Court Requires Defendant to Compensate Plaintiff for Medical Treatment of His Choice

Earlier this month, a state appellate court issued a written opinion in an interesting car accident case requiring the court to determine if the plaintiff was entitled to compensation for his medical expenses that were incurred though an out-of-network provider. Ultimately, the court held that an accident victim has the right to choose where to obtain treatment, even if he is insured and chooses an out-of-network provider.

The defendant’s argument that the plaintiff failed to mitigate damages did not convince the court, and the defendant insurance company was on the hook for the sum of the plaintiff’s medical expenses. Although the case arose in another state, the case is important for Maryland truck accident victims because it paves the way for similar arguments to be made in Maryland courts.

The Facts of the Case

The plaintiff was seriously injured when another driver struck him while he was changing a flat tire on his motorhome on the side of the road. Initially, the plaintiff obtained medical treatment through a medical care provider that was covered by his insurance. However, after filing a personal injury case, the plaintiff then switched his medical care provider to one that was not covered by his insurance policy.

The plaintiff explained that he was referred to the new doctor by a friend. However, the defendant insurance company argued that the plaintiff was really referred to the doctor by his attorney, who had written about increasing the “settlement amount” of a case by obtaining out-of-network treatment. The doctor the plaintiff selected performed a specialized surgery and testified that the plaintiff would never be “normal” again.

In a series of pre-trial motions, the plaintiff asked the court to preclude the defense from admitting evidence that he was insured but chose not to seek in-network treatment. Additionally, the plaintiff sought to keep out evidence of how much insurance companies normally pay for the treatment obtained by the plaintiff. The court granted the plaintiff’s motion, and the jury returned a verdict in the plaintiff’s favor totaling over $3.5 million. The defendant appealed.

The Appeal

On appeal, the insurance company argued that the damages were excessive because the evidence showed that the plaintiff failed to mitigate the damages he sustained in the accident by seeking out-of-network treatment. The defendant also argued that it was an error to preclude evidence of the plaintiff’s insured status, as well as the evidence of the average cost of the treatment obtained by the plaintiff.

In a lengthy and thorough opinion, the court rejected the insurance company’s arguments and affirmed the plaintiff’s award (with the exception of a small $1,608 miscalculation). The court explained that a plaintiff who opts for out-of-network care should be treated as an uninsured plaintiff. Thus, the court below properly kept out evidence of the plaintiff’s insurance coverage and other related evidence.

Have You Been Injured in a Maryland Truck Accident?

If you or a loved one has recently been injured in a Maryland truck accident, or any other kind of Maryland traffic accident, you may be entitled to monetary compensation. The dedicated Maryland personal injury lawyers at the law firm of Lebowitz & Mzhen Personal Injury Lawyers have decades of collective experience handling Maryland truck accident claims, and they know what it takes to succeed on their clients’ behalf. To learn more, call 410-654-3600 to schedule a free consultation today.

More Blog Posts:

Filing a Personal Injury Claim after a Maryland Truck Accident, Maryland Trucking Accident Lawyer Blog, published May 17, 2018.

Court Finds in Plaintiff’s Favor in Recent Public Transit Accident Case, Maryland Trucking Accident Lawyer Blog, published May 3, 2018.

Contact Information