How medical and therapy expenses are recovered in a Maine accident claim

Short answer: In Maine you can usually recover reasonable past medical bills and, where you can prove they are caused by the accident, reasonable future medical and therapy costs as part of a personal injury claim. Recovery depends on proving liability, causation, and the amount of the damages. This article explains what you will need to show, common limits and pitfalls, and practical steps to protect your claim.

Detailed answer

What kinds of medical and therapy expenses are recoverable?

If the accident was someone else’s fault you may recover economic and non‑economic damages. Economic damages commonly include:

• Past medical expenses: hospital bills, emergency care, physician visits, diagnostic tests, prescriptions, physical therapy, occupational therapy, chiropractic care, and mental‑health therapy already paid or billed.
• Future medical and therapy expenses: ongoing physical therapy, future surgeries, long‑term rehabilitation, durable medical equipment, home modifications, and expected future mental‑health treatment when supported by medical opinion.
• Related costs: transportation to medical appointments, home health care, and caregiving costs when tied to the injury.

What you must prove to recover those expenses

Three core things a plaintiff must establish:

1. Liability: The other party’s legal fault for the accident (negligence, intentional act, or a statutory violation).
2. Causation: A reasonable medical link between the accident and the injuries/treatment. Treating clinician testimony and medical records are key.
3. Amount of damages: Credible proof of past bills and reliable evidence (medical experts, life‑care plans) estimating future costs.

Evidence that strengthens recovery of medical and therapy costs

Strong proof increases likelihood of full recovery:

• Complete medical records and itemized bills that match the treatment you claim.
• Treatment notes from your primary treating providers stating diagnosis, treatment plan, and relation to the accident.
• Expert testimony or a life‑care planner for significant predicted future care. Experts explain expected treatments, frequency, and cost.
• Photographs, accident reports, and witness statements that support liability and the seriousness of injuries.

How future therapy and long‑term care are valued

For ongoing needs you normally need an expert to project future costs. Courts and insurers look for:

• A treating provider’s opinion that treatment will be needed in the future.
• Detailed cost estimates (hourly rates for therapists, expected sessions, equipment costs, etc.).
• Documentation tying projected treatments to the accident injuries rather than to preexisting conditions.

Effect of your own fault

Maine reduces a plaintiff’s recovery by the percentage of that plaintiff’s fault. In practice, if the factfinder assigns any percentage of fault to you, your total award for medical and other damages will be reduced proportionally. If fault allocation is complex, consult counsel before settlement.

Health insurance, liens, and subrogation

Recovering medical expenses from a third party often triggers health‑insurer or government liens and subrogation claims. Common considerations:

• Private insurers often seek reimbursement from your settlement for payments they made. The insurer’s contract may control their recovery.
• If Medicare or Medicaid paid, federal and state rules may require repayment or notice and can complicate settlement. Follow the statutory notice and lien procedures for these programs.
• Ask for itemized statements showing what was paid versus what remains owed. Resolving liens is a routine part of personal injury settlements.

Timing: statute of limitations and why you should act promptly

Maine law imposes time limits to file a lawsuit. Missing the deadline can bar recovery. See Maine’s civil statutes for the applicable limitation periods and exceptions. For an overview of Maine’s limitations framework, see the Maine Revised Statutes, Title 14 (Civil Procedure): https://www.mainelegislature.org/legis/statutes/14/title14index.html. For the specific statutory sections that govern time limits, review the text on the Maine Legislature site, or consult an attorney promptly to preserve your claim.

Practical steps to protect your right to recover

1. Seek immediate medical care. Prompt treatment documents injuries and helps prove causation.
2. Keep all medical bills, receipts, and a treatment diary (symptoms, limitations, missed work, therapy progress).
3. Follow your doctors’ treatment plans and keep scheduled appointments—gaps can weaken claims for ongoing care.
4. Notify your insurer and preserve evidence (photos, witness names, police report).
5. Before accepting any insurer settlement, consider how it resolves future care and whether liens will reduce your net recovery.

When to get a lawyer

Consult an attorney if any of the following apply:

• Your injuries require ongoing or expensive future care.
• Liability is disputed or multiple parties might share fault.
• Government benefits (Medicare/Medicaid) paid medical bills.
• An insurer offers a quick lowball settlement before full recovery is known.
• You face complex liens or subrogation claims.

An attorney can value future damages, handle negotiations, and ensure liens are addressed so you receive appropriate net recovery.

Helpful Hints

• Document everything: dates of treatment, names of providers, invoices, receipts, and missed‑work records.
• Get written opinions from treating physicians linking treatment to the accident—this is key for future care claims.
• Keep copies of communication with insurers and any demand letters.
• Do not sign medical release forms beyond what is needed for the claim without understanding the scope—they can allow insurers to obtain unrelated records.
• Ask insurers to itemize their subrogation or lien claims. Make sure reductions are lawful and proportionate.
• Consider hiring a life‑care planner or rehabilitation expert if you face long‑term therapy or support needs.
• Consult a Maine attorney before signing a settlement that attempts to close out future medical claims.

Disclaimer: This article is for general informational purposes only and is not legal advice. It does not create an attorney‑client relationship. Laws change and every case turns on its own facts. For advice about your situation, consult a licensed Maine attorney.

Relevant Maine statute resource: Maine Revised Statutes, Title 14 (Civil Procedure): https://www.mainelegislature.org/legis/statutes/14/title14index.html