News & Analysis as of

Medical Expenses Insurance Litigation

Troutman Pepper Locke

Litigation Heats Up Over Air Ambulance Billing Practices Under the No Surprises Act

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There has been a flurry of recent activity in a case originally filed by six air ambulance companies claiming $20 million in unpaid emergency services invoices. ...more

Tyson & Mendes LLP

Calculating Past Medicals in California

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The Third District Court of Appeal in California recently addressed the standard in proving the reasonableness of charges for past medical services within the context of the Hospital Lien Act’s definition of emergency and...more

Snell & Wilmer

Redefining the Rules: How Audish v. Macias Reshaped Future Medical Expense Claims in California Personal Injury Cases

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In Audish v. Macias (2024) 102 Cal.App.5th 740, the California Court of Appeal decided a key issue concerning the admissibility of a plaintiff’s future Medicare eligibility in calculating damages for future medical expense...more

Rumberger | Kirk

Florida Supreme Court Says Permissive Language of Florida PIP Statute and Policy Provisions Dictate Payment of Medical Expenses by...

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In Florida, personal injury protection (PIP) coverage limits reimbursement of medical charges to 80% of “all reasonable expenses.” What is “reasonable” is generally determined by a statutory schedule of maximum charges...more

Carlton Fields

New Jersey Court Holds Primary Home Insurer Must Cover Dog Bite Injury at Insured’s Second Home

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In Berardi v. FMI Insurance Co., a panel of New Jersey’s Superior Court, Appellate Decision, affirmed a lower court’s ruling, which ordered a primary home insurer to defend its insured in a dog bite lawsuit, stemming from...more

Rumberger | Kirk

The Multiple Issues Surrounding Medicare and Past Damages

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What amount of past medical expenses can a plaintiff present to the jury when he or she is a Medicare recipient? The short answer: only the amount of past medical expenses the plaintiff is obligated to pay, not the gross...more

Jaburg Wilk

Arizona Insureds are Legally Entitled to Recover Reasonable Rather Than Incurred Medical Expenses

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Is an insured legally entitled to recover the incurred amount of medical expenses or a reasonable amount of medical expenses? This issue often arises in first-party bad faith cases arising from uninsured motorist (“UM”) and...more

Butler Weihmuller Katz Craig LLP

Dial v. Calusa Palms Master Association, Inc. - Florida Supreme Court Confirms Only Amounts Actually Paid By Medicare Are...

On April 28, 2022, the Florida Supreme Court issued its decision in Dial v. Calusa Palms Master Association, Inc., which addressed the question: DOES THE HOLDING IN JOERG V. STATE FARM MUTUAL AUTOMOBILE INSURANCE CO., 176...more

Jaburg Wilk

Arizona District Court Holds "Reasonable" Medical Expenses Are Amounts Accepted by Providers as Payment in Full Rather Than Billed...

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The Holding - In Jimenez v. Progressive Preferred Ins. Co., 2020 WL 2037113 (D. Ariz. Apr. 28, 2020), a putative breach of contract and insurance bad faith class action arising from a MedPay claim, the Arizona District...more

Dentons

Iowa Legislature Addresses "Phantom Damages" in New Bill

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Governor Reynolds signed a bill this week altering and clarifying the amount of damages a claimant may recover for medical expenses in a personal injury lawsuit. This new law remedies confusion that had arisen over time...more

Carlton Fields

Court Compels Arbitration of Balance Billing Dispute Under a California Health Plan, Severs Certain Unconscionable Provisions, and...

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A patient sued her health plan and the plan’s debt collector under various California and federal laws in connection with alleged attempts by the plan to unlawfully collect the balances of the plaintiff’s medical statements...more

Butler Snow LLP

Bills, Bills, Bills: Calculation of Past Medical Expenses under Texas Law

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Under Texas law, recovery of past medical expenses is limited to the amount actually paid or incurred. Section 41.0105 was enacted in 2003 by the Texas Legislature as a tort reform initiative to limit past medical damages to...more

Butler Snow LLP

Dedmon: The Destiny Of “Reasonable” Medical Expenses In Tennessee Part II

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In Tennessee, personal-injury plaintiffs may recover as damages the reasonable and necessary costs of the medical treatment that they received for their proven injuries. Until recently, a plaintiff’s ability to prove a...more

Butler Weihmuller Katz Craig LLP

Florida's SIU Tool Belt Is a Bit Lighter Today

Florida has been plagued with insurance fraud for decades.  All insurance coverages are susceptible to fraud, but scams are especially prevalent in the context of automobile accidents.  Staged crashes, patient brokering,...more

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