Past
and Future Medical Expenses
Past
and future medical expenses and lost wages are the only items
of damages upon which the Texas Medical Malpractice Act does
not place a cap. However, there are some specific laws which
address the procedure for payment of these medical expenses.
Texas law places a cap of $250,000 on all
items of damages in a medical malpractice suit except past
and future medical expenses and lost wages. If a patient
goes to trial and wins, the defendant must pay for the past
and future medical expenses above and beyond the cap.
In cases involving serious injuries, these
expenses can be quite large. Moreover, in many instances,
the patient's own insurance company or medicare may have
paid the past expenses on behalf of the patient. In those
instances, Medicare or the private insurance company may
have a lien against the recovery of any sums from the defendant.
This means that if a plaintiff gets a settlement
or verdict which includes past medical expenses paid by
someone else, the entity paying those medical expenses is
entitled to get some or all of that payment back from the
recovering plaintiff. Otherwise, the plaintiff will recover
sums that he never expended himself and will receive an
unexpected windfall.
When medicare or a private insurance company
does have a lien, the attorney handling the case will usually
contact them and try to work out some sort of deal for them
to take less than they actually paid. The reason for this
negotiation is because the patient had to hire and pay for
an attorney to recover the monies which will be paid back
to the entity that paid those expenses.
Most entities are amenable to reducing their
lien by some percentage to account for this fact. However,
as insurance contracts change, some companies have included
language that allows them a full recovery of their lien
even though they have not contributed to the legal fees
to recover those sums. Each contract should be checked by
your attorney to determine whether all or part of a lien
will need to be repaid.
