Provides relative to health insurance coverage with respect to certain claims

House Bill 95 enacts a new statute, R.S. 9:2800.31, that imposes a cap on recoverable past medical expenses in automobile accident claims when a claimant has failed to use available health insurance coverage. The statute defines health insurance coverage broadly to include benefits provided through traditional insurance policies, preferred provider organizations, health maintenance organizations, Medicare, Medicaid, and equivalent state health plans. The core mechanism limits a claimant's recovery of past medical expenses to the amount that would have been paid by the claimant's own health insurance, effectively preventing a claimant from recovering full charges when the claimant had applicable coverage but chose not to use it.

The practical effect of this statute falls primarily on claimants bringing automobile accident injury claims who possess health insurance but did not utilize it to pay their medical expenses. Under this law, such claimants cannot recover the full amount billed for medical services; instead, their recovery is capped at what their health insurance would have paid. This change affects both individual claimants and defendants in automobile accident litigation, as defendants gain a statutory defense based on the claimant's failure to utilize available insurance. Healthcare providers and insurers may also experience secondary effects through changes in how claims are valued and settled in the automobile accident context.

This statute operates within Louisiana's tort recovery framework and interacts with the state's existing rules on damages in negligence actions. The statute explicitly excludes workers' compensation claims from its application, preserving the separate statutory scheme governing workplace injuries under R.S. 23:1020.1 et seq. The provision addresses the broader principle of damage mitigation in tort law by creating a statutory requirement that claimants exhaust or utilize their own available insurance resources, though the statute does not require the claimant to actually apply for or pursue coverage, only limits recovery when coverage was available but unused.