Detailed Answer
Under Mississippi law, an insurance adjuster cannot unilaterally reduce your medical bills by invoking North Carolina Rule 414. Rule 414 is part of North Carolina’s Rules of Evidence governing admission of certain character evidence in court. It has no force in Mississippi and does not apply to insurance claim handling here.
In Mississippi, adjusters must follow the Unfair Claim Settlement Practices Act (Miss. Code Ann. §83-11-501), which requires them to act in good faith, investigate claims fairly, and pay covered expenses that are reasonable and necessary under the policy. You can review the statute here: Miss. Code Ann. §83-11-501 (Ch. 11, Title 83).
Adjusters often negotiate with medical providers to accept discounted “network rates” or “usual and customary” fees. Those agreements come from your policy language (for example, medical payments coverage or health-care provider networks), not from Rule 414. If your policy includes a fee-schedule or network-provider clause, the adjuster may pay less than your full billed charges, but only because your contract authorizes it.
If you have no such clause, the insurer must cover all reasonable and necessary medical expenses up to your policy limits. If an adjuster reduces or denies bills outside of those terms, you can challenge their decision through your insurer’s appeal process or file a complaint with the Mississippi Insurance Department.
Helpful Hints
- Review your policy’s insuring agreement and any fee-schedule or provider-network provisions.
- Understand Mississippi’s collateral source rule (Miss. Code Ann. §11-7-17), which generally prevents reducing your recovery by other payments you receive.
- Keep detailed records of all medical treatment and billing statements.
- Request a written explanation if an adjuster denies or reduces a bill—ask them to cite the specific policy provision.
- File a complaint with the Mississippi Insurance Department if you believe an adjuster violated Miss. Code Ann. §83-11-501.
- Consider consulting a Mississippi attorney if the insurer continues to undervalue or deny covered medical expenses.
Disclaimer: This article is for educational purposes and does not constitute legal advice. You should consult a qualified attorney to discuss your specific situation.