical Bills Included in an Injury Claim

When someone files a personal injury claim, there are always medical bills involved. In fact, when the injured person retains an attorney, the first thing that the attorney will do is send his client to a physician. This physician is not just an excellent doctor; he is also well versed in working within the personal injury legal system.

Doctors:

The doctor that the attorney refers his injured client to will treat the patient until he has recovered. This physician will also send the patient to other doctors, specialists and medical providers such as orthopedists, burn specialists, plastic surgeons for scar repair, physical therapists, chiropractors and psychiatrists. These medical providers will report to the main treating physician.

Who is Responsible:

If the injuries occurred because of the negligence of another party, that party's insurance company is responsible for the plaintiff's doctor bills. If a driver of one car was hit by another car, then the car at fault would be responsible for the medical bills.

Comparative Negligence:

At times, one driver is primarily at fault, but the other driver contributed in a small way to the accident. This is called comparative negligence. In this event, the driver with the most liability will pay most of the medical bills. The other driver will pay a small amount of the medical bills. This is usually determined by the judge at the time of trial.

When are Medical Bills Paid:

Medical bills are paid out of the plaintiff's court award or settlement at the conclusion of the case. These expenses are paid before the plaintiff is paid. This is because the medical providers agreed to provide their services on a lien basis prior to ever seeing the patient. So, as soon as the doctor or pharmacy or physical therapist begins treating the injured plaintiff, he files a lien against the case and updates it each time he provides medical services to that patient.

When the plaintiff is done treating with a medical provider, that provider will file a final lien for all expenses that the plaintiff has incurred with him.

Settlement:

Any settlement of a personal injury case should always include any future medical care that the plaintiff will need. The settlement will already include the amount that the doctors and other providers will receive for treatment that has been previously given. Future medical care, however, can be a significant factor in the amount of settlement a plaintiff may get.

Trial:

At the trial, all of the medical bills are taken into consideration. The amount of damages in the plaintiff's complaint are factored into a winning verdict. If comparative negligence is found, though, not all of the medical bills will be paid by the defendant's insurance company. Some will be paid by the plaintiff's insurance company.

If the financial award in the case is not high enough to cover all of the medical bills, the plaintiff's attorney then negotiates with all of the medical providers to lower their bills. This process is called "negotiating a lien." Often times a medical provider with automatically take 20 percent off the top of the lien.

In the worst case scenario, there is a lot of comparative negligence on the plaintiff's part. If his insurance company decides not to cover 100 percent of the medical liens that have been assigned to the plaintiff, hard negotiations must be undertaken with the medical providers.

The process of negotiating "worst case scenario" liens is similar to negotiating a settlement. Both the plaintiff's attorney and the medical provider's agent go back and forth in the negotiating process until a figure is reached. Hopefully, in this event, the medical provider will at least receive payment for a portion of his services provided to the plaintiff. Of course, when a doctor, pharmacy or some other specialist provides services or products on a lien basis, they are always taking a risk of not being paid.