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Will a Medical Malpractice Settlement Pay My Medical Bills?

The cost of healthcare in the United States can be extremely expensive. Victims of medical malpractice become very aware of the costs of a doctor’s mistake when it can add up to tens of thousands of dollars in medical bills. When the damages in a medical malpractice case are added up, it can be hundreds of thousands or even over a million dollars. When you receive a medical malpractice settlement, will the money be used to pay the medical bills?

Depending on the structure of the settlement offer and the total amount of the award, some of the money may be used to pay medical bills. Medical bills are a significant part of the damages in most medical malpractice claims. If you receive a settlement, a portion of the settlement can be used to pay your medical bills. However, each case is different. If you want to know what will happen in your situation, it is best to contact an experienced medical malpractice lawsuit team. Contact our office today online or by phone at 800-529-6162.  

Medical Bills and Expenses After a Malpractice Injury

If you go to the hospital for treatment, you will be billed for any services rendered. If you have health care insurance, your insurance policy may cover some or all of the treatment. You may have a co-pay or have a bill for any portion of the treatment that is not covered by your policy. If you received negligent care from a doctor or the hospital, that can complicate your medical billing situation. 

For example, you go to the hospital for an appendectomy after suffering appendicitis. You expect to receive a medical bill after treatment. However, during the surgery, the doctor leaves behind surgical sponge material inside your body. After surgery, you suffer pain and fever because of the left-behind surgical items. After the serious infection spreads, you are hospitalized for treatment when the doctors finally find the surgical sponge and remove the material. 

For the treatment, your medical bills were $10,000 for the appendectomy and $10,000 for the medical care for the additional treatment and removal of the cause of the infection. You may expect to pay for the appendectomy but not for the additional care caused by the surgical doctor’s errors. The hospital still sends the bill but who is expected to pay for it?

The billing for any treatment caused by your injury should be included in the damages in your medical malpractice claim. Damages include any loss caused by the negligent care, including medical bills, lost wages, future medical treatment, pain and suffering, and loss of enjoyment in life. Depending on the type of injury, medical bills may be a majority of the financial award of malpractice damages. 

Costs of Medical Care

Medical bills are a significant expense of a medical malpractice claim. As part of the economic damages in a lawsuit, medical bills can include the cost of treatment received, as well as the anticipated future expenses of medical care. The costs of medical care in your medical malpractice case may vary, based on several factors. In a complex medical malpractice injury case, medical care may include: 

  • Ambulance costs
  • Emergency room treatment
  • Hospitalization
  • Surgery
  • Post-surgical care
  • Plastic surgery
  • Medications
  • Medical devices
  • Mobility devices
  • In-home care
  • Nursing care
  • Therapist treatment
  • Medical supplies

Average Cost of Surgical Procedures

Healthcare costs are high and even outpatient surgery costs are rising. According to research from the University of Michigan, from 2011 to 2017, out-of-pocket expenses increased 50% and total payments increased 29%. Hospitalization and other medical expenses are also increasing.

A report from CBS found the most expensive single medical procedure in the U.S. is exploratory chest surgery. The average cost for this is more than $137,000. Partial removal of the esophagus costs an average of more than $113,000. A liver transplant averages more than $100,000, more than twice the cost of a kidney transplant. Even relatively common gallbladder surgery is more than $50,000. And these are just the costs of a single procedure.   

At Johns Hopkins Hospital in Baltimore, Maryland, they offer an online estimate for medical services but even those estimates are subject to additional fees and changes. Estimated fees are only hospital fees and do not include the cost of the room, medical supplies, physician or provider fees, the cost of medication, medical equipment, and homecare services. As a result of a single medical procedure, you may receive bills from: 

  • Hospitals
  • Ambulance company
  • Multiple physicians
  • Anesthesiologist
  • Hospitalist
  • Pathologist
  • Radiologist
  • Cardiologist 
  • Emergency room doctors
  • Other specialists

Future Costs of Care

A serious injury can require lifetime care. For example, a back surgery injury could result in chronic pain, requiring lifetime pain management. A wrong-side surgical error resulting in amputation could require lifetime care for the prosthesis. A child who suffers a birth injury that causes permanent brain damage may require around-the-clock care for life. Birth injury medical care can be more than a million dollars, just in future care. 

How are you supposed to estimate the costs of medical care when the care is in the future? This is where experts come into play. In a medical malpractice lawsuit, expert witnesses are medical experts who practice in medicine or have specialized training in estimating the type of medical care that will be required, including the costs of care. Expert reports on the value of future care can be used to estimate the total damages in your case, which can inform the settlement amount. 

For example, the economic damages in a birth injury case include the costs of lifetime care for someone who may live 80 or more years, forever dealing with the medical needs caused by a doctor’s negligence. The family and baby can have a fulfilling life but they may have medical expenses that are directly related to a doctor’s carelessness. According to an article from the Centers for Disease Control and Prevention (CDC), the lifetime costs of a child suffering with cerebral palsy is almost $1.4 million (adjusted for inflation to 2021).

