Court Finds that Plaintiff Who Chose Treatment Outside Insurance Should be Considered Uninsured for the Purpose of Economic Damages

Recently, a state appellate court issued an interesting ruling that addressed economic damages in situations in which an insured accident victim seeks treatment outside their network. Although the case arose outside New Mexico, the various issues presented in this opinion may be relevant in New Mexico trucking accident cases in which an insurance company denies coverage or offers only limited coverage.

The Facts of the Case

The accident occurred when a couple was driving their motor home on a California highway and experienced a flat tire. The woman put her hazard lights on and pulled over to the side of the highway. While the couple was on the side of the road, a truck driver, who was traveling about 50 miles per hour, slammed into the motor home. The impact was so strong that the passenger seat was completely destroyed. The husband suffered injuries to his lower back, neck, teeth, and face.

The Medical Treatment Sought

The husband initially received treatment through providers that were covered under his insurance, but, after filing a lawsuit against the defendants, he began seeking treatment through a specialist outside his network. The defendants argued that, contrary to the plaintiff’s assertion that he was referred to the doctor by his colleagues, he was actually referred there by his attorney. The defendants argued that this was a tactic precipitated by his attorney to recoup a larger payout for the firm.

The Procedural Posture of the Case

The parties filed several motions regarding the plaintiff’s medical costs and whether they were reasonable in light of the plaintiff’s out-of-network treatment. The trial court found that the defendants were negligent and awarded the plaintiff a large sum for his medical expenses, noneconomic damages, and future noneconomic damages. The defendants appealed the decision.

The Appellate Court’s Ruling

The court ultimately found that plaintiffs are entitled to choose the medical provider they would like to treat them, regardless of insurance coverage. The court held that the trial court appropriately excluded evidence of the plaintiff’s insured status and found that he was entitled to introduce evidence of his medical services.

Have You Been Injured in a New Mexico Trucking Accident?

If you or a loved one has been injured in a truck accident, you may be entitled to monetary compensation. In addition to the emotional and financial toll of an accident, there can also be long-lasting physical health issues. It is important that injured motorists get the best medical care available and that they are not financially liable for the costs associated with that care. An attorney at the Fine Law Firm can assist you in understanding your rights and remedies, and can help you pursue a claim for compensation. Contact the firm at 800-640-6590 to schedule your free initial consultation. Calling is free, and we will not bill you for our services unless we are able to assist you in recovering compensation for your injuries.

More Blog Posts:

The Importance of New Mexico Trucking Limitations and Restrictions, New Mexico Personal Injury Lawyer Blog, May 10, 2018.

How New Mexico’s Pure Comparative Negligence Statue Works to Divide Fault in New Mexico Truck Accident Cases, New Mexico Personal Injury Lawyer Blog, May 23, 2018.