I talked about the four ways in my last video, one being health insurance, two being med-pay coverage on your auto policy, three being cash payments and four liens with your medical providers.
Now I’ll elaborate on the first, your health insurance. Take into consideration that when you cover medical expenses with your health insurance, you’re probably going to get a discount from what the going rate is for a charge. Let’s say your hospital bill is $5,000 if you were going to have to pay by cash, because you don’t have insurance, but your health insurance company gets a discount because they bring so many patients to these facilities that your $5,000 bill might be something like $2,000.
Just keep that in mind when you’re covering expenses with medical insurance. It’s great to have medical insurance, but when you’re in a personal injury case you need to understand that you’re not going to be able to recover from the third party, the person who caused your accident, the full billable amount of your medical expenses. You’re only going to be able to recover the amount that was charged to your insurance carrier and actually paid. We don’t like it, but that’s the state of the law right now.
Understanding Medical Expense Recovery in Personal Injury Cases
When facing a personal injury claim, one of the most pressing concerns is how to manage and ultimately recover the cost of medical treatment. Your last video outlined four primary ways to cover these expenses: health insurance, Med-Pay coverage on your auto policy, cash payments, and liens with medical providers.
This article delves into the first and arguably most common method: utilizing your health insurance. While a great safety net, relying on health insurance introduces a critical complication in your personal injury case—the challenge of the discounted rate and its impact on the final compensation you can recover from the at-fault party.
The Advantage of Health Insurance: Negotiated Discounts
Health insurance is invaluable, especially after an unexpected accident. When your medical bills are processed through a private or public health insurance plan (like Medicare or Medicaid), the amount actually paid to the healthcare provider is often significantly less than the original, full-billed amount.
How the Discount Works
Contractual Agreements: Health insurance companies represent a massive volume of patients. They leverage this patient volume to negotiate contracts with hospitals, doctors, and clinics. These contracts set a lower, pre-determined payment rate for various services.
The Sticker Price vs. The Actual Cost: Consider a scenario where a hospital bills $5,000 for a procedure. If you were an uninsured patient paying cash, you might be responsible for that entire amount. However, if your health insurer has a contract with the hospital, they might only be required to pay $2,000 to satisfy the bill. The difference of $3,000 is the discount—often referred to as a “write-off” or “contractual adjustment.”
Financial Relief: For the injured individual, this is a clear financial benefit in the short term. The substantial reduction in the bill protects you from immediate financial distress and prevents the full, inflated charge from becoming your out-of-pocket responsibility (aside from deductibles and co-pays).
The Downside in a Personal Injury Claim: Recovering Damages
While the discount is a win for your personal finances upfront, it introduces a major hurdle when seeking compensation from the at-fault driver or their insurance company.
The Recoverable Amount is Limited to the Paid Amount
In many jurisdictions, the law governing the recovery of damages in a personal injury case dictates that you can only recover the actual amount paid or incurred for medical treatment, not the full, initial billable amount.
Crucial Concept: If your health insurance paid only $2,000 for a bill that was initially $5,000, you are generally limited to recovering only the $2,000 paid amount from the third-party driver. The $3,000 discount, which you never paid, is often deemed non-recoverable.
This legal reality can be frustrating for accident victims. It means the negligent party or their insurer gets to benefit indirectly from your foresight in securing health insurance, effectively paying less for the harm they caused.
Navigating the Legal Landscape: The Collateral Source Rule
This topic is complicated by a legal principle known as the Collateral Source Rule.
What is the Collateral Source Rule?
The Collateral Source Rule, in its traditional form, prevents a negligent defendant from reducing the damages they owe to the injured plaintiff simply because the plaintiff received compensation from an independent third party—the “collateral source”—such as health insurance.
Original Intent: The rule was meant to ensure the wrongdoer pays the full cost of the injury, and that the benefit of a plaintiff having insurance (which they paid premiums for) does not fall to the defendant.
State-Specific Modifications: However, due to various “tort reform” efforts, many states have modified or partially abolished the Collateral Source Rule, particularly concerning medical expenses. These changes are what often limit a plaintiff’s recovery to the paid amount (the discounted rate) rather than the original, full-billed amount.
The varying interpretations of this rule are why it is so critical to understand the specific laws in your state. The law is constantly evolving, and what constitutes a recoverable expense can change depending on legislative action and court rulings.
