Can someone sue for the entire cost of medical bills if the insurance paid for most of it? 31 Answers as of February 17, 2012

Can someone sue for the entire cost of medical bills when their insurance paid the majority of them and they only paid $50 out of pocket for co-payments?

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Patrick M Lamar Attorney
Patrick M Lamar Attorney | Patrick M Lamar
No. You may sue for the entire amount but can only recover that amount you have paid or may be obligated to pay. This means the subrogation interest. You need to discuss this with a local attorney.
Answer Applies to: Alabama
Replied: 10/5/2011
Eftekhari Law Offices
Eftekhari Law Offices | Ehsan Eftekhari
Yes. However, you have to have an expert testify that the difference was fair, reasonable and customary.
Answer Applies to: Illinois
Replied: 9/19/2011
Paul Whitfield and Associates P.A.
Paul Whitfield and Associates P.A. | Paul L. Whitfield
Yes, but Oct 1st the legislature is changing the rules. If you are going to do it, do it before Oct 1 so there is no question.
Answer Applies to: North Carolina
Replied: 9/19/2011
Kelaher Law Offices, P.A.
Kelaher Law Offices, P.A. | James P Kelaher
You can and should sue for the entirety of the medical bills, but your health insurer will undoubtedly ask to be reimbursed for whatever they paid for which you were reimbursed.
Answer Applies to: Florida
Replied: 9/19/2011
The Law Office of Josh Lamborn, P.C.
The Law Office of Josh Lamborn, P.C. | Josh Lamborn
Yes. If you are negligent and you injure someone and that person uses their own insurance to pay for their medical bills, you are liable for the entire amount to pay back their insurance. Why would you get the benefit of the insurance that they paid for? If you had insurance to cover your negligence, then your insurance would indemnify you by paying the other company back. If you do not carry insurance, then you are personally liable for your negligence.
Answer Applies to: Oregon
Replied: 9/19/2011
    Ewusiak & Roberts, P.A.
    Ewusiak & Roberts, P.A. | Christopher J. Roberts
    It is quite common that a person in an injury lawsuit seeks recovery of all medical expenses including those covered by insurance, because the insurance companies generally demand repayment of their money if the person recovers from the at fault party. Sometimes insurance companies even become part of the lawsuit, but it is not necessary for them to do so in order to seek compensation as part of the lawsuit. They generally will assert a lien against their insured, which the insured has to pay out of any settlement or judgment. So unfortunately if you are the defendant in this situation, the attempt to seek recovery of all the medicals is possibly legitimate even though the injured person only paid $50 out of pocket. Something you can argue, however, is that the person should not be allowed to recover more than the insurance company actually paid. Sometimes doctors charge a much higher amount on the bill then the insurer pays. If the doctor accepted the lower insurance payment, the plaintiff generally cannot recover for an amount above that. There is some conflicting law on this point, but it's something to keep in mind.
    Answer Applies to: Florida
    Replied: 2/17/2012
    The Law Office of Stephen R. Chesley, LLC
    The Law Office of Stephen R. Chesley, LLC | Stephen R. Chesley
    You cannot sue for the medical bills if they were paid. However if it is determined that there a personal injury action you can sue for your pain and suffering. To determine if you have a personal injury action we need to have information,
    Answer Applies to: New York
    Replied: 9/19/2011
    Wooten, Kimbrough & Normand, P.A.
    Wooten, Kimbrough & Normand, P.A. | Council Wooten
    We have to deal with this is in almost every caseThe answer varies with the type of insurance , the insurance policy language , certain Florida and Federal statutes, regulations, and case law interpretationswe cannot give a detailed or definte answer because of these many factual and legal issues that must be considered.
    Answer Applies to: Florida
    Replied: 9/19/2011
    Cody and Gonillo, LLP
    Cody and Gonillo, LLP | Christine Gonilla
    yes and if there is a trial the judge will set off the amount of the medical paid by insurance after the jury has made the award.
    Answer Applies to: Connecticut
    Replied: 9/19/2011
    David F. Stoddard
    David F. Stoddard | David F. Stoddard
    You don't mention what kind of case it is or what type insurance paid. If it is a personal injury case, and health insurance paid the bills, you cn sue for the entire bill, but you usually have to reimburse the health insurer for what it paid.
    Answer Applies to: South Carolina
    Replied: 9/19/2011
    Bernard Huff, Attorney/Mediator
    Bernard Huff, Attorney/Mediator | Bernard Huff
    The insurance company is entitled to andcan seek rhrough subrogation the sum it paid to its insured less the deductible $50 amount. Its insured is not entitled to a double compensation.
    Answer Applies to: Indiana
    Replied: 9/19/2011
    Law Office of Jared Altman
    Law Office of Jared Altman | Jared Altman
    Yes, they can sue. But under the "collateral source" rule you are entitled to show that it was reimbursed in whole or in part and have any recovery reduced accordingly. It is your burden to show this.
    Answer Applies to: New York
    Replied: 9/19/2011
    Wooten, Kimbrough & Normand, P.A.
