Medical bills after a personal injury are no joke.
You're in pain, both physically and mentally, and suddenly your finances are suffering from the thousands of dollars in doctor's bills that keep piling up on you. The good news?
Knowing how medical expenses work in a personal injury claim can save you thousands of dollars.
The thing is…
Medical expenses can end up being the largest component of any personal injury settlement. And understanding how to properly document, calculate, and negotiate medical expenses can mean the difference between financial stability and a personal injury case that financially destroys you.
Here's what you'll learn:
- Why Medical Expenses Are The Foundation Of Personal Injury Claims
- The Two Types Of Medical Expenses You Need To Track
- How To Document Medical Costs The Right Way
- What Insurance Companies Don't Want You To Know
- Calculating Future Medical Expenses Like A Pro
Why Medical Expenses Are The Foundation Of Personal Injury Claims
Personal injury law, at its core, is about one simple goal: restoring you to your pre-accident condition.
Meaning that you're compensated for all the ways that the accident impacted you. And do you know what takes up the biggest slice of that pie?
Medical expenses.
Medical records are the costliest expense category you can have in a personal injury case. They're a staple in any personal injury case because they provide verifiable, indisputable proof of your injuries and their severity.
The catch?
Insurance companies use your medical expenses as the baseline for calculating your overall settlement value. The more legitimate medical costs you rack up, the more your potential settlement can be worth.
Which is why if you've had a serious accident, and you or a loved one are in need of a fatal car accident lawyer, you'll want to pay extra special attention to medical expenses and make sure your claim is setting you up for the biggest compensation your family can receive.
The Two Types Of Medical Expenses You Need To Track
In a personal injury claim, there are two different categories of medical expenses:
Past Medical Expenses
These are the easiest type of medical costs to calculate because they have already occurred. Past medical expenses include ER visits, doctors' visits, prescription drugs, therapy, and medical equipment.
Safely store every single receipt. Every co-pay you made, every prescription you filled, every metered taxi you used to get to the hospital. It all counts.
Future Medical Expenses
And then there are future medical expenses.
Which is where things get a bit more complicated…
Future medical expenses are projected costs that you are likely to incur because of your injury. This may include continued therapy, future surgeries, medication, and medical equipment to accommodate disabilities.
The tricky part? Demonstrating what you'll need and how much it will cost you in the future.
How To Document Medical Costs The Right Way
So what's the single biggest mistake that people make with medical expenses?
Poor documentation.
Insurance companies love nothing more than disputing medical costs because of shoddy record-keeping. Here's how you can avoid falling into that trap:
Create A Medical Expense File
Have a file for all injury-related medical documents: bills, insurance forms, receipts, and medical records. Organized documentation is your best friend.
Track Everything
Including mileage to and from appointments, parking fees, medications, equipment purchases, etc. People tend to forget about these little expenses, but trust me, they add up quick.
Use The Billed Amount
Here's a little tip that insurance companies won't tell you…
Even if your insurance company negotiated a discount with your doctor, you're still entitled to claim the full billed amount in your personal injury case. And why is that?
Because the billed amount is an accurate reflection of what your medical care should actually cost.
What Insurance Companies Don't Want You To Know
Insurance companies have a singular mission: pay you as little as possible.
They have legions of adjusters whose sole job is to reduce your medical expenses as much as humanly possible. Here are some of their favorite tricks:
The "Excessive Treatment" Argument
Your insurance company will claim your treatment was unnecessary or too much. That's why having a doctor who can justify why each treatment was medically necessary is so vital.
The "Pre-Existing Condition" Claim
Your insurance company will try to pin your current medical requirements on pre-existing conditions. Proper medical documentation showing the before and after of your injury is crucial.
The "Quick Settlement" Offer
Your insurance company will pressure you to settle early, before you're fully aware of your injuries' extent. Remember this:
95% of personal injury cases settle out of court, but that doesn't mean you should rush to settle your case.
In fact, personal injury cases incur 4.1 expense types on average. That's the truth of the matter.
Calculating Future Medical Expenses Like A Pro
Future medical expenses are where the big money is in a serious injury case.
But they're also the hardest to substantiate. Here's how the experts do it:
Get Expert Medical Opinions
You'll need to have doctors provide detailed reports on your current medical needs, prognosis, treatments, and costs.
Use Life Care Planning
For severe injuries, consider hiring a life care planner. These professionals specialize in calculating lifetime medical costs.
Factor In Medical Inflation
Medical costs increase by approximately 5-6% a year. Your future medical cost calculations should include that inflation.
Document Maximum Medical Improvement
This is the point at which your injury no longer shows signs of improvement. MMI is important in establishing what kind of ongoing medical care you'll need.
The Insurance Game: Playing To Win
Insurance companies have deep pockets and legions of experienced lawyers working for them.
But you have something that they don't have: the truth on your side.
The Settlement Formula
Insurance companies, to a person, tend to use a simple formula for calculating settlements:
Medical Expenses × Multiplier + Lost Wages = Settlement Range
The multiplier is usually a number between 1.5 and 5, depending on the injury severity.
Why Medical Documentation Matters
The better you document your medical situation, the higher the multiplier they'll use to calculate your settlement. If you don't keep detailed medical records, the insurance company will offer you a lot less money.
Keep this in mind: 70% of people who filed a personal injury claim received a payout. Medical expenses are your ace card when it comes to negotiation.
Common Medical Expense Mistakes To Avoid
Don't shoot yourself in the foot with these easy-to-make errors:
Delaying Medical Treatment
Get medical treatment after an accident immediately. Waiting gives insurance companies ammo to argue your injuries weren't serious.
Skipping Follow-Up Appointments
Failure to show up for doctor's appointments can indicate to the insurance company you're not that injured.
Paying Bills Before Settlement
If at all possible, allow medical bills to build up until after settlement.
Failing to consider Alternative Medicine
If you're paying for chiropractic care, acupuncture, and/or physical therapy, those are all legitimate medical expenses that you can claim.
Maximizing Your Recovery
Want to leave the negotiation table with every dollar that you are due?
Don't settle for the first offer. Insurance companies expect you to negotiate. Their first offer is going to be the absolute bottom of what they can offer you.
Get multiple medical opinions. If you're dealing with a serious injury, don't be shy about getting multiple doctor's opinions. These opinions can only strengthen your case.
Look for the long term. Don't just consider immediate treatment costs. Plan for the future. What will your medical needs be in 5 years? 10? 20?
Pulling It All Together
Medical expenses in a personal injury claim aren't just about the money you've already spent, they're about ensuring that you get the resources that you need in order to rebuild your life after an accident.
Careful documentation and strategic thinking can make all the difference in your final settlement.
Your medical expenses tell the story of what your injuries did to you. Don't let them shortchange you. Be thorough. Be smart. Take it all the way to trial, if you need to.
Insurance companies have teams working to minimize your claim. You deserve someone working just as hard to maximize it.