The Next Steps: Subrogation and Repayment
If your health insurance pays for your medical treatment, it’s highly likely they will have a right of subrogation or a reimbursement lien.
Subrogation Explained: Subrogation is the legal right of an insurer (your health plan) to step into your shoes and recover the money they paid on your behalf from the at-fault party.
Your Responsibility: If you successfully recover the medical payments from the third party, you will then typically have a legal obligation to reimburse your health insurance company out of your settlement for the amount they paid.
An experienced personal injury attorney is crucial at this stage. They can often negotiate with the health insurance company to reduce their subrogation claim, a process that puts more money back into your pocket from the final settlement.
In conclusion, while health insurance is the best way to ensure your immediate medical bills are covered at a discounted rate, this benefit creates a complicated legal issue. You are generally limited to recovering only the discounted amount paid by the insurer, and you then owe that amount back. It is a nuanced process that requires careful legal guidance to maximize your overall recovery.
When I got into my accident I was really not looking for an attorney, however I became frustrated with the other parties insurance company. I then went online and found Sally Morin Law and called for a free courtesy consult. Annie quickly called me back and spent 30 minutes explaining the attorney process. This made my decision easy,,, an All female attorney group certainly did not disappoint. Annie and her team (Amber) were on the case immediately, making calls, sending emails and dealing with the other party insured (or lack of insured). I’m so pleased to have had this incredible team of ladies to help me through this process. They did all their professional expertise, none of which I was capable of. They advocated for me in every way from medical bills, insurance liens, med pay, demand letters, phone calls, emails etc. All I needed to do was send receipts, and most importantly focus on getting better. Thank u team for all u have done. I am grateful for so much,,, and I can say that making that first phone call was the best decision. Keep up the great work and helping others
Sincerely
KJJ
I unfortunately got injured in an auto accident and called a bunch of different attorneys with little to no help. I called Sally Morin Law and got help from Rebecca who was absolutely fantastic. She was there every step of the way to help and Isn’t just trying to make a quick buck. She took her time with me and went out of her way to help out. Thanks for all the help Rebecca!!
I was t-boned by someone who ran a red light, totaling my car and sending me to the hospital with multiple breaks to my pelvis, among other smaller injuries. Once released from the hospital, I was confused, angry, and extremely anxious about what to do next. A friend encouraged me to seek legal help, and I found the team at Sally Morin. I was drawn to their all-women team, and immediately felt assured that I was in good hands. They took the reigns on handling everything, leaving me significantly more relieved to rest and heal like my body needed. With their help, the case was settled within four months of the accident, and I can now move forward with my life and leave this behind me. I would absolutely recommend the team at Sally Morin to anyone in a similar situation!
I was injured while riding my bicycle and a friend recommended Sally Morin Personal Injury Lawyers. In my experience, they made the process transparent and smooth, allowing me to focus on recovery — they were professional, empathetic, and effective! Rebecca and Carmen made a difficult time much less stressful.
My mom was in a car accident and was badly injured. We wanted her to focus on her recovery without the worries of medical bills and dealing with multiple insurance companies so we hired Sally Morin Lawyers. Fortunately we received Annie Heller who showed strong ownership of the case, dealing with all communications from medical to slow moving insurance companies. Annie and team helped us settle the case with money in my mom’s pocket, but more importantly helped all of us not worry about anything besides my mom’s recovery. thank you!
Carmen and team at Sally Morin are the best. Having Carmen and her team for my personal injury case is one of the lucky thing for me in 2024
Carmen is a very capable law professional. she is expert in her domain, also she is very skillful in finding the key information.
Carmen is also a compassionate and kind person, she listened and also put my interests in priority. At the same time she patiently explained to me the law information.
Carmen is also very good with execution, the whole process she is proactively driving it towards the satisfactory result
What more can you ask for a lawyer who is capable, professional, kind, effective and efficient.
I was very fortunate that, by pure luck, I found Sally Morin’s firm online. It wasn’t recommended to me by anyone, but I now want to recommend them to EVERYONE, especially my fantastic attorney, Annie Heller. Annie was compassionate, honest, attentive, and responsive to my calls and emails. Throughout the entire process of my claim, I felt completely supported by her, and even after my case was successfully settled, she followed up with me. Thank you Annie, for your exceptional legal service!!
