Hopefully, you won’t be involved in an incident where someone’s negligence causes you injury. If you are faced with this event, it is helpful to know how your claims will be treated by a court of law. Even though most cases are settled, the economic value of a case is directly tied to a hypothetical evaluation of how a court would instruct the jury and how it could be expected to rule. Parties can only submit evidence that complies with evidentiary rules. The basic rules for introducing medical bills are that the charges must be “usual and customary” and that the treatment must be “reasonable and necessary” and finally that the physician must testify that the treatment was more likely than not, necessitated by the incident. Now, it appears that there may be threats to the current way cases are evaluated.
A recent ruling on whether a hospital could bill for the difference between insurance payments and the face amount of the bill was addressed in West v Shelby County the Court in West held that these undiscounted medical charges were not “necessary and reasonable” because they “did not reflect what was actually being paid in the market place.” [West, 459 S.W.3d at 45.] A federal district court has extended this ruling to apply to a personal injury action. The reasoning was that if the bill wasn’t necessary and reasonable in the hospital lien setting, it logically follows that it isn’t reasonable in the personal injury setting. We disagree, however defense attorneys want the law changed as it would make it easier for them to pay less.
Until the Tennessee Supreme Court addresses this issue, injury cases are going to be more complicated. We’ll update you when this matter is decided. Until then stay safe, but if you are hurt by the negligence of another, get help from a qualified attorney quickly.