Medical Bills & Liens in Injury Cases
Getting injured in an accident, regardless of how small or great it is, is always a setback. There are likely medical bills, and sometimes medical liens are placed. When you file a claim or a lawsuit for the costs of your injuries, these medical bills and possible liens will matter with great respect to how much you actually receive in terms of compensation after a settlement or award verdict. Particularly with liens, you may put yourself at risk if you don’t understand all the ins and outs.
We believe that informed clients make the best decisions for themselves and their recovery. Here, you’ll find more information about medical bills and liens related to personal injury claims. When you are ready, contact us. We will then help you find the best attorney for your circumstances. Keep in mind that a successful case depends on you being informed as much as it depends on the attorney you hire to advocate on your behalf.
What are Medical Bills & What Should You Know About Them?
Medical bills include all the medical expenses an injured party must put forth to treat injuries. Medical bills can include but are not limited to:
- Ambulance bills
- Hospital bills
- Health care facility bills
- Doctor bills
- Chiropractic care
- Physical therapy
- At-home care
- Medicine
- Medical transportation
- MRI, CT Scan, X-Ray, Blood Test, and any other diagnostic testing
- Other.
Medical bills are used to help directly determine the value of economic damages and indirectly determine the value of non-economic damages. Medical bills that can be recovered via a settlement or jury award include:
- Medical bills personally paid by the victim;
- Medical bills paid by insurance company; and
- Medical bills that have not yet been paid (i.e., outstanding bills).
To qualify for compensation, past and future medical expenses and treatment must have been or will be reasonably necessary. Any treatment or medicine that is not reasonably necessary will not be recovered. Reasonably necessary means:
1. Any provided medical care was necessary due to injuries sustained in an accident at-issue; and
2. The medical care is customary for the injuries.
In effect, a jury can render an award for damages but not cover the final sum of all your medical bills. There are some treatments that will typically never be recovered, like compensatory and alternative medical treatment (e.g., herbal medicine, energy therapy, and ayurvedic medicine, etc.) There are also traditional, mainstream treatments that may not be compensable because they were not needed for the specific injury, or the bill for the treatment was inflated. In the first instance, you will not recover for these medical expenses and in the second instance, you will recover only what is reasonable.
Keep in mind that personal injury damages are valued based on the services provided by the medical providers and not what you paid for those services. So, you want to make sure you are getting the best rate for your medical treatment because higher medical bills will not necessarily render higher settlement or verdict awards, and if the compensation doesn’t fully cover the medical costs, you are liable for the remainder. You need an attorney who will make sure you receive fair and full compensation for all your medical bills.
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What are Medical Liens & What Should You Know About Them?
A medical lien is basically a guarantee to a lienholder that it will recover the cost of medical assistance provided and associated with a personal injury case. A medical lien is invoked when health care professionals, providers, or facilities have not been paid for the services they provided at the time of the injury or are not paid for services they continue to provide for a personal injury. Medical liens are granted easier in situations where the patient either:
1. Does not have private health insurance, auto insurance, ERISA, Medicare, Medi-Cal, Med Pay, or another type of insurance to cover the costs;
2. Has insurance but cannot pay the out-of-pocket costs of co-pays or deductibles; or
3. The medical provider does not accept the health insurance coverage that the patient has.
A medical lien is an agreement between you and the medical provider––so, it’s a legally binding contract. After the medical lien is entered into by the parties, a lien must be “perfected.” According to California Civil Code § 3045.3, perfecting a lien means that written notice is provided to the liable parties, responsible insurance companies, and all interested parties.
