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WHAT IS ROBINSON V. BATES, AND HOW DOES IT APPLY TO OHIO PERSONAL INJURY CASES?

On Behalf of Diehl & Hubbell, Attorneys at Law March 24, 2022

The Robinson v. Bates case changed how courts in Ohio look at personal injury cases. Before this case, plaintiffs could recover the full amount of medical expenses incurred following an injury. All they had to do was provide evidence of the original medical bill. To understand the impact of this ruling, let's discuss the original medical bill, the write-off, and the paid amount. 

Original Medical Bill 

Like other states, you may be eligible for compensation for your injuries in Ohio when you get into an accident caused by a negligent party. Medical bills are part of the many damages you may be able to recover if you win a claim or lawsuit against the other party. After receiving treatment for your injuries, you can request a copy of your medical bill from your healthcare provider. Your attorney will then add this bill to many other expenses to calculate the amount of compensation you deserve. This is what is usually referred to as the original bill.

The Write-Off

The original bill may not be the exact amount paid by your health insurance company to your health care provider. This is because your healthcare provider might decide to 'write-off' a certain portion of the original bill for different reasons. Whatever the reason, the healthcare provider might decide that your insurance company will only have to settle a certain percentage rather than the full amount. The medical bill will then be considered as paid. 

The Paid Amount

When your healthcare provider accepts a certain amount of money from your health insurance company as payment for your injury, this amount is often referred to as the paid amount. Here's a hypothetical example: 

Suppose you get into a car accident and the cost of your medical treatment is $200,000. In that case, you expect your health insurance company to pay the amount either in part or full, depending on the type of coverage you have. But if your coverage has a limit of $50,000, your insurance company won't pay more than that. 

In that case, you'll owe the health care provider $150,000, the difference between the original amount ($200,000) and what the insurance company paid. But if, for any reason, you're unable to raise the $150,000 out-of-pocket, your healthcare provider can decide to accept the $50,000 paid by your insurance company as the final payment for that particular bill. 

Pre-Bates v. Robinson Ruling

Before the Bates v. Robinson ruling, you could claim the original medical bill even if your healthcare provider only accepted a portion of it from your insurance company and forgave the rest. Using the example above, you could recover the full $200,000 instead of the $50,000 the insurance company paid. In addition, the jury wasn't supposed to know how much was written off from the original bill. 

Post-Bates v. Robinson Ruling 

After the Bates v. Robinson ruling, the defendants could disclose how much was written off, preventing the plaintiff from recovering the original amount. The jury would then use the original amount to understand the severity of the injury and then compare it with the paid amount. After evaluating the two figures, and many other case-specific factors, the jury would then award the plaintiff an amount considered to be 'reasonable.' 

The Effects of Bates v. Robison Ruling 

Since the Bates v. Robison ruling, insurance companies in Ohio now offer less money as compensation for personal injury victims. These companies make huge profits from monthly premiums paid by their insured but then spend less than what they should as personal injury compensation. For this reason, it's become more important than ever to work with an experienced Ohio personal injury attorney in your pursuit of the compensation you need and deserve.