InsureBlog points us to a case before the Ohio Supreme Court that rung a few bells for me, in a rather odd way.
Apparently a woman successfully sued her building management for an injury she suffered in her home. The health care providers billed for $1900 worth of services. Her insurance company paid $1300. The trial court judge said she should only be reimbursed the amount actually paid. The appeal is over whether what happened to the billable amount after billing was even relevant and should have been allowable evidence.
I'm confused by one thing right off the bat: if the insurance company paid that bill, then why is she getting compensated for it at all?
But leaving that aside Hank at InsureBlog points out that, although the $$ amounts in this case are small, the ramifications are big.
This all reminds me of the time someone ran into my car in my apartment complex parking lot many years ago, and actually left a note. Their insurance company was State Farm, and at the time all State Farm did was have me bring my car to them, they estimated repair costs and cut me a check. I don't even remember if the gave me a list of recommended body shops or not, probably they did. BUt the point is that they judged the value of the damage, gave me the $$, and then couldn't care less what I did with it. As it happens I did find a shop to repair it for probably $500 less than they had given me.
I can tell you that I felt pretty good about that.
And I didn't feel guilty about it at all, because no one was compensating me for the time and aggravation of the entire incident. The person who hit me gave me a phone number, and they were done...meanwhile I had to shlep all over, do my comparison shopping, go car-less for a bit of time etc. It felt pretty fair to me.
I have no idea what insurance companies do now, or if policies have changed, which tells you I'm a very good driver :) [Knock on wood.]
Anyway, I agree that it seems odd to give her more money than ultimately got paid out. On the other hand, as a patient, I bet she feels the overage doesn't really compensate her for the time and aggravation!
But it's not really a case of how much $$ this particular woman should get. It's a more esoteric legal point about evidence. And I have no personal experience to relate that to.
Elisa:
Thanx for the link!
Yeah, I was a bit confused about the woman being reimbursed for expenses her health insurance apparently paid, too.
I let it go because it seemed tangential to the primary issue(s).
Posted by: hgstern | January 07, 2006 at 08:22 PM