The car accident was bad enough, but what happened to the victim afterward was even worse. In this case, an Ohio hospital victimized its own patient. As Ohio personal injury attorneys, we were determined to make it right.
The pedestrian car accident
Freddie* was 30 years old, mentally disabled, and lived with his mother. Despite his limitations Freddie was a very productive young man. He had a job at a neighborhood restaurant and he went to work every day just like anyone else.
One day, Freddie was walking back to work after a break when a careless driver made a rolling right turn through the crosswalk Freddie was using, and hit him square on. It was a devastating accident. Freddie sustained a serious head injury, and his shoulder was hurt badly enough to require a replacement. Worse yet, Freddie lost his job because he was unable to work after the accident. In addition to his long and arduous recovery, the accident left Freddie with severe post-traumatic stress disorder. He didn’t want to leave his mother’s house, much less get in a car or cross the street—his life was totally transformed by the tragedy.
According to Ohio law, if a driver strikes a pedestrian who’s outside of a crosswalk, the driver can’t be held liable for the accident. That’s the position the driver and her insurance company took. We countered their position by hiring an accident reconstruction expert. Speed analysis measurement and eyewitness testimony were used to establish that Freddie was indeed in the crosswalk when he was struck by the driver’s car. By proving the driver’s negligence we were able to secure a settlement that would help Freddie on his road to recovery.
Establishing the driver’s liability was great news for Freddie, but it certainly wasn’t the last obstacle that he would have to overcome in regards to this accident.
Ohio Health preys on a vulnerable man
As a patient of Ohio Health, Freddie’s medical bills totaled over $110,000. If he’d had insurance, or if he’d been covered by Medicare or Medicaid, the insurer would have offered to pay a certain percentage of the bill, the hospital would have accepted it, and that would have been the end of the story. It’s a common practice in the healthcare business—hospitals bill one amount, but they take whatever the insurers are willing to pay. Because hospitals know they’ll only get a fraction of the amount billed, they have an incentive to inflate the bills.
Ohio non-profit hospitals have a state-required program called H-CAP, which is a charitable program that covers medical bills for those in our society who are uninsured or impoverished. The day after the accident, someone from Ohio Health’s billing office went to Freddie’s room with a form to determine if he was eligible for H-CAP. This person asked Freddy—who was badly injured, traumatized, and on pain medication—how much money he made. On the form, that person recorded that Freddie’s income was $18,000 a year, which made him ineligible for H-CAP.
But Freddie never made $18,000 a year in his life. Now maybe he said $8,000 and somebody wrote it down as $18,000. Or maybe he was on pain medication and didn’t say anything. (They never even tried to ask his mother, who was present and who certainly would have been able to provide that information.) Denying Freddie H-CAP assistance would be a big win for the hospital. H-CAP eligibility would eliminate his debt entirely, but if Freddie wasn’t eligible, the hospital would be in line for a big payday from the insurance company. So the hospital was financially motivated to keep Freddie from receiving H-CAP benefits, even though he was precisely the type of candidate the program was designed to benefit.
Freddie’s employer didn’t provide him with health insurance. So here’s a man with no private insurance and who, according to Ohio Health, is ineligible for H-CAP. It gets worse: Rather than trying to collect the amount that Ohio Health would have accepted if Freddie had been insured (something in the range of $40,000) Ohio Health demanded the whole $110,000. And it didn’t just try to collect, Ohio Health actually sued Freddie for everything—his medical bills, his therapy, for every last dime of the inflated bill.
Ohio Health’s financial greed led them to prey on an impoverished and mentally disabled young man in the midst of an incredible hardship, and it’s despicable.
Helping Freddie land on his feet
It was our goal to keep Freddie from having to pay the overinflated $110,000, which would have amounted to a significant portion of his settlement. He’d been through enough at that point and we believed his settlement should have been used to help him get back on his feet, not compensate the hospital at exorbitant rates. Fortunately, we were able to negotiate a much more realistic bill, and Freddie was able to retain the majority of his settlement.
Sometimes good people get taken advantage of, and we’re just glad to be able to our part in correcting these situations when we can. It hasn’t been easy for Freddie or his mother, who had to take a lot of time off of work to take care of him. Freddie has a lot to live for and we’re eager to see him recover physically, recover from his post traumatic stress disorder, and get back into the world.
*Names in this article have been changed to protect our client’s privacy. The outcome of any client’s case will depend on the particular legal and factual circumstances of the case.