How People Get Medical Care While a Truck Case Is Pending

Here's the problem almost every seriously injured person runs into, usually in the first month.

The wreck wasn't your fault. The trucking company's insurance carrier knows it wasn't your fault. And they're not going to pay a dime toward your treatment until the whole case resolves, which could be a year or more. Meanwhile, you need surgery, or physical therapy three times a week, or an MRI somebody has to authorize, and the hospital is already sending statements. Nobody explains this part in advance. So let's go through what the actual options are in Mississippi.

Use your health insurance. Yes, even though it wasn't your fault.

People resist this constantly, and the instinct is understandable. Why should my insurance pay for something somebody else did?

Use it anyway. Two reasons. The first is practical. Health insurance gets you treated now, at negotiated rates, without anyone waiting on a liability determination. The second is that Mississippi law is unusually good on this point. Under the collateral source rule, the fact that your health insurer paid your bills cannot be used by the defendant to reduce what you recover. The Mississippi Supreme Court said so directly in Brandon HMA, Inc. v. Bradshaw, 809 So. 2d 611 (Miss. 2001), holding that even Medicaid payments are subject to the collateral source rule and stating the rule this way: "compensation or indemnity for the loss received by plaintiff from a collateral source, wholly independent of the wrongdoer, as from insurance, cannot be set up by the latter in mitigation or reduction of damages."

That case rejected the argument that a plaintiff can only recover what was actually paid. Mississippi is a full-billed-amount state. If the hospital charged $80,000 and your insurer paid $22,000 under a negotiated rate, the $58,000 write-off is a benefit that belongs to you, not to the trucking company that hurt you.

That's a better rule than most states have, and it's a reason to run the bills through insurance rather than letting them sit unpaid.

One warning that comes with it. The rule protects you from a reduction, but a plaintiff who testifies inaccurately about the bills can open the door. In Robinson Property Group v. Mitchell (Miss. 2009), the Court noted that evidence of collateral source payments may come in "for the purpose of impeaching false or misleading testimony." So when you're asked about your medical expenses, the answer needs to be accurate. Don't say you paid something you didn't.

Mississippi has no general hospital lien statute

This surprises people who've dealt with cases in other states.

Alabama has a hospital lien statute. Tennessee has one. Louisiana has one. Mississippi does not. A Mississippi hospital cannot attach a statutory lien to your settlement for ordinary treatment. Its remedies are whatever it got you to sign on admission, or a suit on the account like any other creditor.

The one narrow exception in the Mississippi Code covers uncompensated traumatic burn care at a hospital designated as a burn center by the State Department of Health, under Miss. Code Ann. §§ 85-7-301 through 85-7-315. Even there the requirements are strict - written notice at least fifteen days before filing, a verified statement filed with the chancery clerk within seventy-five days of discharge for a hospital, and § 85-7-303 provides that "the failure to perfect the lien by timely complying with the notice and filing provisions... shall invalidate the lien." Section 85-7-307 also caps payment toward those liens at fifty percent of the claimant's balance.

For everything else, what a provider has is a contract claim, and contract claims can be negotiated.

The made-whole rule, which is better here than most places

When a health insurer pays your bills and then wants reimbursement out of your settlement, Mississippi law puts a real limit on that. In Hare v. State, 733 So. 2d 277 (Miss. 1999), the Mississippi Supreme Court held that "until the insured has been fully compensated, there cannot be a double recovery." And it went further than most states go:

"[The made-whole rule] is not to be overridden by contract language, because the intent of subrogation is to prevent a double recovery by the insured."

The Court reasoned that letting boilerplate in an adhesion contract destroy the insured's equitable rights would ignore the reality that nobody negotiates their health insurance policy. Memorial Hospital at Gulfport v. Proulx (Miss. 2013) reaffirmed that an insurer "is not entitled to equitable subrogation until the insured has been fully compensated," and that the rule reaches contractual subrogation as well.

That's a genuinely strong position for injured people in this state.

The exception you need to know about. A self-funded ERISA plan which is an employer's own health plan rather than a purchased insurance policy plays by federal rules, and federal law can preempt state doctrines like made-whole. Whether a particular plan is self-funded, and what its plan documents say, is one of the first things worth finding out. It changes the math.

Medicare and Medicaid have to be dealt with, not ignored

If Medicare paid for any of your treatment, the Medicare Secondary Payer statute, 42 U.S.C. § 1395y(b), requires that those conditional payments be reimbursed. The statute gives the United States the power to sue and provides that it "may... collect double damages" against entities responsible for payment. Interest starts running sixty days after CMS's demand.

