Anyone called as a juror to fulfill their civic duty in the State of Missouri for the first time, is walking into the unknown. At trial, jurors will not hear everything about the case due to rules in place from lobbying from large insurance corporations. I will spare the reader the history of our judicial system and why it is so important for individuals to take this time to participate in their community justice system; however, the importance is monumental. This article will shed some light on these hidden rules.
Does Health Insurance Pay for Medical Treatment in a Personal Injury Case?
The answer is sometimes. If an individual has health insurance, the health insurance will often times pay the medical bills. Depending on the type of health insurance, most health insurance companies require reimbursement for the medical bills paid if the injured party recovers for their losses from another person.
When an individual takes a case to trial to recover for their harms and losses, there are numerous rules and prohibitions taking place, completely hidden from the eyes and ears of the jury. Insurance is one of those areas dominating the need for rules. The State of Missouri is in a situation where reform is needed to protect the injured. The following reference to a select few rules are by no means exhaustive.
Why Do Juries Not Hear About Health Insurance At Trial?
Health insurance is deemed a “collateral source” under Missouri law. The collateral source rules prohibits jurors from hearing evidence that a victim’s damages were, or will be paid for by some source other than the defendant. To simplify the matter, the law seeks to prevent the wrongdoer from avoiding responsibly for causing the loss. Think about this example. God forbid you were in a St. Louis car crash and as a result, you broke your arm. This injury would certainly require extensive medical treatment and result in a substantial amount of medical bills. What if you had a nice aunt who paid your medical bills for you to ensure that your credit was maintained and collection agents were not calling constantly for money. You would not want a jury considering the fact that your aunt paid your bills when determining the amount of your reimbursement for your injuries. You would want to pay your aunt back for her kind deed. The bad driver who caused the crash should not be allowed to argue that since your medical bills have already been paid, he owes less, should he? Your aunt has the right to be repaid for her act of kindness, right? Of course.
Health insurance acts the same way. If you have health insurance, you have that insurance because you have been paying a monthly premium. You have a contract with your health insurance company which you have purchased with your money. You have likely been making years worth of monthly premium payments. When you are injured, your contract kicks in and your bills are paid. However, your health insurance company generally takes the position that if you recover money for those bills from another, they are entitled to reimbursement for what they have paid. In addition, due to the bulk business your health insurance company does with the hospital, your health insurance company gets a discount off of the full amount billed. This results in two separate figures, the amount billed and the amount paid to satisfy the bill.
Now the absurdity comes in. Keep in mind the long standing collateral source rules, commonly called the collateral source doctrine, state that the defendant should not get a break from his responsibility because you had the foresight to have health insurance in advance or a nice aunt. However, when you go to trial, the jury will hear both the initial amount of the bill, and also, the amount paid to satisfy the bill in full. (This is the discount amount your health insurance company receives for doing bulk business.) The reality of this is that the defense will generally stand up and tell the jury that their client should not be responsible for the full amount of the bills, just the discounted amount? Why? The defendant did not pay your premiums did he?
Jurors need to know this extremely important fact about Missouri personal injury law. If you are not fully informed, a clever defense lawyer may try to convince you that the plaintiff is being greedy by asking for the full amount billed before the discount. The fact that this is a common occurrence should concern us all. It allows negligent parties to escape full responsibility for their conduct and places the victims with a greater load to bear when they receive an injury through no fault of their own.
What If The Victim Does Not Have Health Insurance?
Then typically you will receive more money for your case as a whole because the hospitals will not give you a discount, thereby obligating you to pay the full amount of the bill.Then what occurs is that the medical doctors are actually paid what the deserve, and the defendant’s liability insurance does not profit at doctor’s loss. At trial, the jury will only hear the total amount of your total medical bills if none have been written off or paid by the time of trial. If your medical bills have been paid, the jury will be allowed to hear the amount of bills and the amount paid to satisfy the bills. What jurors will not hear is how those bills were paid, does the victim have to pay them back, etc.
Who Benefits From Keeping Insurance Out of Trial?
The wrongdoers car or liability insurance company. In a car accident senario, the person who causes the crash and hurts another forces that person to incur medical bills. If that person has health insurance, their health insurance pays the bills. Then the defendant (through their liability insurance company, because their liability insurance company is the one actually paying the money the defendant is ordered to pay by the jury, despite the fact that jurors will not get to hear about this at trial) takes advantage of the discounts and the victims years of paying their premiums by arguing to the jury that they should only have to pay the reduced amount.
Defense lawyers defending wrongdoers hope that jurors use the medical bills as the basis of the entire case. They seek to base the extent of the injury on the medical bills. For instance, if you lost your arm, it may only cost $20,000 to close the wound, and your health insurance may satisfy that bill in full for $8,000.00. Does the fact that your health insurance paid $8,000 have anything to do with the fact the extent of your injur? Of course not, but it is the hopes of the insurance companies that you will see the injury in a more minor light, because it only cost your health insurance company $8,000 dollars to pay the bill off completely? Don’t pay any attention to the fact that someone is missing an arm. Never mind the fact that jurors do not get to hear about the victims health insurance premiums they have been paying or if they will increase after this injury.
Message To The Community Juror
In today’s day and age of higher premiums and less benefits, of socializing the risk and privatizing the profits, it is important to be aware of what is going on at trial. This could not be more true for a juror. A juror is going to decide the full measure of reimbursement required to place the victim back in the same position they were before their injury. For this reason, it is important for us all to focus on the injury itself as the primary means of determining the full measure of responsibility. Then you can consider what the defendant needs to pay to reimburse the injured party for their out of pocket expenses for things like medical bills. When it is time to consider this, jurors need to take into account all the factors at work. Think about the fact that it was because the victim paid his health insurance premiums constantly that the discount exists. Why should the defendant get the break when he caused the crash?
If you have been injured in a St. Louis car accident or suffered another Missouri personal injury, contact an experienced Missouri accident lawyer to obtain aggressive representation. Today’s insurance companies are powerful machines. It is imperative you hire an injury lawyer capable of obtaining reimbursement for all of your harms and losses at trial.