Ever since Rule 414 of the North Carolina Rules of Evidence, now known as the controversial “billed versus paid” law, was amended in October of 2011, personal injury victims who are covered by health insurance can now only prove damages for the amount that was actually paid, not what was billed. This may seem logical at first, but considering how insurance companies will negotiate lower payments to medical providers, this can cause insured victims to lose a major portion of what they could have claimed for damages.
A relevant part of text from Rule 414 reads:
“Evidence offered to prove past medical expenses shall be limited to evidence of the amounts actually paid to satisfy the bills that have been satisfied, regardless of the source of payment, and evidence of the amounts actually necessary to satisfy the bills that have been incurred but not yet satisfied.”
In other words, if you have $15,000.00 in medical bills, but your insurance company only paid $7,000.00 to the provider at a discounted rate, you, as a personal injury victim, can only submit proof of the $7,000.00 that was actually paid.
Compare this situation to someone that does not have health insurance – they had the same $15,000.00 in medical bills, but since they do not have coverage, they can submit the full $15,000.00 for damages. This not only causes the person with health insurance to seem like they have lesser injuries, but it also helps the person with no insurance to recover more in damages. If you also consider the amount of money the insured victim has paid to date for their insurance premiums that will not be brought up as evidence, Rule 414 can absolutely cause issues when it comes time for court.
This law, among the others that affect personal injury victims, are muddying the waters and making it more difficult than ever for an injury victim to recover their full amount of damages owed. To some jurors and judges, a dollar amount that is submitted for evidence is how they decide the fairness of the damages, and that can be heavily diluted with the imposition of Rule 414. That is one of the many reasons that hiring an experienced personal injury attorney will be the best option.
If you or someone you know and care about has been injured, or killed, in a car accident or tractor trailer accident, or is the victim of a wrongful death in North Carolina, contact Collins Law Firm at 910-793-9000 for a confidential consultation.
By Karen M. Thompson, Paralegal