Medical Expense (Past and Future)

In accidents caused by the negligence of another, by law and by New Mexico Uniform Jury Instruction 13-1804, you are entitled to recover medical expenses from the defendant or the defendant’s insurance company.  In addition to those medical expenses already incurred, under UJI 13-1804, you are also entitled to recover damages for future medical expenses associated with the injuries.  

Personal injuries associated with an accident can range from minor to severe. A plaintiff may sustain only cuts and bruises requiring little or no medical treatment. Depending upon the severity of the plaintiff’s injuries, the injuries may require extensive medical treatment which might include physical therapy, rehabilitation, surgery (sometime multiple surgeries), pain medication, pain management, and in very serious cases a lifetime of medical care.  

Depending on the severity of the injuries, medical bills can be staggering.  Even in relatively minor cases, they can be quite burdensome.  For those that have health insurance, the health insurance carrier will customarily pay the medical expenses associated with the accident.  The insurance company will then have a lien on any future personal injury related settlement or other recovery.  

For the great number of people that do not have health insurance, obtaining proper medical care can be a challenge at best.  In the absence of private insurance, Medicare, Medicaid or other governmentally provided healthcare, an injured plaintiff is fully responsible for all medical expenses.   This has a number of serious implications.  First, the person may not be able to obtain proper care.  Second, in the absence of recovery in personal injury claim, the person will be wholly responsible for the medical expenses.  It will matter little to the healthcare provider that someone else was at fault in the absence of a personal injury recovery.  

An experienced personal injury attorney can often assists with these matters.  The attorney will often be able to obtain treatment for the injured plaintiff in advance of payment in anticipation of settlement.  The attorney will often always be able to stave off the collection hounds until there is recovery on the personal injury claims.  

To get to that recovery, as with all recoverable damages, the medical expenses (both past and future) must be proven.  To receive a damages award or settlement for medical expenses, the plaintiff must provide a full set of medical records and bills associated with the injuries.  In many cases, the insurer will also request past medical records where there is a dispute as to the source of the injuries.  Insurers will frequently seek to reduce damages awards by claims of preexisting injuries.  Disproving these claims by the insurance company can be quite a chore particularly where a plaintiff has an extensive medical history.  

Finally, while the insurer should reimburse you for necessary medical expenses related to the accident, it will not reimburse you for medical care that does not relate the accident.   This situation occurs on occasion where a plaintiff will take the accident as an opportunity to address a host of unrelated medical conditions or injuries.  These cases can cause significant problems for the plaintiff where again he or she is fully responsible for all medical care until paid.


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