The Apples and Oranges of Fair Compensation

Jay Stillman

3 min read

In this post, Stillman and Friedland offers you a look at recent rulings which nearly upset the apple cart of usual rates of compensation for personal injuries in Tennessee. Although the status quo for plaintiffs was upheld, the decision raises a number of issues which may re-surface at a later date. We will explain these issues clearly—without the legalese so you can understand the implications for cases in Tennessee.

Why is a Lawyer Your Best Bet if You Have Been Injured in an Accident?

If you have incurred expenses for medical treatment for your injuries, those medical bills are the key to your proving injury—other factors are lost wages and pain and suffering, but medical costs and treatment are the main determinant of the severity of your injuries. At Stillman and Friedland, we save our clients a lot of money by negotiating reductions in the amount of medical bills you have to reimburse to our health insurance. On the other hand, your settlement amount will be based in part on the original costs, before reductions are made.

Two recent rulings dealt with the issue of full medical expense vs negotiated net amount of medical expenses to be submitted in court for compensation.

In the first case, the Tennessee Supreme Court ruled on the issue of hospital liens. In some cases injured plaintiffs are dependent on the proceeds of their settlement to actually pay medical bills, because they have insufficient or no medical insurance. A hospital will hold a lien against the proceeds of the settlement—essentially the lien is the patent’s IOU for the medical bills. In the case of West vs. Shelby Healthcare Corporation, the Court basically held that the liens should be based on the discounted amount of the medical costs, not the full cost. This ruling put more money in the plaintiff’s pocket, because the reduced lien means more of the settlement remains in the plaintiff’s pocket.

In a “turnabout’s fair play” move following the West vs. Shelby decision, defendants in another case claimed that the settlement also should be based on discounted rates. The defendants were obviously the insurance company liable to pay the claims. Ultimately, the Court upheld the status quo for a full-rate basis for plaintiff compensation. This is a big victory for personal injury clients. You won in two ways:

  • The Tennessee Supreme Court upholding the full gross sum of medical expenses as evidence, means you can afford representation to get the best results. Without representation, you would be at the mercy of insurance companies, and far less likely to get fair compensation.
  • An attorney will always counsel you to take your time and complete treatment. Insurance companies want to open and shut claims as fast as possible. Injuries, especially back and neck traumas often manifest weeks after the injury, and take a long time to resolve. Without counsel and with a rushed settlement you could end up without compensation for essential treatment and the possible lost wages due to back pain, etc.

There are multiple issues within these rulings which will be revisited. The coming collapse of Obamacare, and a new system of insurance will again raise issues of fair compensation. Some of these issues are due to differences in cost of care for insured and uninsured patients and questions as to whether fixed rate schedules should be the basis of compensation.

Whatever the results of these upcoming shake-ups, Stillman and Friedland will be here to provide the best counsel based on our many years of helping clients achieve fair compensation.

Because we care…