Proving and Collecting Medical Expenses: Billed Versus Paid - Tragic North Carolina Tort Reform

The rights of North Carolina accident victims are under attack. Recent legislation has dramatically decreased the value of personal injury cases in settlement and at trial. The new evidence law allows a jury to only see the amount of victim medical bills actually paid by health insurance. If the victim has no health insurance, the jury sees the full medical bill. If the victim has Medicaid or Medicare, doctors are forced to accept discounts of up to 85 percent of billed charges. For a victim with a $100,000.00 surgical bill paid by Medicaid, the jury is told that the total medical bill is only $15,000.00!

Insurance companies now insist that victims present medical bills along with proof of all health insurance payments. They then limit the amount they pay to the amount covered or paid by health insurance. Unfortunately, juries now only see part of the picture. They are told that the full medical bills are less than the actual amount charged by hospitals and doctors. This likely will result in very unfair verdicts. If billed treatment totaled $100,000.00, but a jury hears that total bills were only $15,000.00, they may conclude that treatment was less invasive and that injuries were less severe.

The task of presenting medical bills has been expanded because of the new law. The victim must now provide explanation of benefits (EOB) forms along with the raw medical bills to show exactly what was covered and paid by health insurance. If EOBs are not available, the victim must go to the doctor and demand invoices that show all payments, credits, and health insurance adjustments for all accident-related medical treatment.

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