Are Double or Triple Recoveries of a VA Personal Injury Claim Medical Expenses Permitted? | Shapiro, Washburn & Sharp

Generally, the damages recoverable through a personal injury claim include medical expenses, lost wages, and pain and suffering. What you may not know is that Virginia has special rules about the types of damages that are recoverable through an injury claim, including special rules relating to “double recoveries” of medical expenses. To accurately explain what a “double recovery” would look like, let’s use an example:

Let’s say you have a health insurance policy and a car insurance policy on your own vehicle, but you are hurt in a car wreck when a careless driver fails to stop at a stop sign on busy road. You go to the emergency room for treatment and provide your health insurance details. Your health insurance covers most, if not all, of your medical expenses. Now, lets say you have a Virginia auto insurance policy with optional coverage called “med-pay” (aka “medical expense benefits”). Med-pay is optional under Virginia automobile insurance policies but covers a defined amount of medical expenses that arise from a motor vehicle accident.

So you wind up incurring $2,000 worth of emergency room expenses that are covered by your health insurance policy. Again, you also have car insurance “medical expense benefits” that cover medical expenses arising out of an automobile accident. This means that the same $2,000 worth of emergency room expenses may be submitted to the automobile insurance company under your medical expense benefit policy.

Basically, this is a “double recovery” under insurance.

Your health insurance plan pays all of the emergency room bills but you can still obtain the $2,000 through your medical expense benefit coverage in your automobile insurance policy.

For related info about double or triple recoveries, check out these articles:

What about something called subrogation?

Virginia has an “anti-subrogation rule” which prohibits health insurance companies from seeking reimbursement of health insurer payouts from personal injury case proceeds. This is important since it means that your health insurance company cannot seek a recovery of the $2,000 it paid for your medical bills if you get $2,000 from your med-pay coverage.

Your recovery options continue to expand if you hire a Virginia Beach personal injury lawyer and file a claim against the at-fault careless driver. You can claim the same $2,000 in emergency room bills despite the fact that they have been paid twice over.

This is a legal “triple recovery” because of a special personal injury rule called the “collateral source rule.”

Usually, an at-fault driver does not get the benefit of the fact that the injured party (i.e. you) paid for insurance benefits. This includes health insurance or medical expense benefits under your automobile insurance policy. The reason is that you PAID for those side insurance benefits and the law does not want to “reward” the careless party by introducing the fact that you have insurance coverage. In fact, in Virginia, juries are usually instructed by Judges on this collateral source rule:

The presence or absence of insurance or benefits of any type, whether liability insurance, health insurance, or employment-related benefits for either the plaintiff or the defendant, is not to be considered by you in any way in deciding the issue of liability or, if you find your verdict for the plaintiff, in considering the issue of damages.

The Virginia Supreme Court has applied this collateral source rule in personal injury cases for more than a century. The Virginia Supreme Court reasoned that the injured party should be made whole by the tortfeaser (i.e. the at-fault party) and not by a combination of compensation from the tortfeaser and collateral sources like health insurance. In fact, in a recent case, Virginia’s highest court held that portions of bills for medical expenses “written off” by an injured party’s health care provider could NOT be deducted from the amount of damages owed by the tortfeaser. This means that the integrity of the “collateral source rule” was kept intact.