Can you claim more than your out-of-pocket expenses for your medical bills in your Virginia car accident case?

If you’ve been involved in an accident, and required medical treatment, you’ve likely received a lot of medical bills.  Depending on whether you have health insurance, you may have paid a significant amount of bills out of pocket.  Now you’re wondering what you can recoup in your personal injury claim.

Don’t let the adjuster fool you, it’s more than you probably think.

If you’ve been working with an insurance adjuster, you may be left with the impression that you can only claim how much you’ve actually paid out of pocket.  However, under Virginia law, you are entitled to the retail price of your medical bills.  Stated another way, you can claim the full price of your bill, even if your health insurance paid a lower rate.

But isn’t this double dipping? 

No. Virginia applies something called “anti-subrogation.”  What this means in common terms is that the person that caused your injuries does not get the benefit of you having health insurance.  So, when you make a claim against that person (and their car insurance), you will claim for the retail price of the medical bills, pain, suffering & inconvenience, and lost wages. (To lean more about the damages you can claim in a Virginia car accident case, click here.)

Just because you only had to pay a $20 co-pay for your hundred-dollar bill, doesn’t mean you’re only entitled to $20.  You’ll claim the $100 bill plus more.

You need to think ahead. (Health insurance reimbursement).

While you may be getting more than you expected, you also need to be aware that your health insurance may have a right to be reimbursed.  Indeed, many health insurance contacts have lien rights for your health insurer if you obtain money in your car accident case.

Indeed, if you have a government sponsored health plan (Medicare, Medicaid, TriCare, Federal Employee Health Plan (FEHBA), etc.) you should expect there to be a lien. But some private policies have liens as well. (To learn more about health insurance liens, click here.)

However, when reimbursing your health insurance, you only must pay them back what they actually paid on your behalf.  That will typically be 30%-40% of the retail price of your medical bill.  So, you still are in a better position than if you were just entitled to your out-of-pocket expenses.

But what if the insurance adjuster disagrees?

Don’t worry, just call us.  Even if an adjuster undervalues your claim – they often do – reach out to us.  If we think we can add value to your personal injury case, we’ll help out.  If they still disagree, we’ll file a lawsuit.  After all, that’s what court is for!

Still have questions?

Make sure to check out our Personal Injury & Criminal Defense Practice Pages where we’ve answered many other questions you likely have.  James Abrenio is a Fairfax-Based Personal Injury & Criminal Defense attorney who practices throughout Northern Virginia. You can learn more about James Abrenio, some of our Prior Results, and Read Our Reviews.  Make sure to contact us at Ph. 703-570-4180 for your Free Consultation.