Can You Receive Both Workers’ Compensation and Uninsured Motorist Benefits Following a Maryland Car Accident?
If you are injured in a car accident caused by a negligent driver, you have the right to sue that driver for compensation. Under Maryland law, you are entitled to seek a variety of damages, including your past and future medical bills.
Generally speaking, the negligent party in a personal injury claim is not absolved of their obligation to pay damages just because the victim may have already received compensation from other sources. So if your health insurance covered some of your medical bills, the negligent driver can still be held liable for the full amount of those bills.
But there are some exceptions. For example, say you are injured in an auto accident that occurs in the course of your employment. You are entitled to workers’ compensation benefits through your employer. But you may also be covered by an auto insurance policy that provides uninsured/underinsured motorist (UM/UIM) benefits, which provide coverage beyond what the negligent driver’s insurance covers. Maryland law forbids a “duplication of benefits” in such cases by permitting the UM carrier to deduct or “offset” the workers’ compensation payments from what it must pay.
Maryland Court of Appeals Addressed “Differences” Between Face Value of Medical Bills and What Insurers Must Pay
This issue is further complicated by the fact that health care providers often charge one amount for their services while accepting lower payments from insurers. How does that affect the offset rule? Earlier this year, the Maryland Court of Appeals addressed that question.
The case before the Court, Westfield Insurance Company v. Gilliam, involved a man who was injured in a rear-end auto accident while driving his employer’s vehicle. The other driver only carried $30,000 in liability coverage. The employer’s insurance policy had $1 million in UM coverage.
The employer also carried workers’ compensation coverage. The victim received about $628,000 in workers’ compensation benefits following the accident, which included about $118,000 in payments for his medical bills. The negligent driver’s insurer also settled with the victim for the $30,000 policy limit.
That left the employer’s UIM carrier. Litigation ensued between the accident victim and the insurer over the amount of its coverage obligations. Specifically, there was a disagreement over whether the insurer could deduct the difference in the “face value” of the victim’s medical bills–which was about $243,000–and the payments that those providers were required to accept under workers’ compensation law, which as previously mentioned was only $118,000.
The federal judge overseeing the litigation asked the Maryland Court of Appeals to weigh-in on this issue. The Court of Appeals held that “[a]ssuming that the fair and reasonable value of the medical treatment exceeds the payments made by the workers’ compensation insurer … that difference is not part of the offset against uninsured motorist benefits.” The Court reasoned there was no risk of duplicating benefits in this scenario as the difference was never recovered by the victim in the first place and was not subject to a claim for reimbursement under workers’ compensation.
Contact Waldorf Car Accident Attorney Robert Castro Today
This article has been provided by the Law Office of Robert Castro. For more information or questions contact our office to speak to an experienced lawyer at (301) 870-1200.
Source:
https://scholar.google.com/scholar_case?case=17542516298646997974
