AboutDoctor Settlement Expertise 27 years of front line plaintiff`s trial lawyer experience in PERSONAL INJURY INSURANCE CLAIMS. Along with other attorneys and insurance adjusters, we have created a website to help injured people settle their own personal injury claims. With the help from feedback from hundreds of satisfied members, www.settlementcentral.com has become THE AUTHORITY for Internet personal injury insurance claim settlements. I am humbled and honored if people can benefit from my experience and current volunteer work in helping injured people. I hope I can explain things in a manner that is useful for the questioner. If not, do not hesitate to e-mail me and I will take a second shot at it! Best Wishes for your physical and financial recovery.
Experience
Life Experience: 27 years of front line plaintiff's trial lawyer experience
Organizations: American Trial Lawyers Association (AAJ)
Washington State Trial Lawyers Association
Awards and Honors:
I am humbled and honored everytime I am selected to help injured people. And when people give feedback that they have benefited from my experience and current volunteer efforts, then that is a double honor and award for me.
Question My question concerns what figures counts as medical special damages when calculating a settlement? Is it the out of pocket amount I had to pay after my medical insurance? Or is it the actual cost of the medical care? My out of pocket figure doesn't represent the seriousness of my injury which entailed a trip to the ER, splinting, casting, xrays, multiple visits to the Orthopedic, etc. I want to be prepared to argue this if necessary.
Answer Hi Mary,
You will always claim the actual GROSS billing -- BEFORE ANY DISCOUNTS---assuming that your doctors will testify that the charges are BOTH reasonable and necessary as a consequence of the impact trauma your body suffered.
The tortfeasor does not get a discount because his victim had the foresight to buy insurance or because he or his agents worked a discount from the medical car providers.
The testimony that proves the value is from your doctor to the effect that her services AND her charges are BOTH reasonable and necessary. Normally we all assume that to be the case and the value of the claims is figured on the gross billing, before any discounts or waivers are allowed.
Now, as to what you actually will collect, there could be a fight if your state does not allow the collateral source rule. Most states DO allow that rule. The point of the rule it that the tortfeasor DOES NOT get to introduce testimony to the effect that your doctor waived some fees or that your insurance paid only part and you have no further obligations. Hence, in those states with the collateral source rule, you will collect the entire amount billed.
Since your insurer paid some of that billing in advance of your settlement, it is to be expected that they will put in a subrogation claim. http://www.settlementcentral.com/page0459.htm
Hence, you will pay back all that they paid up front, but you will retain your out of pocket payments. Does that make sense?
I trust that my extra time here has produced some information that has been of value to you, and thus I would respectfully request that you take the time to locate the FEEDBACK FORM on this site and leave some feedback for me.
