Your Unpaid Medical Bills When You’re in a Car Crash

  • Dan T. Matrafajlo
  • Tue Nov 2019
  • Auto Accident,Car Accidents,
  • 0

unpaid medical billsA few months ago, the warning came out as far as selecting maximum for New Jersey PIP coverage. At the time, there was absolute uncertainty as what could happen to your unpaid medical bills when you’re in a car crash. A Supreme Court ruling seemed to suggest that you could get saddled with enormous debt – even if the accident wasn’t your fault.

The problem in the case that made it to the highest court is that the injured parties weren’t hurt enough to pursue a liability claim. However, in two separate lawsuits, both had medical bills that exceeded the amount of their coverage.

At the time, the Supreme Court ruled that they could only look for reimbursement from the responsible parties if they’d taken $250K as a PIP option and their bills exceeded that amount. Quite literally, this case created a stir across the state. After all, people who opt for nominal coverage generally don’t have the money to afford more coverage. Of course, it also stands to reason that they’ll have a hard time paying for medical treatment in excess of their policy limits.

Joshua Haines v. Jacob W. Taft essentially dealt with the intent of the legislature in dealing with no-fault insurance laws. Months later, state lawmakers clarified what happens when policyholders opt for only $15K in benefits and find themselves strapped with medical bills in excess of that cost. The bottom line is that it is possible to sue for “all uncompensated medical expenses not covered by PIP.”  It doesn’t matter if you chose a lesser amount of coverage.

Meanwhile, medical expenses can pile up even with higher coverage. You may want to see what happened in this recent case.

Car Crash Resulted in Many Unpaid Medical Bills

The New Jersey Appellate Division decided the matter of Napolitano v. MSS Vending, Inc. on November 7, 2019. Unlike the Haines case, the decision is unpublished. While it applies to the named parties, the “opinion does not constitute precedent or be binding upon any court.”

First, you’ll want to understand a brief history of the case. Maria Napolitano was injured while riding in a car driven by her father, Giuseppe. According to the case history, Tony Hudson was operating a truck that struck the Napolitano vehicle in the rear.

In the meantime, Hudson contended that the accident occurred after he was stopped partially in an intersection at a red light. Truth be told, he said it was Maria’s father who put his car in reverse and backed into the truck.

Maria’s injuries caused her to seek medical treatment that substantially exceeded the $50K PIP policy limits by $765K. Notably, she hurt her knees, shoulder and spine and sought damages for pain and suffering.

At the onset, the defendant’s attorneys disputed Maria’s claim for medical expenses. They asserted that she failed to produce witnesses to testify with expertise or training in evaluating medical bills – or who were competent to speak on their reasonableness. Defense counsel also argued that the PIP schedule should apply to all of the bills.

The trial court dismissed defense counsel’s attempts to bar the medical bills as economic loss. When they asked for reconsideration, the judge referenced the Haines matter, stating that Maria’s “medical expenses exceeding PIP limits were not inadmissible under N.J.S.A. 39:6A-12.”

Jury Awarded Some Unpaid Medical Expenses

Although there was an attempt to blame the accident on Maria’s father, the jury decided otherwise. They found that Tony Hudson’s negligence was a proximate cause of the accident. As a result, they awarded Maria $75K in damages, and half of her medical expenses.

The defendant’s appealed the court’s decision. In the first place, they argued the court should have allowed oral testimony as far as the motion to bar the claim for medical expenses. Defense counsel also contended that the judge didn’t provide a statement of the reasons for her decision.

As far as the admissibility of the medical bills, the defendants questioned the methodology used to determine their reasonableness. Notably, expert medical witnesses provided testimony with regards to the unpaid medical expenses. Additionally, the defendant claimed it was prejudicial to let the jury know that the defendant had insurance.

As it turns out, the new law regarding PIP limits became a point of interest in the matter. However, because the accident occurred before August 1, 2019 (when the law was enacted), it did not apply to this case. This accounts for the lesser amount awarded for unreimbursed medical expenses.

On appeal, the New Jersey Appellate Division reviewed the testimony of all of the medical experts and the methodology used to essentially justify the bills. The court recognizes that “health care providers and health agencies” themselves define what are the “usual, reasonable and customary” charges for medical services.

What about the issue as far as letting the jury know that the defendant had insurance? Upon review, the Appellate Division determinate that “while it was well within the judge’s discretion to tell the jury the issue of insurance coverage was irrelevant, it was a mistaken exercise of that discretion to advise the jurors that defendant was insured.”

Contact Us

Without question, injuries from a car crash can amount in overwhelming medical expenses. At the Law Offices of Beninato & Matrafajlo, we can help you through the insurance claims process. Give us a call to set up an appointment.

Dan T. Matrafajlo

Dan T. Matrafajlo

NJ State Bar #: 031722003

Dan T. Matrafajlo, Esq., is the managing member and lead partner at Beninato and Matrafajlo, Attorneys at Law, LLC. Renowned for groundbreaking contributions to personal injury law, he has set legal precedents with influential Appellate decisions and garnered recognition in the New Jersey Law Journal. A consistent honoree on Super Lawyers' Rising Star list for the past five years, Matrafajlo's litigation prowess is widely acknowledged. He has won various awards like Super Lawyers, Thomson Reuters Association 2019, and Nominated into Super Lawyers as a Rising Star from 2012 until the Present.

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