The collateral source rule in a New
York personal injury case means the plaintiff cannot receive compensation for
items covered by other sources, such as health or disability insurance. In
other words, the plaintiff cannot accept payment twice for the same expense. The
collateral source rule is fair, but the medical and benefit billing system is
complex.
A New York City personal injury lawyer at Douglas & London not only protects your rights but keeps you abreast of all developments in your case and makes sure every aspect is clear. If the collateral source rule applies to your personal injury lawsuit, we will let you know.
Collateral Source
Circumstances
Usually, the collateral source rule
applies after a jury trial. Damages for medical expenses, lost wages, and
employee benefits are awarded. Under the collateral source rule, the defendant
is given a short time to request a hearing from the court. At that hearing, the
defendant must provide evidence that the plaintiff has collateral sources
paying for these benefits.
For example, if the plaintiff was
awarded $10,000 in medical expenses, but the defendant can prove that health
insurance or another source paid $8,000 of this amount, the medical expenses award
is reduced to $2,000. However, any real out-of-pocket medical expenses, such as
transportation to and from a healthcare provider’s office, remains part of your
damage award.
Moreover, if the plaintiff’s health
insurer paid all of the medical bills, it is possible for the jury to award what
the plaintiff paid in insurance premiums for two years before the verdict. Also
included are the estimated costs of health insurance benefit maintenance. That
is because this health insurance pays for future medical bills related to the
claim and thus offsets plaintiff damages.
Not all collateral sources of benefits
are counted. Exceptions are made for life insurance and Medicare. However, part
of the complexity surrounding the collateral insurance rule involves Medicare demanding
repayment from the individual after paying for the claim. This can take time and effort to resolve.
Lost Wages
Injuries often mean considerable time
lost from work. The award may have included lost wages. The defendant may
request a reduction in this category of the award based on the amount of lost
wages paid by the plaintiff’s insurance company.
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Collateral Source
Examples
In addition to private health
insurance, examples of potential collateral sources include:
- Workers’
compensation - Medicaid
- Social Security
- Other federal or
state assistance programs
If the plaintiff was able to receive
these benefits, whether or not a lawsuit went forward, they are likely examples
of collateral sources.
Reasonable
Certainty
The defendant must reach the standard
of “reasonable certainty” with their documentation to show the plaintiff has
these collateral sources for reimbursement. That standard of proof is
relatively high. It is the defendant’s burden to prove they exist and are
sufficient for paying the defendant’s expenses.
If there are discrepancies in the
evidence, such as a bill that was not covered by insurance and listed as paid
by an alternative source, your attorney will address this.
Contact us for a
free consultation
Personal injuries occur in many different ways, but they all have something in common. They resulted from another party’s negligence or recklessness. If this has happened to you, contact an experienced personal injury lawyer at Douglas & London.
We offer free consultations where we
will review your claim and advise you of your options. Call or text us 24/7 or
complete our online form to schedule an appointment.
Our clients have recovered more than
$20 billion in verdicts and settlements due to the diligent work of our
dedicated attorneys. You will only pay a fee if you receive compensation.
