Recovering Medical Expenses in a Personal Injury Claim

Accident ReconstructionAfter an accident, physical and emotional pain usually takes precedence. However, after checking into the hospital, you soon feel the financial burden of paying medical bills. This burden can be cumbersome, especially when the accident results in severe injuries requiring specialized care and extended hospital stay.

Suppose another person or entity is to blame for the accident in which you suffered injuries. In that case, you have a right to sue them and recover medical expenses alongside other damages resulting from the accident. This article looks into medical expenses, particularly how to maximize your recovery in a personal injury case.

Understanding Medical Expenses

Medical expenses are costs that go towards financing medical treatment. They include ambulance charges, hospital bills, the cost of prescription medication, therapy, assistive devices, and home care services. These expenses mean you can only recover the amount spent on expenses and nothing more. Also, you have to prove big expenses with evidence such as receipts, hospital bills, bank statements, and invoices for home service provision, etc.

Factors Affecting Recovery of Medical Expenses

Recovering medical expenses is subject to factors in a personal injury claim, such as:


The first hurdle to recovering medical expenses in a personal injury claim is proofing fault on the part of the defendant. Typically, fault is established through negligence, where the negligent party carries liability in an accident. To prove negligence, the plaintiff must show the defendant owed them a duty of care; they failed to uphold that duty, resulting in an accident and compensable damages. However, not all claims are based on negligence.

In product liability cases, strict liability applies where the defendant is held liable even when the accident did not result from negligence.

In some circumstances, a defendant and the plaintiff may have shared a folder in an accident. Under such circumstances, the state approach to shared fold determines whether or not the plaintiff can recover compensation.

In states that fall over a contributory approach to negligence, a plaintiff loses the right to compensation if they are partly to blame for the accident. Conversely, the plaintiff can recover compensation in comparative negligence states, but the year percentage of fault will limit the recoverable amount.

Insurance Coverage

As stated earlier, medical expenses are the sum of all costs of treating your injuries after an accident. However, it is essential to note that your deserved compensation doesn’t always equal what you recover because it may be limited to the defendant’s insurance coverage. Typically, you recover compensation from the defendant insurer. If your medical expenses exceed the defendant’s policy coverage, their insurer can only pay up to the policy coverage limit, leaving you to recover the balance directly from the defendant. Unfortunately, there are no guarantees that the defendant will have the resources to pay the balance.


If you have medical insurance or are covered under Medicare, your health insurance provider or the government will cover your medical expenses. So, recovering compensation for medical expenses in your personal injury claim would mean you get double recovery for your losses.

To prevent such a scenario, the law allows third parties, in this case, your insurer and the government, to seek reimbursement for expenses covered as part of your treatment in a process called subrogation.

Subrogation is not always mandatory, and some entities may not seek reimbursement. Also, your lawyer can negotiate with the subrogation entity on the amount they can recover to maximize what you recover in your claim.

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