Don’t Get Shortchanged: How Carabin Shaw Fights the Paid vs. Billed Gap in Texas Courts

If you are injured by someone else’s negligence in Texas, you have a right to pursue damages for your medical bills and other related losses. Unfortunately, a 2003 statute limits the amount a victim can recover for their injuries by distinguishing between “paid” and “billed” medical expenses. The difference can significantly affect whether accident victims receive fair compensation.

The Texas personal injury lawyers at Carabin Shaw provide guidance for accident victims to maximize their compensation in San Antonio, Houston, Austin, Dallas, El Paso, and other Texas cities. We fight for the damages they deserve, despite limits imposed by Texas law. Our experienced team offers free case reviews 24/7 in English or Spanish. Call us toll-free at 1-800-862-1260 or contact us online.

When you are injured, your medical provider bills you for treatment based on the fees they charge for their services. If the bill is processed through your insurance company, the total may be discounted under your insurance company’s agreement with your provider. The amount after the discount is considered the paid amount.

In 2003, the Texas CPRC Sec. 41.0105 went into effect. This new statute limited the amount of damages an accident victim could seek to the amount actually paid by the victim or their insurance company. An insured accident victim may be eligible only for a portion of their medical treatment costs, while an uninsured victim may be able to recover the full value.

The statute creates inequity in personal injury claims. For example, two people with identical injuries may receive the same treatments from the same providers. However, the insured victim will only receive a portion of what the uninsured victim receives. Insurance companies often use this law against accident victims to limit the damages they receive.

The value of your personal injury claim should not be based on the amount of money your insurance company pays for your treatment. Instead, the value should account for the severity of your injuries and their impact on your life now and in the future. Our lawyers help accident victims pursue fair compensation for their injuries and related losses, regardless of their insurance coverage.

Since Texas has the highest uninsured rates in the country, the inequities introduced by this statute are quite significant. Medical bills for uninsured patients may be two to eight times higher than those for insured patients. Despite the higher rates, only 20 percent of uninsured patients actually pay the full bill amount.

The statute also leaves much up to interpretation, with ambiguity surrounding the term “actually paid or incurred.” Accident victims and their lawyers argue that “paid or incurred” should refer to the amount billed by the medical provider. Insurance companies counter that “paid and incurred” is limited to the amounts actually paid to medical providers.

These factors increase the complexity of personal injury cases, which require the expert guidance of an experienced personal injury attorney to protect your rights and your compensation. Don’t wait to get the legal assistance you need to navigate your personal injury claim. Our law firm offers our services on a contingency-fee basis, so you pay no money up front for our experience.

Our legal team has extensive experience fighting the “paid vs. billed” gap for Texas accident victims. We will:

• Maximize non-economic damages to ensure sufficient compensation
• Leverage letters of protection to include the full billed amount in your claim
• Challenge the “reasonableness” of payment reductions by the insurance company
• Use expert testimony to testify that the initial bill amounts were reasonable and necessary

If you aren’t getting a fair shake on your personal injury claim, it’s time to search for “a Texas injury lawyer near me” to help you with your case. Carabin Shaw helps accident victims throughout Texas, including San Antonio, Houston, Austin, Dallas, and El Paso, as our law firm’s client reviews attest. Now is the time to call our legal team toll-free at 1-800-862-1260.

For more information:

• DAMAGES
• Health Insurance Coverage by State.
• JDSUPRA