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How Are Future Medical Expenses Calculated In A Personal Injury Settlement?

With respect to future medical care, it is handled by medical expert advice, usually in the form of a letter stating the nature of your injuries and what type of medical care you are going to need in the future because of your injuries. The medical doctor will look at your life expectancy and do costs projections whenever they can and put it in the narrative letter to your attorney.

Future medical care may then have to be analyzed by another expert to determine the value of that future medical care because most doctors do not have a grasp on the specifics of the value of future medical care. Sometimes you will have to have someone else look at the codes used by the doctors for the different medical treatments recommended and assign a dollar value for your particular codes on future medical care.

Should Someone Pay The Medical Bills As They Come In Or Should They Wait For The Claim To Be Resolved Before Paying The Bills?

Generally speaking, you want those bills paid as they come in. Most people have a health insurance policy or an auto medical pay policy that will pay for the medical bills, but if they do not have either and if they can pay their medical bills as they are coming in, they can help avoid some of the problems at the time of the settlement. It becomes a bit more problematic when the medical bills become outstanding and you have to negotiate with healthcare providers over the division of the settlement proceeds.

If your medical bills get written off when you don’t or can’t pay your medical bills, the bills do not get the full value of consideration by the insurance company when determining the value of your case. When the healthcare provider has written off the bill, you do not get the full value of that bill when considering the total value of your case. So if you can afford to pay the bill, it is always better to go ahead and pay it avoiding collections and dealing with this issue while you are trying to recover.

When Do Clients Discover That The Parties Involved In The Settlement Get Recompensed?

Compensation is dependent upon the nature of the right of reimbursement or the lien that is being claimed under Kansas law with a typical automobile accident case. We usually see three types of liens asserted. One is the no-fault lien carried by your own auto insurance policy that has a right of reimbursement if your recovery is a full recovery from the person who caused the accident. It is a lien that is negotiable with insurance companies. In so many cases, that lien is waived or reduced substantially.

The second type of lien we often see is the hospital lien, which under Kansas law is subject to a determination by the District Court. If you have a situation where you do not recover fully all of the damages you sustained in that accident and your hospital lien is larger than $5000, then you can go to court and have a judge decide whether it is fair to have the hospital take a substantial portion of your personal injury settlement.

The third type of lien is an ERISA claim/lien, which is a claim held by a self-funded insurance plan that looks and acts like a healthcare plan which has paid part of the medical bills from your automobile case. They will often assert a right of reimbursement from your personal injury settlement, and you need to have a lawyer carefully look over the plan to determine under the law whether this is enforceable because there are many different plans with different verbiage that has to be looked over by an experienced lawyer. Your attorney should be able to determine whether the plan has language in the self-funded health plan that allows for reimbursement. In those plans, the first thing a lawyer does is determine whether the plan is, in fact, self-funded or just like every other insurance policy. If it is a true health insurance policy under Kansas law, then there is no right of reimbursement under Kansas law and that lien can be defeated. Therefore, anytime you are dealing with an ERISA plan, you need to consult with a lawyer because those are quite complex plans that need to be evaluated very carefully by an experienced attorney.