There are two things to keep in mind about medical liens in California:
1. Medical liens can be risky but they are negotiable; and
2. Medical liens do not involve insurance companies––that’s another process known as subrogation.
The Risks of Medical Liens
The real risk of medical liens comes with not having enough to cover them and ending up with nothing for yourself. The first issue arises with finding a medical professional who will agree to a medical lien in order to provide continued services for an injury. This is often the case when a patient/victim doesn’t have enough money to cover the treatment and either doesn’t have health insurance or the insurance policy either doesn’t adequately cover or doesn’t cover the treatment. A resourceful personal injury lawyer in Los Angeles, however, can help you locate a medical professional who will agree to treat you. Your lawyer may be able to reassure the medical professional that
- you were not at fault; and
- someone else caused the injury due to negligence, gross negligence recklessness, intent, or strict liability.
The second issue is this: there’s not much in the way of oversight on medical services, the costs of the latter, and associated medical liens. This can materialize into two situations: (1) the medical provider over-charges for services; and/or (2) the medical provider over-treats the injuries. Keep in mind that the costs of medical treatment under medical liens often tend to be much higher than if a health insurance company paid the costs.
The third issue arises when you don’t succeed in obtaining fair compensation or any compensation. In the first instance, you may not have enough to cover all the costs of the medical treatment, and in the last instance, you won’t have any funds to cover the costs. Now, the medical providers may come after you personally. This is where and why it is particularly important to retain the right personal injury attorney in the Los Angeles area who will fight for just and fair compensation so that, at the end of the day, all past and future costs are paid and/or waived, medical providers are satisfied, and you still end up with a fair amount of the settlement to be reimbursed for your pain, suffering, and all other damages you suffered.
Also, the good news is that medical liens can be negotiated in California, and a good personal injury attorney will be able to do so in your favor. In many cases, the medical provider will provide you with bills for the treatment, which will result in an outstanding bill that is paid upon settlement or jury award. But remember: it’s best to enter into a medical lien if it is necessary given the risks involved.
The Difference between Subrogation and Medial Liens
Many people think that health insurance companies can agree to medical liens as well, but that’s not the case in California at least. Insurance companies––like Medicare, Medicaid, auto insurers, healthcare insurers, and workers’ compensation insurance––go through a process known as subrogation and not medical liens. Subrogation is often referred to as a reimbursement provision in a person’s insurance policy. When an insurance company covers the costs of your medical treatment, the State of California allows it to reserve the right to reimbursement if you receive a settlement or an award against the liable party. To note, under California’s subrogation law, insurance companies can intervene or sue the liable party for property damage but not personal injury cases, and that’s why subrogation clauses are popular in California.
Example 1: Medical Lien for Emergency Care
Imagine you were in a bad car accident and whished away from the scene to the Emergency Room (ER). You don’t have adequate health insurance, but the ER treats you for broken bones and traumatic brain injury (TBI). The hospital knows you were in a car accident. It enters into a medical lien to cover the costs of emergency care. After your case is settled or won at trial, the ER will receive reimbursement for services provided when you receive any funds from the settlement or verdict.
Example 2: Medical Lien for Ongoing Care
Imagine all the same facts above, but after your release from the ER, you must still undergo treatment, including a follow-up with the orthopedic and therapy for the TBI. You, however, are underinsured for the treatment. You must find a health care provider who will sign a medical lien that basically states he or she will be reimbursed for the services through any settlement or verdict, and if there isn’t a settlement or verdict, the patient will cover the costs. You enter the costs of the treatment as evidence and submit to the liable party or insurance company for payment.
Example 3: Subrogation
Imagine now that you were in a truck accident and the ER treated your injuries. You have health insurance and it covered most of the medical bills associated with your personal injury. When you present claims to the at-fault party, you include the medical bills as evidence of damages. You will be paid the costs of treatment, in addition to the pain, suffering and all other damages, but the insurance company must first be reimbursed for what it paid.
Retain a Smart, Trusted Personal Injury Lawyer in Los Angeles Today
If you have received medical treatment after a personal injury caused by another person or entity, contact us today. Medical bills and liens––especially medical liens––can be tricky and cause you more pain than anticipated. We will connect you with a personal injury or medical malpractice attorney in Los Angeles who knows the law, understands how medical bills and liens work, and is committed to getting you the best outcome possible.
