Detailed Answer
Under Alabama law, you can recover medical expenses as part of a personal injury settlement. To confirm an offer fully covers your medical costs, follow these steps:
1. Itemize Past Medical Bills
Request all bills from hospitals, physicians, therapists, and pharmacies. Review each line item for accuracy, service dates, and outstanding balances.
2. Project Future Medical Needs
Consult your treating physician or a life care planner. Estimate costs for additional treatments, surgeries, rehabilitation, follow-up visits, and durable medical equipment. Obtain a written cost projection.
3. Account for Medicaid Liens
If Medicaid covered any treatment, the Alabama Medicaid Recovery Act (Ala. Code §22-6B-1 to §22-6B-7) requires reimbursement. Determine the lien amount and include it in your total demand.
4. Verify Hospital Liens
Alabama hospitals may file statutory liens for services related to injury cases under Ala. Code §35-11-199 (link). Confirm any recorded liens and adjust your net settlement needs accordingly.
5. Understand the Collateral Source Rule
Under the collateral source rule, defendants cannot reduce their liability by payments from third-party sources (Ala. Code §6-5-548). Despite this rule, insurers may assert subrogation rights, which you must address.
6. Compare Offer to Total Costs
Add past bills, projected future expenses, and lien obligations. Compare this sum to the settlement offer. If the offer falls short, prepare to negotiate or reject.
7. Engage Medical and Financial Experts
Consider hiring a medical billing advocate to audit charges and a forensic economist for future cost analysis. Expert reports strengthen your position during negotiations.
8. Negotiate with Insurers
Submit a demand letter detailing itemized costs, liens, and projections. Attach supporting documentation. A clear presentation often leads to improved settlement terms.
Helpful Hints
- Gather itemized medical records and billing statements early.
- Use a life care plan for long-term cost estimates.
- Identify potential Medicaid or hospital liens before settlement talks.
- Hire a medical bill auditor to detect billing errors or inflated charges.
- Review your health insurance policy for subrogation clauses.
- Consider a structured settlement to ensure treatment funding over time.
- Consult an attorney before accepting any final offer.