Mississippi Medicaid has its own recovery statute, Miss. Code Ann. § 43-13-125. Two things in it matter to you.

The good part: the Division's recovery is applied first to "the reasonable costs of the collection, including attorney's fees, as approved and allowed by the court" — meaning Medicaid bears its share of what it cost to get the money.

The part that trips people up: the statute requires that "a copy of the pleadings shall be certified to the division at the time of the institution of suit," and it provides that no compromise of the claim binds the Division "unless the division, with the approval of the Governor, has entered into the compromise in writing."

Neither Medicare nor Medicaid goes away because nobody addressed it. They get worse.

Med pay, and the coverage most people forget

Check your own auto policy for medical payments coverage. It's optional in Mississippi and a lot of people don't know whether they have it. It pays regardless of fault, usually in modest amounts, and it can bridge a gap early.

Then check your uninsured and underinsured motorist coverage, because in a truck case it can matter far more than people expect.

Here's why. Federal law requires an interstate for-hire carrier hauling ordinary non-hazardous freight to carry only $750,000 in public liability coverage. That's 49 C.F.R. § 387.9, and that number has not been raised since 1980. Haul oil or most hazardous materials and it goes to $1 million; haul bulk hazardous substances, explosives, or poison-gas materials and it's $5 million. But a lot of trucks on I-20 are running general freight at the $750,000 floor.

In a catastrophic injury or a death case, $750,000 does not cover it. Which is where your own UM/UIM coverage comes in. In Mississippi, UM coverage is required by Miss. Code Ann. § 83-11-101 unless the named insured rejected it in writing on a form approved by the Department of Insurance. If there's no valid signed rejection, the coverage exists whether anyone thought they bought it or not. Always get the rejection form.

Mississippi folds underinsured coverage into the same statute — § 83-11-103(c) defines an "uninsured motor vehicle" to include a vehicle whose liability limits "are less than the limits applicable to the injured person provided under his uninsured motorist coverage." That's a limits-to-limits comparison, which makes stacking the whole game. Under Miller v. Allstate Ins. Co., 631 So. 2d 789 (Miss. 1994), Class I insureds — the named insured and resident relatives — can stack UM coverage across policies regardless of which vehicle they were in. Section 83-11-102 lets a policyholder with four or more vehicles elect nonstacking coverage, but that election has to be made.

Adding up every UM policy in a household is often the difference between a recovery that covers a lifetime of care and one that doesn't.

Letters of protection

When someone has no health insurance and no other coverage, a provider will sometimes agree to treat and wait on the strength of a signed authorization directing that the bill be paid out of any recovery. The Mississippi Bar's own Professional Guide for Attorneys & Physicians includes a form for this, worded as a client authorization: "I... authorize... my attorneys, to pay, from the proceeds of any recovery in my case, to Dr. [name], the reasonable amount owed for professional services rendered."

Note the structure. It's the client directing payment, not the lawyer guaranteeing the debt. That distinction matters, and Mississippi Bar Ethics Opinion 266 (2022) reinforces why: the Committee held it improper for a lawyer to sign a release "approving" or "agreeing to" terms that would personally obligate the lawyer, including indemnity for unpaid third-party payers. Your lawyer should not be personally guaranteeing your medical bills, and if someone offers to, ask why.

Working with Coxwell & Associates

We advance the costs of investigating and litigating a case, such as the accident reconstruction, the record retrieval, the depositions, the expert work — and under Miss. R. Prof. Conduct 1.8(e) repayment of those litigation expenses can be contingent on the outcome. That's how these cases get built when the person who was hurt has no money coming in.

What we spend most of the early effort on, though, is the part described above: figuring out what coverage actually exists. Health insurance and whether the plan is self-funded. Med pay. Every UM policy in the household and whether anybody ever signed a rejection. Whether Medicare or Medicaid paid anything. What the carrier's federal minimum is and whether there's excess coverage above it.

That inventory usually turns up more than the client thought was there. It is also the part nobody does for you. If you're getting statements you can't pay for treatment you didn't cause, at least find out what coverage you have before you start making decisions about care. Getting treated is not just about your health, though it is mostly about that. Gaps in treatment are also the first thing a defense lawyer will point to later.

Sources

This article is provided for general informational purposes only and does not constitute legal advice, nor does it create an attorney-client relationship. Every case turns on its own facts. Statistics cited are drawn from the public sources listed and reflect the data years indicated; figures are updated periodically by the issuing agencies. If you have questions about a specific situation, consult a licensed attorney. Coxwell & Associates, PLLC, 500 North State Street, Jackson, Mississippi 39201. Free background information available upon request.