When a person is injured in California due to another person acting negligent or recklessly, they often face catastrophic injuries that require ongoing treatment. If a lawsuit is filed, the victim has a right to recover damages for both past and future medical expenses associated with the injury. If the victim has insurance, then their damages can be limited to how much their insurance company paid – not the total value of the care they received.
A recent appellate ruling dealt with a situation in which a plaintiff that was insured was required to stick within their own medical plan when getting treatment for their injuries to mitigate the damages. Read on to learn about the results of this case and what it may mean for other car accident victims. Then contact Law Offices of Fernando D. Vargas at 909-982-0707 for a free legal consultation if you have been injured in an accident.
The facts of the case
The case involved a man who was coming back from a camping trip in 2011. His wife was driving their motor home when it got a flat tire. The wife steered the vehicle to the shoulder of the road, stopped it, and turned on the hazard lights, but a portion of the motor home was still in the travel lane. A tractor-trailer came up on the motor home traveling 50 miles per hour. It hit the back of the motor home and the plaintiff received serious injuries to his face, back, neck, and teeth. He was treated right away at a local hospital but required ongoing treatment due to the back injuries.
The plaintiff had insurance through Kaiser Permanent but he decided to work with an orthopedic specialist that was not included on his insurance plan. As is often done, the doctor billed the man on a lien basis, which should have resulted in him being paid when the plaintiff won a personal injury case. The plaintiff did indeed win his case and the jury awarded the full amount of his actual medical bills. The award was appealed by the defendant who claimed that the man had a duty to keep his bills as low as possible by getting treatment within his provider network.
The results
The court decision stated that the plaintiff did not have a responsibility to mitigate his damages and that he had the right to seek the best treatment he could find, even though that doctor was not in his network. The court also said that the man should have essentially been treated as uninsured, since he was not in his network, his insurance company was not billed, and he was personally liable for the billed amounts.
The plaintiff provided experts that testified that the amounts billed were reason able in that area for those procedures and so he was able to keep the entire jury award, which was in excess of $4 million. If you have been injured in an accident and have required medical care then we urge you to contact Law Offices of Fernando D. Vargas at 909-982-0707 for your free legal consultation.