Amazing! After months and months of going it alone and getting nowhere with our sons accident, and struggling...badly, we were lucky enough to get refered to Sally and Rebecca.
They took over the whole case and handled everything.
The whole team was very personable, professional, keeped us in the loop the entire time and cared about what was going on.
They also set us up with all the right people to make sure the settlement funds were properly handled in the most efficient way for us.
I just dont think we could have done all of this without them. It was a terrible time for our family, and we are very gratefull for everything they did for us! Thank you guys! ~HavasuLew
Rebecca and the Sally Morin team provided invaluable support during a challenging period after our daughter was involved in a car accident. Their care, expertise, and dedication resulted in an outcome that exceeded our highest expectations. Working with them was a great experience, and I wholeheartedly recommend their services to anyone, without hesitation!
I worked with Annie on my case and had such a pleasant experience! I felt supported and understood throughout the whole process. I highly recommend Sally Morin firm. Being injured isn't pleasant, so having a team behind you that's got your back makes the experience that much better.
I just spent the last 8 months working with a team of caring, compassionate, relatable women for my personal injury claim. Brief background: I was hit by a car while riding my bike to work. The driver pulled out of a parallel parking space without looking and was completely at fault. Initially, he and the others in the car were very concerned, but ghosted us afterwards and made up a story in order to not take on the blame. I ended up needing surgery and costs mounted, so I sought legal advice. After much research, I settled on Sally Morin Law. The team at this law firm is invested and responsive in a very personable way. I specifically worked with Carmen and Annie. Carmen took the lead and she answered every email, text, and annoying question my husband and I sent her way. She wrote a detailed demand letter that personalized my case and thoroughly explained the impact the accident had on my life, my children's lives, and my husband's life. In the end, our own insurance policy covered the claim to the fullest amount. Additionally, Carmen was able to negotiate the medical lien to $0, and my husband received a separate smaller amount for loss of consortium. We are more than happy with the results as it’s way beyond what we expected, and completely life changing. We didn't proceed with the case thinking we would have the outcome we did, and almost didn't pursue the case. However, after spending my own money on copays, days off from work, take out, uber rides, babysitters, and special equipment, it just didn't feel right not to seek help and I am so glad that I did! I highly recommend Sally Morin Law!
Last year me and my partner was in a MC/Car accident. I was clueless on what rights we had and how to proceed with insurance claims etc. I contacted Sally Morin Personal Injury Lawyers, who guided us through the year long process in a very pedagogical manner, a lot of support, expertise and professionalism - answering any questions we had in a timely manner. Highly recommended, they made a painful experience very manageable. Thank you, Rebecca, Carmen, and Amber!
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Amy R.
Verified
I can't recommend Rebecca at Sally Morin Personal Injury Lawyers more highly. Rebecca is transparent, honest, and client-centered in a way that was completely different from the other firms I considered. Rebecca broke down what can feel like a very opaque process, and helped me understand my options in an approachable way. It was immediately clear that Rebecca's advice and guidance centered around my personal best interest, not what would make her firm the most money. Thanks Rebecca and team!
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Mike B.
Verified
I unfortunately got injured in an auto accident and called a bunch of different attorneys with little to no help. I called Sally Morin Law and got help from Rebecca who was absolutely fantastic. She was there every step of the way to help and Isn't just trying to make a quick buck. She took her time with me and went out of her way to help out. Thanks for all the help Rebecca!!
Posted on Yelp
Shannon Y.
Verified
Carmen and team at Sally Morin are the best. Having Carmen and her team for my personal injury case is one of the lucky thing for me in 2024
Carmen is a very capable law professional. she is expert in her domain, also she is very skillful in finding the key information.
Carmen is also a compassionate and kind person, she listened and also put my interests in priority. At the same time she patiently explained to me the law information.
Carmen is also very good with execution, the whole process she is proactively driving it towards the satisfactory result
What more can you ask for a lawyer who is capable, professional, kind, effective and efficient.
Posted on Yelp
Dinora G.
Verified
I was very fortunate, and by pure luck, I found Sally Morin's firm on YELP. The firm wasn't recommended to me by anyone, but I now want to recommend them to EVERYONE, especially my fantastic attorney, Annie Heller. Annie was compassionate, honest, attentive and very responsive to my calls and emails. Throughout the entire process of my claim, I felt completely supported and even after my case successfully settled, she followed up with me. Thank you Annie for your exceptional legal service.
