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Last Modified: December 23, 2022

Medical Expenses

The term “medical expenses” seems like it would be easy to define. Yet, what expenses qualify as “medical” matters to insurance companies, employers, and others who may have to foot the bill for someone else’s injury. The debate on medical vs. non-medical expenses is not just an attempt by these people to save their profits; in some cases, medical care needs to stop at some point. For instance, spinal cord surgery after a car accident obviously passes as a medical expense resulting from this accident, but what about rehabilitation? What if the injured person hurts a different part of the body while trying to deal with their first injury? Serious injuries can be like a line of dominoes, and knowing where to draw the line on medical expenses is more complicated than simply knowing what the two words mean. A rough definition for “medical expenses” is given in 31A-22-307(1)(a) of Utah’s insurance code. According to guidelines set for Utah’s PIP (personal injury protection) insurance, medical expenses include medical, surgical, x-ray, dental, rehabilitation, ambulance, hospital, and nursing services up to the value of $3,000. This definition provides a list of examples, but does not specify which procedures are necessary under which circumstances. Further down the page, 31A-22-307(3) clarifies that the provisions given earlier “include expenses for any non-medical remedial care and treatment rendered in accordance with a recognized religious method of healing.” The legal definition given in Title 31A does little to clear up the difference between medical and non-medical care. We learn in 34A-2-402(4)-(5) and 34A-3-106(4)-(5) that medical expenses may not cover the stresses involved with standard employment procedures like work evaluations, layoffs, demotions, etc. or even harassment and other behaviors that are punishable by other laws. Yet, this does little to narrow the field. While Utah’s laws provide some basic framework for defining “medical expenses,” definitions will vary from case to case. A broken arm does not require a dental examination, a head injury doesn’t always entail a ride in the ambulance, and those mental stresses that are legally covered by medical expenses are unlikely to demand x-rays. To find out what constitutes your own specific medical expenses, you probably need to consult with a doctor to learn what you need done, an insurance adjuster to learn what procedures will likely be covered, and a personal injury attorney to help you pinpoint where these other two cross. Part of the Federal Agricultural law provides a definition for “allowable medical expenses” and provides a list of possible medical expenses.

Example Sentence

As a result of her car accident, Jenny had to deal with many medical expenses including x-rays, surgery, and rehab.

Case Study

This true story illustrates medical costs and how large of a burden they can become in a time field with grief. After finding out that a car had struck their daughter on her way to school, a couple went to the hospital. They then had to watch as their daughter slipped into a coma and out of this life. Left without their child and with medical expenses over $1,000,000, the parents came to Good Guys Injury Law for help. The driver’s insurance limits could not cover all of the expenses which included the life flight helicopter that took their daughter to the hospital, life support, and other hospital expenses trying to preserve the life of their daughter. We worked with the insurance company and medical providers to cover all of the medical costs and even establish a fund in memory of their daughter without having to go to court.

Other Important Information

Some medical providers will work with you to pay your large medical bills. Many will split up the bill into monthly payments. Others may allow you to set up a lien, which allows you to pay them once your case has settled. Sometimes your own insurance company may pay the expenses for you, which allows them to go after the party that caused the injury. They call this subrogation.

Image “Tools of the Trade” copyright  by the 807th Medical Command.