Dealing With the Insurance Companies

No one likes dealing with insurance companies. Unfortunately, it is a necessary part of a medical malpractice claim. You may be dealing with your own health insurance bills while the doctor has an insurance provider specifically to deal with malpractice claims. Insurance claims can be complicated, especially when there are multiple insurance companies involved and insurance subrogation claims. Insurance issues involved in a medical malpractice claim may include: 

  • Health care coverage
  • Medicare and Medicaid
  • 3rd-party insurance 

Experienced medical malpractice attorneys, like the trial lawyers at Gilman & Bedigian, are well versed in the tricks and tactics of insurance companies. They can use their trial experience to advocate for you and make sure you don’t get taken for a ride by the insurance company. 

Health Insurance 

Many people have health insurance through their employer. Self-employed workers may have to purchase their own insurance. Others use state-sponsored insurance plans, private plans, or have no coverage at all. If you do have health insurance, the cost of your medical bills can vary drastically, based on: 

  • Type of treatment
  • In-network/out-of-network care
  • Co-pay
  • Policy limits
  • Optional care
  • Elective treatments

If your insurance company pays for your medical bills related to a malpractice claim, they may want reimbursement for their payment out of your settlement. Your health care insurance company will generally expect repayment for any medical costs where another party was at fault for the treatment. 

Medicare and Medicaid

Medicare and Medicaid are government programs that act similar to health insurance companies. Like private insurance, Medicare and Medicaid may expect reimbursement for any medical expenses that are related to malpractice claims. After you receive a settlement, the Centers for Medicare and Medicaid Services (CMS) will likely send a demand letter for payment. 

Third-Party Insurance

In a medical malpractice case, the doctor is generally covered by a medical malpractice policy. This means that the doctor has insurance coverage to pay for the costs of a malpractice claim. A doctor rarely has to pay anything out of pocket because of a negligent injury. Instead, their insurance provider will pay for the costs of the lawsuit, including having lawyers represent the doctor. 

When you are involved in a medical malpractice lawsuit, most of the defendants’ lawyers are actually working for the insurance companies. The doctor will rarely have their own attorney involved. This means that when you win your case, it is a 3rd-party insurance company that pays off your medical bills. That is, the doctor’s medical malpractice insurance will pay for the costs of your medical treatment caused by negligence. 

The 3rd-party insurance may pay for medical expenses indirectly, through a settlement or jury verdict. If you have $10,000 in medical bills and receive $20,000 in a settlement, you may then use $10,000 of the settlement to pay off your medical bills. 

Can You Negotiate Your Medical Bills?

Many people expect medical bills to be a set cost but it is possible to negotiate the costs of your medical care. It may be surprising to learn that insurance companies regularly pay less for medical care than a consumer would. Hospitals generally have a master list of charges, depending on the services. Insurance companies negotiate a much lower price with each doctor and hospital. For a $10,000 hospital bill, an insurance company may end up paying $5,000. Are you really expected to pay the full amount?

You can negotiate to reduce your medical bills. However, it can be a complicated and exhausting process. If you call up the hospital billing department directly and ask to negotiate, they may simply offer you a payment plan, to pay the full amount over time. Instead, your attorney may be able to handle a medical bill negotiation to settle the amount owed and reduce your total expenses. In a medical malpractice settlement, reducing the medical bills can mean more money in your pocket to cover any other damages or expenses. 

Is a Settlement Offer Better Than Going To Trial for Medical Malpractice?

With so many questions about how a medical malpractice settlement can pay your medical bills, you may be tempted to take the case to trial instead and make sure you get the full damages necessary. However, there are plenty of reasons why you should seriously consider a settlement. Jury trials can be unpredictable. Even if you think you have a strong case, the jury could find in favor of the doctor. The benefit of a settlement is that it is a guarantee of the compensation you can receive, including enough money to pay off all your bills. 

Even if you win your case, it may be up to the judge and jury to decide how much of the award you are to receive. In some states, including Maryland, there is a cap on noneconomic damages in medical error claims. This would not impact your economic damages claim for medical bills but it does mean that the judge can reduce the award amount even after the jury gave you a bigger award. With questions about the outcome of your medical injury claim, talk to an experienced medical malpractice law firm

How Much Will I Receive in a Settlement After Bills Are Paid?

A medical malpractice settlement is an agreement between the parties to release any legal claims in exchange for an award. Settlement negotiations can take place anytime during the claim, from the time the lawsuit is filed up until a jury makes a verdict. The majority of medical malpractice cases are settled before they go to trial. 

Coming up with an estimate for a settlement case can be complicated. There are a lot of factors that go into estimating a medical malpractice settlement, including:

  • Nature of the injuries
  • Extent of damages
  • Age of the victim/estimated lifespan
  • Strength of the case
  • Permanence of the injury
  • Level of care required

The best way to find out how much you can receive in a medical malpractice settlement after any bills are paid is to talk to an experienced attorney. An experienced law firm can help you through the difficult process and make you confident that you are in the right hands. Talk to medical malpractice trial attorneys who can review your case, get an expert review, and help you understand your settlement options after a medical negligence injury. Contact Gilman & Bedigian online or at 800-529-6162 for a free consultation.

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