Medical expenses for injuries in Kentucky case ruled reasonable

by Mandy Hicks

It is not unusual for an insurers to balk at paying medical expenses for injuries suffered in a car accident or to take the stance that an accident was too minor to have resulted in a serious injury. Medical experts often disagree with this position, however, since each person has a different threshold for injury, and even a “minor” crash can cause permanently disabling injuries.

In one recent case, chiropractic bills were the subject of a lawsuit in which an injured person sought to have those covered by an insurance company.


The Facts of the Case

In the case of State Farm Insurance Company v. Morris, the plaintiff was an insurance company that asserted a subrogation claim against the defendant driver, whose negligence allegedly caused a 2010 automobile accident in which the plaintiff’s insured was hurt. The insured sought chiropractic treatment after complaining of bilateral pain in her neck area, and the plaintiff paid some $6,679.08 in medical bills under the no-fault (also known as personal injury protection or basic reparations coverage) component of the insured’s coverage.

Although the defendant never filed an answer to the plaintiff’s complaint and was not present at trial to contest the plaintiff’s claim, the Jefferson Circuit Court entered a zero-judgment in the case on the basis that there was nothing to suggest that the “low-speed, low-impact, non-injury automobile accident” caused the injuries of which the insured complained. The plaintiff appealed.

The Decision of the Court of Appeals

The appellate court reversed the trial court’s entry of a zero-judgment. In reviewing the lower court’s judgment, the court agreed with the plaintiff that it was entitled to reimbursement for the medical expenses paid on behalf of its insured because it had introduced evidence supporting its claim that the bills were both reasonable and related to the accident. Under the provisions of Kentucky Revised Statute § 304.39-020, the medical bills themselves qualified as such evidence.

In so holding, the court noted that the insured received treatment “in accordance with a recognized method of healing” and thus incurred medical expenses. Under the statute, once an insured submitted medical expenses under a basis reparations coverage claim, those bills were presumed to be both reasonable in amount and a reasonably needed expense resulting from the accident. The burden then shifted to the defendant to go forward with evidence to impeach the bill. In the current case, the defendant presented no proof that disputed the reasonableness or necessity of the insured’s medical bills. In fact, a default judgement was entered against him because he did not participate in the proceedings at trial. Thus, the defendant was liable for the expenses submitted to the defendant by its insured.

For Advice About a Kentucky Car Accident Case

If you have been injured in a truck or car accident, you should speak to an attorney about seeking compensation from the responsible party. To schedule an appointment with a knowledgeable Kentucky car accident attorney, call English, Lucas, Priest & Owsley at (270) 781-6500 for an appointment to discuss your case. The consultation is free, and, if your case is accepted, no legal fees are collected unless your case is successfully resolved.

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