Visitor Question

Does the defendant’s insurance company get our medical discount?

Submitted By: Cindy (Houston, Texas, USA)

My husband was hit from behind in an auto accident and suffered back pain soon after. We went to the ER and a few days later we went to a spine doctor because my husband’s back was really hurting.

After a MRI and another visit to the doctor it was determined that my husband needed a cortizone injection. This was done in the hospital. Our medical insurance paid for everything and was given a discount for all services.

Does the other insurance company get the discount also or are they required to pay full price? The adjuster told us she would only pay what our insurance paid, nothing more.

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear Cindy,

This is called the Collateral Source rule and the general answer is “NO”, the defendant does not get the benefit of your insurance company deduction.

You are entitled to a settlement that is based upon the full value of medical services received, not the value of services reduced by a collateral source (i.e. your insurance company).

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney. Find a local attorney to give you a free case review here , or call (888) 647-2490.

Best of luck,

Published: August 13, 2010

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