    Wooten, Kimbrough & Normand, P.A. | Orman Kimbrough, Esq.
    Yes, someone can sue for the entire cost and amount of the medical bills even when the bills have been paid by their insurance. However, just because someone can sue for the entire amount of the bills, does not mean they can recover that amount. The circumstance of why the bills were incurred and the terms of the insurance paying the bills would have an effect on what laws would apply and determine the outcome.
    Answer Applies to: Florida
    Replied: 9/19/2011
    LT Pepper Law
    LT Pepper Law | Luke T. Pepper
    If I am reading your question correctly, the only entity that could sue would be the insurance company who can step in the shoes of the insured and ask for their payments for treatment be reimbursed.
    Answer Applies to: Pennsylvania
    Replied: 9/19/2011
    R. D. Kelly Law Firm, P.L.L.C.
    R. D. Kelly Law Firm, P.L.L.C. | Robert Kelly
    Normally, when a lawsuit is appropriate for injuries to the body, the medical bills are only a portion of the total recovery because the "general damages" for pain and suffering are a separate part of the damages. If your own insurance company paid for medical bills through, for example, a Personal Injury Protection type of policy feature, then your own insurance company would be entitled to get paid back after the final settlement or judgment because of their "subrogation" rights.
    Answer Applies to: Washington
    Replied: 9/19/2011
    Klisz Law Office, PLLC
    Klisz Law Office, PLLC | Timothy J. Klisz
    Only if there is a lien asserted by a health insurer, which is almost always the case in any negligence case except auto cases.
    Answer Applies to: Michigan
    Replied: 9/19/2011
    Craig Kelley & Faultless
    Craig Kelley & Faultless | David W. Craig
    Actually the person who injured you or his/her insurance company owes younthe full amount ofbthe bills. However your insurance company is entitled to bevreimbursed for whatever they paid.
    Answer Applies to: Indiana
    Replied: 9/19/2011
    Oliver Law Office
    Oliver Law Office | Jami Oliver
    Yes. Most insurance companies have "subrogation" clauses in their policies which require that you pay them back out of any funds you recover from the at-fault party.
    Answer Applies to: Ohio
    Replied: 9/19/2011
    Lacy Fields, Attorney at Law, LLC
    Lacy Fields, Attorney at Law, LLC | Lacy Fields
    Yes, the jury is not allowed to know that insurance paid for it. You get paid for the "reasonable value" of the medical services. However, if your insurance paid for it, they can put a lien against your case so that you have to pay them back. They usually settle for less than the full amount though. Plus, if you sue you get to ask for lost wages, mileage to doctor visits, pain and suffering, etc.
    Answer Applies to: Missouri
    Replied: 9/19/2011
    Bulman Law Associates PLLC Injury Law Firm
    Bulman Law Associates PLLC Injury Law Firm | Thomas Bulman
    Yes. The limitation is practical. If the amount is small, it would not be cost effective to file a lawsuit.
    Answer Applies to: Montana
    Replied: 9/19/2011
    Rothstein Law PLLC
    Rothstein Law PLLC | Eric Rothstein
    You can sue for it and even get it awarded by a jury BUT the defense is then entitled to a collateral source hearing and the amount paid by insurance is deducted from the award. Simply stated, you can't win more than you paid.
    Answer Applies to: New York
    Replied: 9/19/2011
    Andrew T. Velonis, P.C.
    Andrew T. Velonis, P.C. | Andrew Velonis
    They may be legally required to pay the insurance company back, so they have to sue for the whole amount if that is the case. If not, they can recoup up to two years worth of premiums, or the entire medical bill, whichever is less.
    Answer Applies to: New York
    Replied: 9/19/2011
    Beaver Holt Sternlicht and Courie, P.A.
    Beaver Holt Sternlicht and Courie, P.A. | Mark A. Sternlicht
    Yes. The current law permits an injured person to recover the reasonable value of medical treatment, which is usually the full amount billed for the treatment. The idea is that the negligent person who caused the injuries should not benefit from the fact that the injured person had insurance.
    Answer Applies to: North Carolina
    Replied: 9/19/2011
    Law Offices of Elliott Zarabi
    Law Offices of Elliott Zarabi | Elliott Zarabi
    Yes, just because someone else paid for your mistake doesn't mean you get out of it.
    Answer Applies to: California
    Replied: 9/19/2011
    Rose, Senders & Bovarnick, LLC
    Rose, Senders & Bovarnick, LLC | Paul S. Bovarnick
    Yes, but they will have to repay their health insurer. They will keep the difference between what the amount they give back to the insurer and the amount of the judgment or settlement.
    Answer Applies to: Oregon
    Replied: 9/19/2011
    Magnuson Lowell P.S.
    Magnuson Lowell P.S. | Richard S. Lowell
    Yes. But note that the insurance company policy probably contains a provision that requires the insured to repay the insurer for any amounts it paid for medical bills.
    Answer Applies to: Washington
    Replied: 9/19/2011
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