In the State of Indiana, recovering medical expenses after a motorcycle accident involves navigating a complex legal landscape where the “billed” amount of a medical provider rarely matches the “paid” amount. Employing an attorney is often critical to maximizing this recovery, as they manage the sophisticated interplay between Indiana’s Evidence Rules, the Hospital Lien Act, and insurance subrogation.
Recoverable Medical Expenses and the “Reasonable Value” Standard
Medical expenses in Indiana are categorized as economic damages and include any “reasonable and necessary” costs associated with treating injuries from the accident. These include:
Emergency Care: Ambulance fees, emergency room visits, and initial diagnostic imaging like X-rays or MRIs.
Ongoing Treatment: Surgeries, hospital stays, physical and occupational therapy, and pharmacy receipts.
Future Medical Needs: For permanent or long-term injuries, victims can recover the estimated costs of future complications, ongoing therapy, and necessary medical equipment or home modifications.
In Indiana litigation, the “reasonable value” of medical services is a contested issue. While a medical bill is considered prima facie evidence that the charges are reasonable under Indiana Evidence Rule 413, defendants may introduce evidence of the lower, discounted amounts actually accepted by providers from insurance companies to challenge that reasonableness. This rule, established in cases like Stanley v. Walker and Patchett v. Lee, applies regardless of whether the payer was a private insurer or a government program like the Healthy Indiana Plan (HIP).
The Role of an Attorney in Maximizing Recovery
An attorney’s primary function is to serve as an advocate against insurance companies that often attempt to downplay the extent of injuries or shift blame to the rider.
- Investigation and Expert Coordination
- Attorneys perform detailed accident investigations to establish fault, ensuring the rider is not unfairly barred from recovery under the 51% modified comparative negligence rule. For medical expenses, they often hire medical experts to review injuries and provide testimony justifying the necessity of past treatments and forecasting the cost of future care.
- Managing Medical Liens (The Indiana Hospital Lien Act)
- Lien: Under the Indiana Hospital Lien Act (IC § 32-33-4), hospitals have the right to place a lien on a patient’s personal injury settlement to secure payment for services.
- Perfection: A hospital must “perfect” its lien by filing a verified statement in the county recorder’s office within 90 days of the patient’s discharge.
- Negotiation: Attorneys often can negotiate these liens down. Because hospitals cannot seek recoupment until the underlying claim is resolved, an attorney can use the final settlement amount to argue for a reduction, especially if the settlement is insufficient to cover all damages.
- Handling Subrogation and the Common Fund Doctrine
- If a victim’s health insurance or MedPay coverage pays for their medical bills, those insurers typically have a right of “subrogation” to be reimbursed from the final settlement. An attorney’s role is to verify the validity of these claims and apply the “Common Fund Doctrine.” This doctrine generally requires the subrogated insurer to contribute to the victim’s legal fees, as the attorney’s work created the “fund” from which the insurer is being repaid.