-Tiffany M. Shrenk, Esq.
The amount of medical expenses is one element of damages a plaintiff in a personal injury case can seek to recover. The collateral source rule allows a plaintiff to recover for her reasonable medical expenses even though all or a portion of the medical bill was paid by an independent source, such as the plaintiff’s health insurance. The reasoning for the collateral source rule has been that the wrongdoer – such as the driver who caused the accident – should not get the benefit of the plaintiff’s resources. Said differently, the wrongdoer should not receive a reduction in the amount of damages that are owed to the plaintiff because of a source – such as health insurance – that provides coverage to plaintiff.
This rule of law is best explained to a client by reviewing a doctor’s bill. On the bill, there are line items for the billed amount, adjustments (or write-offs) taken as a result of the client’s insurance benefits, and the amount paid. When the collateral source rule applies the plaintiff can be awarded the amount billed – so long as it is reasonable – and not just the amount ultimately paid. The application of the rule is favorable to a plaintiff in a personal injury case because the plaintiff can plead the full amount of her medical bills and not just was paid to satisfy the bill. The same is true for future medical bills when a plaintiff will need ongoing medical care.
Whether the collateral source rule applies depends upon the state law applicable to the case. In Delaware, the courts still employ the collateral source rule with some limitations. The collateral source rule does not apply when a plaintiff has public or government benefits, such as Medicaid or Medicare. In those situations, the plaintiff is limited to recovering the amount paid by Medicaid or Medicare and not the full amount that was billed. These exceptions to the collateral source rule are the result of developments in case law, such as the 2015 Delaware Supreme Court case of Stayton v. DE Health Corp., et al.
The calculation of damages and determining the applicability of the collateral source rule are just some of the ways a personal injury attorney can assist with an injury case.
Tiffany is a partner at MacElree Harvey, a full-service law firm serving Delaware and Pennsylvania. Licensed to practice law in Delaware and Pennsylvania, Tiffany represents clients in personal injury cases, trust and estate litigation, adult guardianships, and real estate litigation. She joined MacElree Harvey in the summer of 2016 and spends her time in the Centreville, Delaware office and the Kennett Square office. Contact Tiffany at (302) 654-4454 or [email protected] to discuss your car accident or other civil litigation matter.