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Medicare MSP Compliance

Maximizing Personal Injury Recoveries While Limiting Case-Related Costs

Rasa Fumagalli, JD, MSCC, CMSP-F

Personal injury settlements rarely make an injury victim whole. In light of this, cost management decisions factor into the strategy of the case. For example, while both life care plans and medical cost projection reports may be used as support for a settlement demand, their costs are very different. Life care plans may range anywhere from on the low end $10,000 to $20,000 or more, while medical cost projections are much more economical. The decision on which report to select may depend on the nature of the injuries, the expected range of settlement of the case, available coverage and time constraints associated with the settlement negotiations.

A comparison of the two reports is reflected in the below chart. Although both reports provide support for a demand of future injury-related medical care, the life care plan will usually be based on an in-home visit and interview with the injury victim. The medical cost projection, on the other hand, is based on information that is provided by the attorney handling the matter. Both reports are based on a review of medical records, but the life care plan report may also look to information gained through a conversation with a treating physician. Life care plans often have addendums that address lost earnings, replacement costs of household services and home modifications, while medical cost projections do not. In deciding which of these reports is appropriate to increase the value of the case, an attorney should avoid using a sledgehammer to crack a nut.

Life Care Plan (LCP)Medical Cost Projection (MCP)
Medical costsMedical costs
Durable medical equipment/suppliesDurable medical equipment/supplies
Physician/specialist visitsPhysician/specialist visits
Rehabilitation/physical therapyRehabilitation/physical therapy
Future surgeries/proceduresFuture surgeries/procedures
Home health careHome health care
Long term careLong term care
Transportation mileageTransportation mileage
Assessment of lost incomeN/A
Assessment of loss of earning capacityN/A
Estimate of home modificationsN/A
Estimate of vehicle modificationsN/A
Estimate of cost of replacement of household services that can no longer be performedN/A
Vocational therapyN/A
Based on in-home visit and interview with injury victimBased on intake packet provided by injury victim’s attorney
Review of medical recordsReview of medical records
Contact with physiciansN/A
Average cost: $15,000Synergy’s cost: $2,500


In the right case, don’t miss the opportunity to hit the defense hard early on by quantifying the future medical damages suffered by your client. You don’t have to spend tens of thousands of dollars on a life care plan to do this. Instead, let Synergy prepare a Medical Cost Projection (MCP) report quickly, based upon existing medical records (costs $2,500.00). That way you can quickly present evidence of future medical expenses and include the future medical cost projection report in your initial demands so you can settle cases earlier on.  Contact Synergy today to learn more about how our MCP report can simplify the negotiation of future medical care for your case.

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