Q: Can injured P recover from D the full amount of a medical expense where insured negotiates for less than usual charges?
A: This very question is currently being reviewed by the California Supreme Court. A majority of other states view this "negotiated rate differential" as awardable to the P as collateral-source damages. The rationale is that a P's payment of insurance premiums for medical coverage should be viewed as an investment. The P's insurer in turn is able to use the premium dollars paid by many insureds to negotiate discount rates from medical providers. Non-cash consideration is received by the provider in addition to the case payment in the form of preferred provider designation, guaranteed payment, multiple patients and the like. As a matter of policy, the prudent P should receive the full fair market value of these services rather than allowing the tortfeasor to benefit from the discounted cash payment.
1 user found this answer helpful
Judges have options since the law is in flux.
Lately, Judges are allowing the presentation of the full amount to the jury, but reduce the award for the medical expense to the amount actually paid, after trial. This is important as damages for pain and suffering are often related to those for medical expenses.
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.