According to the 2012 North Carolina General Statutes, Rule 414 or the evidence of medical expenses, states that, “Evidence offered to prove past medical expenses shall be limited to evidence of the amounts actually paid to satisfy the bills that have been satisfied, regardless of the source of payment, and evidence of the amounts actually necessary to satisfy the bills that have been incurred but not yet satisfied. This rule does not impose upon any party an affirmative duty to seek a reduction in billed charges to which the party is not contractually entitled.”
The rule states that regardless of the source of the payment, only the actual sums paid to meet medical expenses may be taken into account.
Say someone gets injured and their medical bills amount to $8,000. In the past, if the person responsible for the injury had liability insurance, the insurance would have been expected to pay the entire $8,000. However, under Rule 414, the liability insurance is now only required to pay the actual amount needed to cover the medical bills, for example, $5,000. So, the insurance would only pay $5,000 instead of the full amount ($8,000), even if the injured person has their own health insurance and pays premiums for it.
It’s important to note that if the medical expenses exceed what the injured person’s insurance or any other contractual agreement covers, there is no legal obligation for the injured person or their insurance to negotiate or try to reduce those charges. They don’t have to actively seek lower medical bills beyond what their insurance coverage or contracts specify.
When you’re proving your personal injury claim, you can only show the amount needed to fully pay the bill or if you still have an outstanding balance, the amount required to settle the bill. It is important to understand that you cannot present the original amount that the medical provider charged you.
The difference between the original amount billed and the amount needed to satisfy the bill is significant. If you have health insurance and you receive treatment from a healthcare provider, your insurance might cover a lower amount than what the provider initially charged. This means that when you’re in court, you should focus on presenting the actual amount you need to pay or will need to pay, rather than the higher amount that was initially billed by the medical provider.
Rule 414 has an effect on claims settlement even though its main focus is on what can be used as evidence in court. Before beginning negotiations, insurance adjusters frequently ask about any additional payments or discounts related to the medical bills. The adjuster may choose not to make an offer if you refuse to disclose this information, even though it is not legally required by Rule 414.
If you or a loved one have been seriously injured, it’s worth taking a few minutes to call Tatum & Atkinson, PLLC at (800) 529-0804 for a free consultation. There’s no obligation, and we can answer any questions you have about your claim. Don’t wait – for personal injury cases in North Carolina, you only have three years (sometimes less) from the date of the accident to file a lawsuit. The sooner you get the process started, the sooner you can receive the compensation you deserve.