What Amounts of Unpaid Medical Bills Can You Recover?

Haines v. Taft, 450 N.J. Super. 295 (App. Div. 2017)

In Haines, plaintiff chose the $15,000 PIP coverage option but, as a result of an auto accident, incurred medical expenses of $43,000. Plaintiff argued that only evidence of those medical expenses paid or eligible to be paid under his PIP policy are inadmissible pursuant to the Statute.

Defendants argued that because $250,000 is the PIP limit provided in a standard policy, the PIP Statute bars evidence of the first $250,000 in medical expenses incurred regardless of the amount of plaintiff’s chosen PIP limit.

Defendants sought to have the Appellate Court interpret the relevant statutory language to hold that all medical expenses up to $250,000, the usual PIP limit in a standard policy, be deemed inadmissible.

Defendants contended that to allow medical bills, in excess of the chosen PIP coverage, to be boardable would be a windfall to the injured party who paid a lower premium for the lower PIP coverage.

All aboard!

The Appellate Division held that plaintiff could recover, because N.J.S.A. 39:6A-12 makes inadmissible “evidence of the amounts collectible or paid under a provision for PIP benefits in a standard policy.”

The Appellate Division noted that by statute, automobile insurers must provide five different PIP coverage options of $250,000, $150,000, $75,000, $50,000, or $15,000. Thus, the Appellate Division held that the phrase “amounts collectible or paid under a standard policy” did not refer solely to policy limits of $250,000. The language instead refers to those PIP limits covering the particular insured, making only those medical expenses up to and including the chosen PIP limit inadmissible.

What that means for you is you are now entitled to recover all medical bills over whatever your PIP limit may be. So, there is less pressure to pay higher premiums for the higher limit of coverage. Ultimately, if you are injured by another wrongdoer, the wrongdoer’s insurance will have to pay!

Contact Verp & Leddy today to get your medical expenses covered!