More Deform Hurting You - And Response (2)

Monday, February 11, 2013

Well, just saw another bill was submitted in Nashville that would take benefits responsible victims secured for themselves and give them to drunk drivers.  It has been masked as the "phantom damages" bill.   

So when the drunk driver takes you out at an intersection, the legislature wants to take away any deductions and benefits you get through your own health coverages that you paid for yourself and give that to the drunk driver.  Bravo.  

This will also hurt BCBS subrogation recoveries.

Jay Kennamer

McMahan Law Firm 

* * * 

If the Phantom Damages Elimination Act proposed by a Tennessee legislator were to become law, recovery of damages for personal injury would be limited. In order to form an opinion whether the bill should be passed or defeated, one must know the limitation sought to be imposed. 

The bill limits only one item of recovery for personal injury, namely, medical expenses. Tennessee law provides that an injured person may recover for past and future medical expenses shown by expert testimony to have been incurred or which are expected to be incurred by reason of the injury. 

If an injured party has health insurance (for example, with BCBS or Medicare), doctors, hospitals and other health care providers probably have agreed in advance to accept less than the actual amount of their medical bills. If so, the injured party pays part of the bills (for example, co-pays and deductibles), and the health insurer pays part of the bills. The remainder of the bills is "written off" or forgiven. 

The health care providers may not recover and the injured party is not liable for the amount of the medical bills which has been forgiven. Under current Tennessee law, however, the injured party, nonetheless, may seek recovery of all of the medical bills. At a trial, the jury would hear testimony about all of the medical bills and would not be told about the fact that part of the bills had been written off and was not owed by the injured party. If the jury awarded the injured party money for the amount of the bills which had been forgiven, the party could keep the money and could not be required to share it with the health care providers. 

The bill seeks to change Tennessee law to provide that the injured party cannot recover the amount of medical bills which was written off. The party could still recover out-of-pocket payments and payments by the health insurer. The bill does not contain any limitation upon recovery of future medical expenses. 

The right of recovery by health insurers would not be affected in any manner. In fact, the bill states specifically that subrogation rights are not altered. 

Don Strickland 

* * *  

However well intended the legislation is, it penalizes the wrong party.  The wrongdoer should be held responsible for all the harm he or she causes.  A party injured by the tortious act (whether intentional or negligence) of another is entitled to recover the reasonable value of necessary medical services.  Presumably, the legislature is seeking to define "reasonable" as what an insurer pays to reimburse a medical provider for services rendered.  In essence, then, the law would punish the victim (and reward the wrongdoer) by precluding the victim from recovering from the wrongdoer for all the harm that he caused, because, the legislature has determined, the original amount of the medical expenses is unreasonable.   

If the legislature believes that the cost of medical care is too expensive and that the lesser amount negotiated by insurers constitutes what is reasonable for the services rendered, then it should regulate the medical industry directly, not through restricting the rights of injured parties. 

Trevor Atchley


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