Can I recover medical expenses even though my health insurance paid them?

Yes, you can.  Virginia law includes what is called the “collateral source” rule.  If someone is negligent and hurts you, there is no reason why he should get the benefit of health insurance that you paid for.  As the Supreme Court of Virginia has said, “A person who is negligent and injures another ‘owes to the latter full compensation for the injury inflicted[,] . . . and payment for such injury from a collateral source in no way relieves the wrongdoer of [the] obligation.’”[1] Thus, the wrongdoer’s obligation to you is not diminished by your receipt of insurance payments, social security benefits, public and private pension payments, unemployment compensation benefits, vacation and sick leave allowances, and other payments made by employers to injured employees, both contractual and gratuitous.[2]

Moreover, in your personal injury claim, you may be reimbursed for the full amount of the medical bills – you are not limited to the amount the health care provider accepted from your health insurance company.  As you may have seen from health insurance “Explanation of Benefits” pages, there is a significant difference between the total amount billed and the amount your insurance company pays, which the health care provider accepts as payment in full.  The reason for this is that by participating with an insurance company, the health care provider gains access to more patients (“customers”) and can make a profit at lower billing rates with a higher volume.  But, because this reduction in cost is something that was negotiated by your health insurer, and benefits you because of your purchase of insurance, the person who hurt you through negligence is not entitled to the benefit of that reduction.

We are fortunate to live in a state that applies the collateral source rule, and gives you the benefit of insurance you buy, while holding wrongdoers fully accountable for the harm they cause.

About The Author: Malcolm “Mic” McConnell is a personal injury lawyer who helps injured persons get the fair compensation they deserve. He is the lead Medical Malpractice attorney at the Allen Law Firm and has nearly 30 years of experience handling cases in a variety of medical specialties. Mic was named the Best Lawyers’ Medical Malpractice Law – Plantiffs “Lawyer of the Year” in 2016 and 2013.

[1] Minnix v. Hall, 178 S.E.2d 519, 520 (Va. 1971).

[2] Acuar v. Letourneau, 531 S.E.2d 316, 320 (Va. 2000).