Liability Insurers Can Benefit From ACA Healthcare Coverage

February 21, 2016| Von Tim Fletcher | Professional Liability | English

Region: North America

The Affordable Care Act (ACA) has survived several judicial challenges and more are coming. Whatever your view on the merits of the sweeping reforms, we see many potential benefits for Medical Professional and other liability insurers. We recently discussed this issue in the context of MPL captive insurers and their policyholders. Many of the elements of care in a serious injury claim are provided through ACA health plans. Consider a bodily injury lawsuit with large future medical costs. With the ACA insuring this care, these costs are potentially excluded from claims for future medical care. Examples include:

• Emergency department visits

• Outpatient care

• Inpatient hospitalization

• Physical therapy and prescription drugs

This does not mean that the ACA or private health insurance plans take the financial burden away from liability insurers. Collateral source and subrogation arguments are often put forth to limit that effect.

It does mean that the total of costs incorporated into a future medical life care plan may no longer be appropriate. With near universal healthcare insurance under the ACA, plaintiffs may be only able to claim the premium for a policy that provides coverage, not the cost of the various services that the policy insures. To achieve these savings, we see several best practices employed by defense attorneys in mediation, litigation and the use of experts. You can read more about them in our article.

For now the takeaway is that the ACA has many possible advantages for traditional and captive MPL insurers, and all liability writers. It is worth keeping the ACA and best defense practices in mind when a serious injury claim arises.


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