Detailed Answer

Disclaimer: This information is for general education and is not legal advice. Consult an attorney for advice about your specific situation.

In West Virginia, no statutory rule like North Carolina’s Rule 414 authorizes an insurance adjuster to unilaterally reduce your medical bills in a personal injury claim. Instead, West Virginia applies the collateral source rule, which generally prevents a defendant or insurer from using evidence of payments you received from third parties (such as health insurers) to lower the damages you can recover.

Key principles under West Virginia law:

• Collateral Source Rule: Courts bar evidence that a plaintiff’s medical expenses were paid by insurance or another collateral source. Defendants must prove that you actually owe less than the provider’s billed charge by showing a binding reduction you agreed to in writing.
• Contractual Write-offs: If your health insurer has a contractual agreement with a medical provider—and you are not personally liable for the difference between billed charges and the insurer’s negotiated rate—then you cannot recover the full billed amount. You may only recover the amount you are legally responsible to pay.
• Medical Malpractice Exception: West Virginia law narrows the collateral source rule in medical-malpractice cases. See W. Va. Code § 55-7B-6 (link: https://code.wvlegislature.gov/55-7B-6/). In most other personal injury cases, the traditional collateral source rule stands.
• Evidence of Insurance: West Virginia Rules of Evidence, Rule 411, prohibits using evidence of liability insurance to prove negligence or the amount of damages. (See https://www.courtswv.gov/legal-community/court-rule-repository/rules-of-evidence.html.)

As a result, an adjuster cannot simply apply North Carolina’s Rule 414 or any West Virginia evidentiary rule to reduce your medical bills. They may negotiate with you or your provider for settlement purposes, but they cannot rely on an evidentiary rule to lower the amount you can claim unless a written agreement binds you to a reduced amount.

Helpful Hints

• Review your health plan’s contract with medical providers to confirm your out-of-pocket obligation.
• Keep itemized bills and any explanation of benefits (EOBs) that show what insurers paid and what you owe.
• Understand the collateral source rule: third-party payments generally cannot reduce your damages.
• Watch for medical-malpractice claims; statutory exceptions may apply under W. Va. Code § 55-7B-6.
• Consider consulting a personal injury attorney familiar with West Virginia law before accepting any settlement.