If someone’s negligence caused your injury in a Florida accident or on a cruise, you may be able to get compensation for your future medical expenses.
In a Florida personal injury claim, you may be able to get other compensation, such as money for past medical expenses, past and future lost wages, past and future pain, suffering, mental anguish and more.
However, this article focuses on getting money for your future medical expenses if someone’s negligence caused your injury in Florida.
Actual Florida cases that talk about future medical expenses awards
In 2007, Ms. Martinez was stopped at a red light when her car was rear-ended by Ms. Vazquez. Ms. Martinez claimed injuries from the accident and sued Ms.Vazquez for automobile negligence.
The appeals court ruled that the jury’s $50,000 award for future medical expenses was unsupported by the evidence. Where an injured person seeks compensation for future medical expenses, only medical expenses that are reasonably certain to be incurred in the future are recoverable.
There must also be an evidentiary basis upon which the jury can, with reasonable certainty, determine the amount of those expenses.
A mere possibility that certain treatment might be obtained in the future cannot form the basis of an award of future medical expenses.
Both Expert Witnesses Said No Need for Future Treatment
In that case, both expert witnesses said that Ms. Martinez did not need future surgery or follow-up treatment. While the experts recognized that Ms. Martinez might seek over-the-counter medications or chiropractic or physical therapy, they did not believe that they would be beneficial.
Thus, there was no competent, substantial evidence establishing that Ms. Martinez was reasonably certain to incur expenses for future medical treatment.
Appeals Court Reduced Award of Future Medical Bills by $50K
Accordingly, the appeals court reverse (overruled) the jury’s award of $50,000 for future medical expenses. The appeals court ordered the trial court to reduce the award of future medical expenses by $50,000.
The case is Vazquez v. Martinez, Fla: Dist. Court of Appeals, 5th Dist. 2015. Florida’s Fifth District Court of Appeal (DCA) issued a ruling on September 18, 2015.
(Florida’s Fifth District Court of Appeal is comprised of Hernando, Lake, Marion, Citrus and Sumter Counties, Flagler, Putnam, St. Johns and Volusia Counties, Orange and Osceola Counties, Brevard and Seminole Counties.
The car accident likely happened in one of these counties. This is because the injured person usually must sue in the court that has jurisdiction over the county where the accident happened.)
Who Has the Burden of Proof to Show That Medical Expenses Will Be Incurred?
It is an injured person’s burden to establish that future medical expenses will more probably than not be incurred. Montesinos v. Zapata, 43 So. 3d 97 – Fla: Dist. Court of Appeals, 3rd Dist. 2010. Kloster Cruise Ltd. v. Grubbs, 762 So.2d 552, 556 (Fla. 3d DCA 2000).
That burden will only be met with competent substantial evidence.
Can You Get Compensation for a Future Surgery If You Will Need the Surgery If You Develop a Condition, and You Might or Might Not Get the Condition?
No. Kloster Cruise Ltd. v. Grubbs, 762 So.2d 552, 556 (Fla. 3d DCA 2000).
In Kloster, Karen Grubbs sued for compensation from a slip and fall aboard one of Norwegian’s Alaskan cruise ships.
Grubbs and her husband were passengers on a cruise ship. After a day in Juneau, Alaska, the Grubbs were on the top deck of the ship to watch the departure from that port.
When Karen entered the doorway to the inside of the ship she slipped on the metal threshold and fell, breaking her hip.
Karen’s claim was that the threshold is slippery, especially when wet, and that the threshold should have been made of non-skid material.
Future Hip Replacement Would Be Needed if She Developed a Condition
The appeals court said that future hip replacement would be needed if Karen developed avascular necrosis (AVN).
(AVN is condition that occurs when there is loss of blood to the bone, and the bone collapses.)
One x-ray contained a suspicious spot which might or might not indicate the future development of avascular necrosis.
However, the doctor who took the x-ray was clear that he had not made such a diagnosis.
Doctor Said Avascular Necrosis Was Unlikely
He thought the likelihood of its developing and the need for a future hip replacement was unlikely.
Another treating physician stated that if in the future Karen began to experience pain over the present level of discomfort it could be a symptom of avascular necrosis and should be investigated.
From this, Karen’s attorney argued that there was enough reliable evidence that Karen was experiencing additional discomfort and that, in his opinion, Karen was developing avascular necrosis even though no doctor had diagnosed that condition.
The appeals court said that the jury wasn’t legally allowed to award future medical expenses for her hip replacement.
Karen may make whatever claims are proper based on her condition at the time if there is competent medical testimony that in the future it is more likely than not that a hip replacement will be needed.
The appeals court ordered a new trial.
‘More Likely than Not’ Standard
The injured person must have medical testimony that in the future it is more likely than not that medical treatment will be needed.
Reasonably Certain to Be Incurred
Florida law limits recovery of future medical expenses to those expenses “reasonably certain” to be incurred. This is according to Florida law and Florida Standard Jury Instruction (Civil) 501.1.
Possibility or Mere Probability is Not Enough
Future medical expenses cannot be based on the mere “possibility” or “mere probability” that specific treatment might be obtained.
Does a Medical Expert Have to Say that Treatment or Surgery is “Reasonably Necessary”?
No. A medical expert may testify that future medical procedures are “likely” or “possible”.
In Florida, a jury can decide if an injured claimant has met his burden of showing that the future medical treatment is reasonably necessary so long as the jury has competent evidence.
In a Florida motor vehicle accident case, do you need a permanent injury in order to get money for future medical expenses?
No. In a Florida auto accident case, you do not need a permanent injury to get compensation for future medical expenses.
What should a doctor say about an injured person’s future medical expenses?
If true, a doctor should write in his records that an injured person will “more likely than not” need future medical care and that this opinion is within a reasonable degree of medical certainty.
Are insurance companies less likely to give you money for future medical expenses than past medical expenses?
Yes, if all things are equal. This is because you’ve already been billed for past medical services. There is no uncertainty.
On the other hand, you may not go through with future medical treatment.
Are insurance companies more likely to give you money for future surgery if you give them proof that it is scheduled?
Yes, if the bodily injury (BI) liability insurance policy limits are low and your damages exceed these limits. This assumes that your future surgery is related to the accident.
BI insurers are more likely to pay you for future surgery expenses in a Florida auto accident case, where the BI liability limits are usually low. This is as opposed to a Florida premises liability case, such as a slip and fall, where the insurance limits are usually high.
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