Posted on Yelp
Phil M.
Verified
Rebecca and the team at Sally Morin are awesome, plain and simple! Honestly, they were the only legal representation that didn't make me feel slimy after the first conversation. I was thrilled to work with them on my injury case after realizing it was more than I could handle dealing directly with the other party's insurance myself. They advocated for me and my family, going into incredible detail and crafting a great strategy for what to do next. The end result was a pleasant surprise, far exceeding my expectations.
Rebecca and the team definitely earn their share by providing amazing value. They're also no-pressure, which was refreshing compared to other lawyers I contacted before choosing Sally Morin. Their priority was making sure I was always informed and knew exactly what was going on, every step of the way.
If something happens again, Rebecca and Sally Morin will be my first call--and I'm sure there will be a multitude of emails to follow! :P
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Steve M.
Verified
Attorneys Annie Levitt Heller and Carmen from Sally Morin Personal Injury Lawyers are the absolute best! They are dedicated, approachable and thorough in all their work. They provided the best possible outcome for my case (I was a pedestrian hit by a car in a crosswalk) and supportive every step of the way. I would absolutely recommend Sally Morin Personal Injury Lawyers to anyone Forever grateful to them!
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James Minh N.
Verified
My sister got in a car accident, was hit badly by another driver, became unconscious, and was immediately taken to hospital emergency with an internal brain bleeding thus could not defend herself. As a result, the police report had false information from the other driver and concluded my sister at fault. While other legal firms purposed disappeared after seeing at the police report and other driver's cheap insurance policy (not easy win), Sally Morin team with great heart and "no win, no pay" written clause took on the case and successfully reversed both insurance + police reports and won the case. My family is grateful to find Sally Morin firm and great team with legal expertise, experience, and most important great heart. Thank you very much.
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Tim K.
Verified
Unfortunately me and my mom were hit by another driver on the freeway. We ended up with hospital bills and a long road to recovery especially for my 85 yr old mother. This was such a tragedy and uncertain times for us not knowing where to turn and what to do about mounting bills while trying to get our lives in order. I contacted Sally and her wonderful team. Carmen one of her associates worked with me and my mom and handled everything. Carmen was awesome and such a caring lawyer as well. She keeps
It real and we loved that about her. When you need a personal injury attorney that will work on handling your case in every aspect, insurance claims, potential health liens and negotiating on your behalf then Sally Morin Personal Injury law firm is the one to contact. You can count on them. Carmen explained everything so we knew what we were in for and was trustworthy and honest. There is no way to state how invaluable and priceless it is knowing the law firm you hired has your back and can be trusted. I hope no one ever needs a personal Injury attorney because being injured is one of the worst things that can happen to you; your life changes in an instant after a bad accident. But having a law firm like Sally Morin with lawyers like Carmen make that terrible experience much better knowing they are there to handle every aspect of your case and do it so well. Thanks Carmen and team. Much appreciated!
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Stephan B.
Verified
I originally reached out to a different law firm to handle my personal injury case, but Sally Morin's team (Rebecca Taylor in particular) left such a good impression on me that I switched to them--and I'm glad I did! They were empathetic and professional, communicated early and often, and patiently walked me through every option. They did thorough research and handled so much on their end that I was able to focus on my recovery/work/life with minimal disruption. So I highly recommend this firm.
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Michele H.
Verified
Word cannot express the honesty from Annie at Sally Morin law . She is honest kind and to the point . If you want to get ripped off by shady humans don't hire Annie . If you want honest kind and attentive go with Annie at Sally Morin law . You will feel good about your choice . She is a firm advocate with insurance and health care . Annie and her team will be available to explain things all the way through . Her integrity is not matched in this field . I would hire again and again
Thanks Annie You made one of the most difficult times in my families life tolerable !
Your kindness and integrity are not matched in everyday life . Much less with personal injury lawyers thank you thank you
Michele Hargrove
This video and accompanying text is not intended to be a source of legal advice for any purpose. Prior results do not guarantee a similar outcome. The information in this video and text does not constitute a guarantee, warranty or prediction regarding the outcome of your case.
About the author Sally Morin
When life throws you a curveball—a serious injury in a traffic accident—you need more than just a lawyer. View author bio
