When someone is injured in a Washington, D.C. accident, the law allows them to file a personal injury lawsuit against the party responsible for their injuries. These lawsuits can provide injured plaintiffs with financial compensation for their injuries, including money to cover their medical expenses. However, courts across the country have struggled with how to calculate the amount owed in medical expenses in situations where the total cost is much larger than what the plaintiff has actually paid, due to health insurance. In some cases, courts have even reduced plaintiffs’ awards, granted to them by a jury, meaning the plaintiff is given less than a jury of their peers decided they were owed.
For example, take a recent premises liability case arising out of a slip and fall accident on a cruise ship. According to the court’s written opinion, the plaintiff in the case was on a cruise with her family and eating at the ship’s breakfast buffet when she tripped over a cleaning bucket and fell to the floor, sustaining injuries to her shoulder and fracturing her humerus. Since the incident, the plaintiff has been to many doctor’s appointments, physical therapists, and specialists to deal with her injuries.
The plaintiff filed a lawsuit against the cruise company, alleging negligence in leaving the cleaning bucket in a highly trafficked area around the breakfast buffet. After trial, the jury returned a verdict for the plaintiff and awarded her over $1 million in damages, including $61,000 to cover past medical expenses. This award for medical expenses roughly matched the amount billed by the plaintiff’s healthcare providers. However, the district court reduced this part of the jury award to $16,326 because that was the amount that the plaintiff and her insurer actually paid. The plaintiff appealed this reduction.
The question here is a complicated one and one that comes up in personal injury lawsuits across the country, including in Washington, D.C. Many health insurance providers have contracts with healthcare providers to settle medical bills at steep discounts, so that there may often be a discrepancy between the amount of medical assistance needed, and the amount billed to the patient, and the amount actually paid. Courts across the country have come to differing conclusions about which amount is correct.
In this case, the court held that the appropriate measure of medical damages is the reasonable value determined by the jury after they have considered all relevant evidence. The jury, in the court’s view, is the proper decision-maker when it comes to what the plaintiff is owed by the defendant. While making their decision, the jury can consider the amount billed by the healthcare providers and the amount paid by the insurers and the plaintiff, in order to come to the best conclusion for each specific case. In this case, the jury had come up with a reasonable number, based on the actual value of the medical services needed for the plaintiff’s injuries, and the district court was wrong to reduce it. As such, the reduction was overturned.
Do You Need a Washington, D.C. Personal Injury Attorney?
If you have recently been injured in a Washington, D.C. slip and fall accident, you may be wondering how to recover financially for the injuries you’ve suffered. Washington, D.C. accidents can leave their victims struggling to pay steep medical bills and recover both physically and financially. That’s why the personal injury attorneys at Lebowitz & Mzhen, LLC, have dedicated their lives to helping accident victims recover from the party responsible for their injuries. Call us today at 800-654-1949 to learn how we can help you and to discuss your case with an experienced attorney.