Part 3: How much is my claim worth? – Medical Expenses

Ashley Tulley

Chief Commercial Officer

Medical Expenses are a crucial part of all claims for compensation. 

Why? Well apart from the obvious fact they pay for the cost of any medical treatment...

... compensation for medical expenses allows you to recover to your fullest extent as it removes the stress of working how how you are going to afford it.

It also gives you access to the tools needed to get back on with life, if you are unlikely to make a full recovery. 

We are continuing our four-part series on discovering the areas that your can claim under. 

Understanding these areas, will allow you to estimate how much your claim is worth. 

In this article, we unpack what medical expenses you can claim for, some example claims and the evidence you will need when approaching the insurers.

Don't forget to read  Part 1 on future economic loss and Part 2 on care costs.

What are medical expenses?

Without stating the obvious too much, medical expenses relate to the costs of rehabilitation following an injury.

The expenses include both past fees that were already paid for, as well as future medical costs.

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How much can you claim?

As is the case in every other area of compensation, the amount that can be recovered will vary depending on the individual’s treatment plan and care needs.

Some real-life case examples have been provided.

Example 1 - Slip & fall, permanent brain injury

Sarah, a 20-year-old student, was grocery shopping on a Sunday evening. As she was walking towards the fridges carrying various objects she slipped and fell on a puddle of water. Sarah hit her head on a display shelf as she fell causing significant brain injury, among other injuries. Sadly, she lost the capacity to walk, has difficulty speaking and has substantial memory deficiencies now. 

Sarah now requires assistance with feeding, toileting and bathing. All movement around her house, getting in and out of bed, and any daily errands will need help from another person. She needs round the clock care.

Sarah requires significant and ongoing treatment including physiotherapy, nursing assistance and others. She also needs the help of various technologies including a wheelchair, specialised computer and electronic environmental controls. To facilitate her independence, she also required to have significant home modifications to make room for her wheelchair and enhance her abilities to access the bathroom and kitchen.

Because her life was irrevocably changed at such a young age and she required significant ongoing treatment and assistive technology, Sarah was awarded $409,000 toward her medical expenses.

Example 2 – pedestrian accident, ongoing hard damage

Adam crossed a busy street at a pedestrian crossing to collect his morning coffee. As he stepped out onto the street, a car came speeding around the corner. Adam flew into the air as the vehicle slammed into him.

He landed heavily on the road, breaking his left ankle in the process. The significant impact also caused nerve damage to his right arm. After much rehabilitation, Adam's nerve damage causes him constant pain. He required significant dosages of painkillers, and his doctor expects that this will be needed well into the future.

Adam was awarded as part of his compensation a total of $32,496 for the cost of his past and future medical expenses (including medical appointments, medications and rehabilitation treatment).

What can you claim?

Some typical medical expenses that are included in a compensation claim include:

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    Hospital bills
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    Diagnostic testing expenses (laboratory fees)
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    Surgery costs
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    Therapy and rehabilitation costs
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    Costs of prescription medicines
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    Costs of future home modification
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    Costs of any assistive technology required (crutches, wheelchairs, modified cars etc.)
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    Pain and suffering management

Medical expenses can, therefore, be very extensive, especially if the injured party has to continue treatment for recurring medical problems.

For this reason, it's essential to be very thorough when documenting injuries in your claim file so that it is possible to calculate damages to account for future problems.

It is also important to attend all medical appointments or therapy sessions.

What evidence will you need?

Proving these expenses may require the help of an expert medical professional. Usually, thorough documentation is needed to calculate the total costs of medical treatment. These may include the presentation of various items of evidence in court, such as:

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    Tax invoices or receipts for any medical treatment (including hospital, outpatient care, private treatment)
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    Pharmaceutical bills; or
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    Any other documents showing the costs of the medical expenses

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Keeping a clear record of items related to your injury is paramount to maximizing your compensation amount.

As the old bible saying goes – Ask, and you shall receive.

There are many cases we have seen where critical medical expenses have been left out of a person’s compensation because of inadequate documentation, or they just forgot to include it.

It is crucial to gain expert advice from an occupational therapist and doctors on likely requirements you will need in the future.

Small expenses such as assistive technology and home modifications are often overlooked but can be so important to an injured person’s quality of life.

Ashley Tulley

Chief Commercial Officer

Keeping a record of the medical expenses (treatment costs, medications, assistive technology) you had due to your injuries is very important, as it can mean the difference between having a claim for care and assistance, or not having a claim at all.

Keep a spreadsheet that details the following:

  • Type of service or item
  • Service or item provider (doctor surgery or pharmacy)
  • Date of service/purchase
  • Cost of service/item
  • Will the service/item be required in the future and how often

To help ensure that you maximise your damages, keep in mind the following helpful tips:

  • Buy all of your prescriptions/dressings/painkillers etc. from the one pharmacy and ask your pharmacist to record all of your purchases.  When it comes time to claim your damages, you can simply obtain a printout from the pharmacy;
  • Keep receipts for any purchases that you have made;
  • Photocopy or scan those receipts, in case they get lost or destroyed;
  • Consistently fill out the table as each service is provided.

Next steps...

Don't miss out on other aspects of your claims... the other blogs in the series below.

Part 1: How much is my claim worth? – Future Economic Loss
Ashley TulleyCheif Commercial OfficerMost people have heard of personal injury claims but very few would understand what quantum is.…and they[...]
Part 2: How much is my claim worth? – Care Costs
Ashley TulleyChief Commercial OfficerCare costs can be the single most significant component of a claim. Particularly when the injured party doesn’t[...]
Part 4: How much is my claim worth? – Pain & Suffering
Ashley TulleyChief Commercial OfficerIt is a significant part of a compensation claim.Particularly for those who cannot claim wage losses.For stay[...]

Written by Ashley Tulley | Chief Commercial Officer