Grey Eagle, MN asked in Personal Injury for Minnesota

Q: I recently tripped and fell over uneven pavement outside a local business, injuring my shoulder, head, arm and knees.

The business owner offered to pay my medical expenses, which total just over $3000. They did open a case with their insurance company. The hospital ER billed my medical insurance leaving a balance owed of $1400 and that's the amount their insurance company is paying me. Am I not entitled to the full amount of the hospital bill? I am in MN.

Related Topics:
1 Lawyer Answer
Tim Akpinar
Tim Akpinar
  • Little Neck, NY

A: A Minnesota attorney could advise best, but your question remains open for two weeks. If a claim is only for medical expenses, the claimant would generally be entitled to only the outstanding amount that was not covered. The premise of insurance law is to make the claimant whole for their loss. In terms of a damages analysis, the $1,600 damages incurred was already picked up by the carrier, so it isn't deemed a loss incurred. That's the way insurance protocols handle economic losses in most any jurisdiction. But if a claim is for pain and suffering and other elements, then the analysis is more involved, where non-economic losses enter the picture. In those settings, the carrier could come after its reimbursements with a lien that needs to be reconciled at the conclusion of a case - that would be something a Minnesota should advise on. In those settings, it would also make a difference if the hospital writes off the $1,400 based on medical necessity, fee schedules, operation of law, or other issues. Good luck

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.