Does Workers’ Comp Cover Medical Bills?
Payment of all reasonably necessary medical expenses is a key component of workers’ compensation insurance plans in Florida. The insurance company must not only pay these expenses. In most cases, it must pay them even if the job injury victim was partially, mostly, or entirely at fault for a work-related trauma injury, like a fall, or occupational disease, like hearing loss.
Insurance company lawyers generally can’t successfully deny liability, even if a pre-existing or non-work condition contributed to the work-related illness or injury. However, insurance companies can, and almost always do, contest the amount of reasonably necessary medical expenses. A Tampa workers’ compensation attorney not only works to ensure that all the victim’s medical bills get paid. An attorney can also connect a victim with a doctor who charges nothing upfront.
Job injuries often happen at large factories in somewhat remote areas. If the victim must be airlifted to a hospital, as is frequently the case, the transportation expenses alone could exceed $40,000. Surface ambulance rides are considerably cheaper, but they could still cost several thousand dollars.
Insurance adjusters often use the “next level down” argument to contest these expenses. For example, if an ambulance took Tom to the hospital after a job injury, an adjuster might argue that he could’ve gotten a ride with a friend or hailed an Uber.
Medical assistance during transportation is usually critical. Even if the victim is relatively stable, emergency medical services should be available if the victim suddenly takes a turn for the worst. Additionally, many job injury victims are unconscious or semi-conscious at the scene. They’re in no position to argue about the mode of transportation, especially since most people naturally defer to medical professionals in this area.
The average hospital stay costs about $3,000 per day. Obviously, these expenses add up quickly. Furthermore, the $3k a day figure usually applies if the patient is under observation. If doctors must do anything other than read charts and drop in on these patients, emergency care medical bills are much higher.
Frequently, insurance companies use boilerplate actuarial tables to determine a “reasonable” amount of medical expenses in these situations. For example, a broken arm in X zip code requires Y treatment and costs Z amount of money. But not all broken arms are the same, and not everyone responds to treatment the same way.
A Tampa workers’ compensation lawyer helps ensure that the medical bill reimbursement is personalized, just like the medical treatment is personalized.
The actuarial tables that many insurance companies use to determine these costs likewise don’t account for individual variations. They also don’t account for ancillary costs, like medical devices, diagnostic tests, and prescription drugs. Usually, a health insurance company covers most or all of these costs. Tests, devices, and drugs are incredibly expensive without insurance company reimbursement.
Furthermore, the law in Florida recently changed on this point. Workers’ compensation benefits now last much longer. That change includes both medical bill payment and lost wage replacement.
Connect With a Tough-Minded Hillsborough County Attorney
Injury victims are entitled to important financial benefits. For a free consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. We do not charge upfront legal fees in these matters.