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. If you have questions regarding your particular situation, don’t hesitate to contact us for a free consultation. 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 bils from:
- Ambulance
- Hospital
- Health care facility
- Physician
- Doctor’s office
- 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 not be recovered, like compensatory and alternative medical treatment (e.g., herbal medicine, energy therapy, and ayurvedic medicine in some jurisdictions) 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 usually not recover for these medical expenses and in the second instance, you will recover 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. So, you want to make sure you are getting reasonable rates for your medical treatment. Ideally, you need an attorney who will make sure you receive reasonable treatment, with fair medical bills, and eventually obtain full compensation for all your medical and other bills, other economic and non-economic damages.
Don’t wait—schedule your consultation.
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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 or does not want to 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.
Some may argue that there may be certain hurdles to overcome with medical liens. For instance, you will need to find a medical professional who is willing to provide continued treatment on a lien basis—meaning treatment is provided without immediate payment, with the understanding that the bill will be paid from a future settlement or judgment. Again, this situation often arises when an injured person does not have sufficient funds to cover treatment and either lacks health insurance or has an insurance policy that does not adequately cover the necessary care. A resourceful personal injury lawyer in Los Angeles, however, can often help locate medical professionals who are willing to treat patients on a lien basis. Your attorney may be able to explain the circumstances of the accident and the available insurance coverage, which can help the medical provider evaluate whether to agree to such an arrangement.
If your claim is successful, you’ll be able to obtain compensation for all economic losses, plus non-economic damages. This is why it is particularly important to retain the right personal injury attorney—someone who will work to pursue the full compensation available under the circumstances. The goal is to ensure that medical expenses and other losses are properly addressed, that medical providers are satisfied, and that you receive fair compensation for your pain, suffering, and other damages.
The good news is that medical liens can often be negotiated in California, and an experienced personal injury attorney may be able to negotiate those liens in a way that benefits you.
In sum, medical providers may issue bills for the treatment they provide, resulting in an outstanding balance that is ultimately negotiated and paid from the settlement or jury award once the case is resolved. At that point, you can receive your part of the settlement as compensation for the damages you have suffered.
The Difference between Subrogation and Medial Liens
Many people think that health or other 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 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 or the provider will waive the medical bills. 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 hospital 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. The health insurance company will then 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 especially medical liens—can be complicated and may create additional stress during an already difficult time. In addition to consulting with you and professionally handling your legal case, we can connect you with a healthcare provider in Los Angeles who is willing to treat you on a lien basis. In the meantime, you can focus on your recovery and your treatment while we remain committed to pursuing the best possible outcome for your case.
