Getting Compensated for Medical Bills in Personal Injury Claims

Arizona law related to personal injury cases can be confusing and there is often at least some case law supporting both sides to every argument made by both plaintiffs or defendants.  For example a defendant's insurance company might argue that a plaintiff in a personal injury case may only recover the reasonable value of all medical services received, not the total bills paid. See Larsen v. Decker, 196 Ariz. 239, 995 P.2d 281 (App. 2000).  However, Arizona law does not clearly define what is considered reasonable value.

Unfortunately, more insurance companies are arguing that they will not compensate injury victims for the full extent of their medical bills based on the "reasonable value" of the treatment they received.  This could leave an injury victim paying more for their medical treatment than they will recover from the insurance company after an accident.  Example: a medical provider charges an injury victim $50,000.00 for medical treatment provided after an auto accident.  The victim is obligated to pay this bill regardless of any recovery from the insurance company.  Later the victim files a claim with the at-fault party's insurance company only to have the insurance company calculate their own value for those same services, essentially arguing that the medical provider is charging too much.  This leaves injury victims between the proverbial rock and a hard spot.  Even if the victim has health insurance the insurance company's offer may not be enough to cover both the costs paid and the health insurance provider's lien.  Let Budge Law Firm, PLLC help you get full compensation for your injuries and resolve all outstanding liens. 

  1. A) Standard. Damages for past medical expenses are virtually always included in tort cases to restore the injured individual to a financial position substantially equivalent to the position he would have occupied had he not been injured. Future medical expenses require a showing that there is a reasonable probability such medical expenses will be incurred, and may require additional proof of the reasonable value of services rendered by physicians, medicine, consultants, etc. Lewis v. N.J. Riebe Enters., 170 Ariz. 384, 397 (Ariz. 1992); see also Griffen v. Stevenson, 1 Ariz. App. 311, 315, 402 P.2d 432, 436 (1965).
  2. B) Full Amount of Medical Expenses. In Lopez v. Safeway Stores, Inc., 212 Ariz. 198, 129 P.3d 487 (App. 2006), the court of appeals held that an injured plaintiff was entitled to claim and recover the full amount of her reasonable medical expenses the health care provider charged, without any reduction for the amounts apparently written off by her physicians pursuant to contractually agreed-upon rates with her insurance carriers. In other words, the plaintiff was entitled to claim the full amount of the billed medical charges, even though neither she nor her health insurer would ever have to pay the full billed amount.
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