“Settlements are like Snowflakes”

No two settlements are identical.  But my friend/cousin/neighbor/etc. settled their claim for $$ and they were not hurt as bad as I was.  We hear this all the time when it comes to personal injury settlements.  Unfortunately, all I can say in response is “Good for your friend/cousin/neighbor/etc.”

Even within the same vehicle in an accident, there can be different settlement results among the claimants. That’s because no two people are identical (except identical twins! And even they are going to have some differences—just ask their Mom).

Think about it.  Even in a rear-end collision, the occupants of the vehicle are going to be affected differently.* Those in the back seat may be impacted greater than those in the front seat since they are physically closer to the impact. Or maybe not.

Maybe the backseat passengers are children who are secured in proper car seats and are more insulated from the impact and were not injured at all, and yet the parents in the front seat sustained soft tissue injuries to their neck and back, or a knee injury from striking the dashboard, or a head injury from striking the steering wheel. Each of those injuries, or lack thereof, is going to merit a different settlement value.

However, the nature of the injuries alone does not dictate settlement value. The amount of settlement bills incurred are also a factor in determining settlement values.  In North Carolina, the amount of bills incurred in an accident has become a veritable playground for insurance companies and hospitals and a minefield for claimants and their attorneys.

This is due to North Carolina General Statute 8C-1-414, commonly referred to as Rule 414.  This is an evidentiary rule stating evidence of medical expenses is limited to the amount “actually paid to satisfy the bills.” Therefore, if the two parents in the above scenario are both employed and each have their own health insurance through their respective employers, and they both go to the same hospital, that hospital may have a different contract with each health insurance provider.  This can result in the hospital charges that each parent is allowed to claim toward the total bills are different, even if the actual amount of the two hospital bills are the same.  Of course, that would even be assuming they received the same treatment at the hospital.

To go even further, the hospital, or other medical providers (radiologist, orthopedist, physical therapist, etc.), may choose not to bill health insurance at all, hoping that it may ultimately get more than it would have if it had billed health insurance. This may especially be true for those who have Medicare and Medicaid.  Even though those are considered a collateral source and secondary payers, insurance companies are often taking those credits, even if they have not yet been applied. This lowers the overall settlement offer and can often force the matter into litigation.

Once in litigation, defense attorneys are taking the depositions of billing clerks to determine or establish that they may take less than the actual bill to satisfy the account, thereby lowering the overall value of the claim.  That is one reason North Carolina personal injury litigation attorneys are opting to not submit the bills at all, but rather only submit claims based on the nature and severity of the accident, the nature and severity of the injury, the length of treatment, and permanency, among other factors.  Of course, each claim must be looked at on a case-by-case basis to develop the best strategy for a particular claim.

At the Law Offices of Jason E. Taylor, PC, we have the experience to navigate these issues and help you make reasoned, informed decisions regarding your case.

*  Robyn M. Buckley is not a bio-mechanical engineer and this statement is merely based on her many years as a personal injury attorney.

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