How New Georgia Laws Affect Your Medical Expense Recovery

The word “reform” generally carries a positive connotation, but that is not always justified. It sounds upbeat, like society is taking a step forward. But some reforms benefit the companies that encouraged them while making life more difficult for individuals who were better served by the system before it was altered.

This is the case with many aspects of tort reform that recently took effect in Georgia. It can be challenging to understand the potential effects of the changes based on readings of news accounts or the amended code. Here, we discuss one potential problem clients may face when recovering compensation for medical expenses after a personal injury. This may affect victims of car accidents, truck crashes, slip and fall cases, motorcycle accidents, animal attacks, and much more.

We cannot provide specific information about how the changes could affect an ongoing or upcoming case without reviewing the details of the situation, but here we can provide a general overview of the changes and potential effects. If you schedule a free consultation with us, we can explain how the laws apply to your specific situation.

How Medical Expenses Have Traditionally Been Handled in a Personal Injury Case

To better understand the changes, it is helpful to consider the situation as it stood before the reforms took effect. In a personal injury case, once an attorney has proven that someone is responsible for causing another person’s injuries, the responsible person can be required to pay compensation to make up for the effects of the harm they caused. The compensation is referred to as damages.

Georgia law allows for recovery of damages for economic losses and non-economic losses. Economic losses are costs with a direct, calculable value, such as medical expenses and lost earnings. Non-economic damages are the intangible factors that impact your life, such as pain and suffering. Strangely enough, Georgia statutes refer to economic damages as “special” damages and non-economic damages as “general” damages.

Medical expenses usually make up the majority of economic losses. Think of the cost of hospital stays, surgery, doctor visits, prescriptions, and physical therapy. Before the reform, an award for economic damages typically would cover the amounts you’d been billed for treatment you already received, plus amounts for treatment you would be likely to need in the future. This seems fair, since you would not have needed this medical care if it had not been for the irresponsible actions of the person who caused the accident.

Damages are usually paid for by insurance companies. Under the old rules, if the hospital billed you $95,000, doctor bills amounted to $30,000, and medical experts estimated that your bills for future care would be another $25,000, then these amounts would be added together to make an award of $150,000 to cover your medical expenses resulting from the accident.

It is important to take great care when estimating future medical needs because if you need more, you cannot ask for it later. When the case ends, your ability to recover compensation ends as well.

New Law Limits the Amount You Can Request

The new law, which is incorporated in the Georgia Code at §51-12-1.1, now makes health insurance payments a mandatory part of the discussion on damages. If you paid thousands of dollars every year for health insurance coverage, and your health insurance company negotiated a better rate for the services you received, then your medical recovery is not based on the amount you billed by the medical provider, but is instead based on the amount charged through the insurance contract. This includes public insurance programs such as Medicare, as well as private insurance.

The average current cost of health insurance in Georgia is over $8,700 per year. If you’ve been a responsible adult paying for insurance every year, you have paid tens of thousands of dollars, and this investment is what has enabled you to get a lower rate on your medical bills. But the new law does not provide you with any compensation for your insurance investment. If your medical bills totaled $150,000 but the cost billed through insurance was $60,000, you are only allowed to request $60,000 in medical damages. The tens of thousands you paid for your insurance are not factored into your recovery at all.

The new “reformed” system could actually reward people who do not protect themselves by investing in medical insurance. This seems grossly unfair. In addition, because juries only hear about the medical bills adjusted for the insurance rate, they can be misled into thinking your injuries are much less serious than they actually are. This false impression can reduce your award for other damages as well.

Working with the Right Attorney is More Important Than Ever Before

The insurance companies have been promoting this reform for some time, and their attorneys are ready to use all the new provisions to decrease awards for accident victims. Now more than ever, you need to work with an experienced and dedicated attorney early on if you want to recover full compensation for your losses.

At Michael M. Day Law Firm, we have been closely monitoring the changes, as we always do. We know how to fight effectively to overcome insurance companies’ strategies and recover the maximum amount available to victims of car crashes and other accidents caused by the irresponsible actions of others.

Talk to Michael M. Day and Find Out What Your Case May Be Worth

If you’re not sure whether your situation qualifies for compensation or whether you want to pursue legal action, we invite you to contact us to learn more so you can make an informed decision about your next steps. To schedule a free, no-obligation consultation and case evaluation, contact us online or call us at 404-480-4284.