The 3 biggest issues that we anticipate seeing in our personal injury cases in Ohio in 2021 will include the following:
1) subrogation or the right of your health insurance or auto insurance company to collect money back from you for the payment of all of your medical bills related to the accident;
2) inadequately documented medical records and inadequate documentation that fails to clearly state all of your injuries, limitations and restrictions and fails to fully document all of your injuries caused by your accident;
3) low jury verdicts and the impact of the Covid pandemic.
Let’s take a closer look at each issue.
In any auto accident, trucking accident, or slip and fall case, you have to pay back your health insurance and auto insurance carrier for all medical bills that they paid for any medical care and treatment you received for your accident. This is called a subrogation claim. Even though you pay your premiums to have this coverage, in any auto, truck, or slip and fall accident, your health insurance and auto insurance company have a special right called a subrogation right to recoup any money that they paid for your medical bills relating to your accident.
In addition to having to pay your health insurance and auto insurance company back, you can only claim the contractual amount that your health insurance or auto insurance company paid and cannot claim the actual charge of your medical bill. With most health insurance plans, your doctors will charge an amount for treatments and be subjected to accept the contractual rate under your health plan, which is the reduced charge. The doctor has to accept the contractual amount and has to write off the rest of the bill. As an example, if your specialist charged you $250.00 for a consultation, your health insurance has a contract with that doctor and can subject that doctor to accept the contractual rate which could be $100.00 or $125.00 in this example. Your orthopedic doctor would have to accept $100.00 or $125.00 as payment in full and have to write off the rest of the bill. Under Ohio law, you could only be paid for the reduced amount of that bill, and, at the same time, be required to have to pay your health insurance back for payment of that bill.
Under Ohio law, even though you are entitled to be compensated in full for all of your medical bills, you are only being awarded the reduced contractual rate. When you have to turn around and pay back your health insurance and auto insurance, you really are not being fully compensated for your medical bills.
Another issue that you have to be aware of is that your auto insurance company does not have a contractual rate negotiated with your doctors like your health insurance company. In my earlier example, your specialist would be happier submitting his or her actual charge of $250.00 to your auto insurance because your auto insurance would pay them the full amount of their charge of $250.00. At the end of your case, you would have to pay back your auto insurance for the full amount charged for your bill of $250.00. You would not have the benefit of the reduced contractual rate that you have had with your health insurance plan. To get the benefit of the reduced contractual rate, submit your medical bills to your health insurance company.
At the end of your personal injury case, we work extremely hard to negotiate a reduction with our client’s health insurance company and automobile insurance to reduce what our clients have to pay them back.
2. Inadequately Documented Medical Records & Supporting Documentation
Another problem that we frequently see in our personal injury cases is that our clients do not tell their treating doctors all of the details relating to their injuries and limitations. When they don’t provide those details, their medical records don’t contain the necessary details that their insurance adjuster will rely on when evaluating the amount to offer them during settlement negotiations. It is extremely important in your case that you provide your treating doctors, physical therapists, and specialists with a thorough history of all of your injuries and limitations since your motor vehicle accident. You have to provide your doctors with all of the details describing the nature and extent of your pain and every injured part of your body. Outline in detail what your pain feels like, whether your pain is constant or comes and goes, and how your injuries have impacted you on your ability to enjoy your everyday work functions and activities.
3. Low Jury Verdicts
The jury verdicts in Franklin County and the surrounding counties are typically low. Since the Covid pandemic, these jury verdicts have gotten lower as jurors have become less sympathetic and less likely to award adequate compensation to our clients.
The average jury verdicts from 2012 to 2018 from Franklin County and generally relative for the four surrounding counties showed jury verdicts with an average of between $12,000.00 to $18,000.00. Because of these low verdicts, we always recommend mediating all of our personal injury cases before going to trial. Mediation involves an experienced attorney or a Judge facilitating negotiations between the Parties in an effort to resolve claims. Generally, the last settlement offer that we see at a mediation is typically higher than the average verdicts that we have seen in Franklin County and the surrounding counties.
Need Legal Assistance?
If you are looking for an experienced attorney to help you navigate the uncertainty of your case, The Law Office of Tom Somos, LLC is just a phone call away. Contact our office for additional information.