Four ways to cover personal injury case medical expenses if you have lost your health insurance (and job) as a result of COVID-19

May 15, 2020

Whether as a result of economic downturn, stay-at-home governmental orders, or other COVID-19 related reasons, many employers have been required to terminate their employees or close business causing those employees to lose their health insurance and other employment benefits. While losing one’s job and health insurance has general detrimental impacts, it may feel even more burdensome to those with active personal injury cases who still require necessary medical treatment. Worse yet, those with personal injury cases may feel the need to choose between paying out-of-pocket for necessary treatment to recover or preserving their own financial resources for the unknown future. While feeling that way may seem reasonable, other options may be available that are worth exploring:

1. Evaluate whether medical payments coverage is available

First, explore whether medical payments coverage is applicable. Medical payments coverage, also known as “med pay”, is a type of insurance that applies, regardless of who is at fault, to cover medical expenses related to injuries sustained as a result of the incident. Med pay is most commonly associated with car insurance, but it can also be included in commercial property policies or home-owners insurance policies. If med pay is available, you may be able to access it to cover related medical treatment. If you do not have health insurance, med pay coverage can ease the burden and financial strain of having to pay for such treatment out-of-pocket.

As mentioned above, one other benefit med pay is that is accessible regardless of who is at fault. Therefore, even if you do not have a personal injury claim, or in instances where you may be at fault, you still may be able to access coverage from the insured property or vehicle to cover the related medical expenses.

2. Determine whether medical providers will accept a letter of protection

Second, if medical payment coverage is not applicable, or has been exhausted, discuss with your medical provider whether it would be willing to accept a “letter of protection.” A letter of protection is a letter, often sent by an attorney, ensuring the medical provider that expenses for all related treatment from the past or for a procedure in the future will be paid for in the future from a future settlement or jury verdict award if one is obtained.

Letters of protection provide several benefits for the patient. First, they allow the individual to continue receiving the treatment necessary to recover without having to pay for such treatment when he or she otherwise might not be able to do so. Second, they prevent unpaid medical bills for which the patient is responsible from being submitted and pursued through collections, which can result in damaged credit scores.

3. Establish a payment plan

Third, if medical payment coverage is exhausted or unavailable, and the provider is unwilling to accept a letter of protection, one should coordinate with the medical provider’s billing department to establish a minimal payment plan. While this scenario often can be financially stressful, it can prevent an individual’s credit from being hurt, which can create more issues later after the resolution of his or her personal injury claim. Many medical providers are willing to consider reasonable and manageable monthly installments.

4. Be careful to avoid pitfalls associated with hospital financial assistance programs

Lastly, if you are unable to establish a payment plan, the medical provider itself may have a financial assistance program. However, it is important to understand the effects such a program may have on your personal injury claim, and be sure to communicate with your attorney, if you have one, about those effects.

As you may already be aware, one’s personal injury settlement value is partly based upon an individual’s medical expenses, among other variables. For Ohio personal injury claims in particular, one variable insurance companies and defendants use to assess settlement values is the cost of medical expenses that were accepted by the medical provider for services rendered. This figure includes that amounts paid out-of-pocket, the amounts that health insurance or car insurance paid, and the amounts that are still outstanding. This does not include any reduced or written off portions. This figure also is known as a so-called Robinson number (Robinson v. Bates).

First, should a medical provider reduce its medical expenses based upon that individual participating in its financial assistance programs or charities, the reduction of expenses could also reduce one’s Robinson number and what damages may be claimed in that individual’s personal injury suit. As a result, the value of the personal injury case may be lowered.

Secondly, hospital financial assistance programs can sometimes include stipulations that require the full value of services to be paid back to the hospital, instead of the reduced, negotiated amount when a personal injury settlement is achieved. At first glance, this seems fair. However, if these issues are not discovered until after a settlement is achieved, one may end up reimbursing the hospital for the full value of services, but only achieve a lower settlement based upon the reduced portion. Therefore, while these programs can provide relief and benefit to individuals, it is important to understand the impact certain decisions may have on your personal injury case and use good strategy in making those decisions.

If you need help navigating the above issues in connection with your personal injury lawsuit, we are here to help. Please feel free to call (614) 221-4035 to schedule a free, no obligation consultation.