Personal Injury Case Billed vs PaidI’ve been litigating personal injury cases across North Carolina for thirty years and have met with a lot of potential clients. At our first meeting, I do my best to learn as much as I can about their accident and how the accident impacted them and their families. I then explain what the law allows them to recover for their injuries, including payment of medical bills.

Up until October of 2011, the discussion of medical bills and the amount recovered for them was pretty simple. That is not the case now.

How Does North Carolina Law Affect Personal Injury Compensation?

A North Carolina law that took effect for accidents occurring on or after October 1, 2011, commonly referred to as “Billed vs. Paid”, changed the way accident victims are compensated for medical bills they incur as a result of an accident.

Instead of being allowed to recover the actual amount billed by a medical provider, accident victims are now limited to “the amounts actually paid to satisfy” the medical bill “regardless of the source”. (Rule of Evidence 414)

The change in the law means that if you use your health insurance, Medicare benefits, or Medicaid to pay all or part of your medical bill, the insurance company for the driver that hit you will pay less in medical compensation. As you will see, that change can have a significant effect on the value of your entire personal injury claim.

For example:

Let’s say you were in an accident and were taken to the hospital emergency room. You give the hospital your health insurance information. The hospital bills you $5000 for your treatment and submits the bill to your health insurance carrier. Given reimbursement rates from the insurance carrier, the hospital does receive $5000 in payment from the health insurance carrier. The health insurance carrier typically pays a substantially discounted amount to satisfy the $5000 bill.

In our example, we’ll say they pay $1000 to satisfy the $5000 bill.

Prior to the law change, if we filed suit and took your case to trial, you would be entitled to put the $5000 charge into evidence as the amount of your medical bill from the hospital, regardless of whether it was paid by health insurance, Medicare, or Medicaid. After the law change, your evidence of hospital medical expense would be $1000, or “the amount actually paid to satisfy” the hospital bill.

Under Billed vs. Paid, therefore, your case’s value would be reduced by at least $4000. I use the term “at least” because the amount of your medical expense would likely have some bearing on how much a jury thought your total case was worth, including damages for pain and suffering.

Why Would a Jury Base Pain and Suffering Compensation on Medical Expenses?

In my experience, some jurors, consciously or subconsciously, consider that the amount of pain and suffering damages you are entitled to is tied to how much you had to spend to “get better” in terms of medical expense.

In their minds, therefore, if you had to spend $5000 to “get better” you probably would have had more pain and suffering than if you had only had to pay $1000. Jurors who reason this way on the issue of pain and suffering are by no means the norm, thank goodness, but their presence on a jury certainly can have an effect on the final decision of the entire jury because verdicts have to be unanimous.

Let Our Experienced Raleigh Lawyers Review Your Personal Injury Case

The above phenomenon is all the more reason to hire experienced counsel in a personal injury case. The current state of the law requires North Carolina attorneys to work even harder to make sure jurors understand the extent to which a person was affected by an accident, regardless of the amount of medical expense.

In order to do that effectively, an attorney needs to get to know the client, talk with the client’s family, friends, and employer, and do whatever other leg work is necessary to show a true picture of an accident’s consequences to that client.

If you or someone you know is seeking that experience in their own personal injury case, feel free to give our Raleigh law office a call at 919-615-2473 or request a case review. Our initial consultation is free.

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Joe is an experienced personal injury and NC land condemnation lawyer in Raleigh. He also handles medical negligence cases in Wendell and Raleigh.