Disclaimer: This article is for general informational purposes only and does not constitute legal advice. Always consult a qualified attorney about your specific situation.
Detailed Answer
Understanding Michigan Rule of Evidence 409
Michigan Rule of Evidence 409 (MRE 409) governs the admissibility of evidence regarding payment of medical and similar expenses. Under MRE 409, if you voluntarily pay or offer to pay medical bills for an injured party, that fact cannot be used in court to prove liability for the injury. You can read the rule here: MRE 409.
Why MRE 409 Doesn’t Let Adjusters Slash Your Bills
- MRE 409 applies only to evidence at trial. It prevents parties from telling a jury that someone paid or offered to pay medical expenses.
- It does not grant an insurance adjuster authority to reduce or rewrite your medical bills.
- Adjusters negotiate payment amounts based on your insurance policy terms, provider contracts, and Michigan’s No-Fault law, not on evidence rules.
How Insurance Adjusters Actually Handle Medical Bills in Michigan
- No-Fault Benefits: If your claim arises from an auto accident, Michigan’s No-Fault Act (MCL 500.3101 et seq.) requires insurers to cover reasonable and necessary medical expenses up to policy limits.
- Usual and Customary Rates: Insurers often pay at “usual and customary” or network-negotiated rates. They compare billed charges to a database of typical fees for similar services in your area.
- Provider Agreements: Insurers may have pre-negotiated discounts with medical providers or use third-party administrators to secure reduced rates.
- Review and Audit: Claims adjusters review itemized bills to remove duplicate or noncompensable charges under your policy.
- Subrogation and Liens: If another party is responsible, the insurer may pursue reimbursement (subrogation) and coordinate lien reductions with your providers.
In short, while an adjuster can negotiate how much your insurer pays, MRE 409 does not empower them to unilaterally cut your bills. Negotiations hinge on policy language, provider contracts, and Michigan’s No-Fault statutes.
Helpful Hints
- Review your policy’s medical expense coverage and limits.
- Obtain detailed, itemized medical bills and compare them to usual and customary rates.
- Ask your medical providers if they participate in your insurer’s network or accept negotiated rates.
- Document all communications with your adjuster in writing.
- Consider consulting a personal injury attorney if you face unreasonable bill denials or excessive reductions.