Under O.C.G.A. § 51-12-1.1, medical damages are limited to the reasonable value of medically necessary care, decided by the jury. If you have health insurance, the jury may hear both the billed amount and the amount insurance would pay, even if you didn't use it. If you treated under a letter of protection, the defense can discover the letter, itemized bills, and who referred you. The law applies to injuries on or after April 21, 2025.
Medical expenses are often the backbone of an injury claim. They are the clearest proof of harm, and insurers use them to anchor their offers on everything else. Georgia's 2025 tort reform changed how those expenses are proven for new injuries, so the way you get treatment and pay for it now matters more than it used to.
This guide explains the new statute, what it does and doesn't do, and practical steps to protect the value of your medical damages. It applies to injuries on or after April 21, 2025. Older injuries are governed by prior law.
The old rule: the collateral source rule
Georgia long followed the collateral source rule: a defendant couldn't reduce what it owed because your own health insurance paid your bills, and the jury usually didn't hear about the insurance at all. Hospitals often bill far more than insurers actually pay under their negotiated rates, so the gap between the "billed" and "paid" numbers could be large. Defense groups called the billed amounts "phantom damages." Injury lawyers pointed out that you paid premiums for that insurance and the at-fault party shouldn't get the benefit.
What O.C.G.A. § 51-12-1.1 says now
- Medical damages "shall be limited to the reasonable value of medically necessary care, treatment, or services," and the jury (the "trier of fact") decides that amount.
- If you have "any form of public or private health insurance," the evidence of reasonable value includes both "the amounts charged" and "the amounts actually necessary to satisfy such charges" under the insurance, "regardless of whether the health insurance has been used, is used, or will be used."
- The collateral source rule is set aside only "to the extent necessary to introduce the evidence" the statute describes, and the court may instruct the jury on the role of collateral source payments.
- Either side can still challenge whether the charges were reasonable or the treatment was medically necessary, including projected future care.
What it does not do
The statute does not cap your medical damages at what insurance paid, and it does not make the billed amount inadmissible. It puts both numbers in front of the jury, and the jury decides what the care was reasonably worth. Some summaries online describe it as limiting recovery to the paid amount. That isn't what the text says.
It also doesn't touch other damages: lost wages, future earning capacity, and pain and suffering are proven the same way as before. Our article on how pain and suffering is valued covers that side.
If you treated under a letter of protection
A letter of protection (LOP) is a promise to pay a provider out of a future settlement or judgment, often used when someone has no health insurance. The new law covers an LOP "or any other arrangement" like it, "regardless of how such arrangement is referred to," and makes these "relevant and discoverable":
- A copy of the letter of protection.
- All charges, itemized and coded under standard medical billing practices.
- If the provider sold the bill to a third party (a factoring company) for less than face value, the buyer's name and the price it paid.
- Whether you were referred for treatment under the LOP and, if so, who made the referral.
Why this matters even if your case never goes to trial
Most injury claims settle without a trial, but every settlement is priced against what a jury would likely do. After April 21, 2025, insurers will value medical damages using the insurance-paid figures where they exist, and will scrutinize LOP treatment closely. A claim built around billed amounts alone, or around providers paid only from the settlement, will meet more resistance.
Practical steps for injuries after April 21, 2025
- Use your health insurance for treatment if you have it, and tell providers you have it. It keeps care accessible, and the paid amounts will be part of the case either way.
- Keep your insurer's explanation of benefits (EOB) statements along with every bill. They show both the charged and paid figures.
- Follow your doctors' recommendations and keep appointments. "Medically necessary" is now part of the statutory test, and gaps in care invite challenge. See documenting your injuries and treatment.
- If you have no insurance and are considering LOP treatment, understand that the arrangement and the referral source can be discovered. Talk to your lawyer about how the provider bills and whether it sells its receivables.
- Remember that health plans, hospitals, Medicare, and Medicaid may have repayment rights out of your settlement. See our guides on hospital liens and Medicare, Medicaid, and health insurance liens.
Frequently Asked Questions
Can I only recover what my health insurance paid in Georgia?
No. For injuries on or after April 21, 2025, the jury can hear both the billed amount and the amount insurance would pay, and it decides the reasonable value of the care. The statute does not cap recovery at the paid amount.
Does the new medical bills law apply to my accident?
O.C.G.A. § 51-12-1.1 applies only to causes of action arising on or after April 21, 2025. Injuries before that date are governed by prior law, including the traditional collateral source rule.
What if I don't have health insurance?
The billed-versus-paid comparison in subsection (c) applies when the injured person has health insurance. If you don't, the jury still decides the reasonable value of medically necessary care, and if you treat under a letter of protection, the letter, itemized charges, and referral source are discoverable.
Is a letter of protection admissible at trial now?
The statute says LOP records are "relevant and discoverable." It does not expressly say they are admissible at trial; that is decided under the rules of evidence.
Sources
This guide is general information about Georgia law as of October 29, 2026. It is not legal advice, and reading it does not create an attorney-client relationship. Laws change and every case turns on its own facts. Talk to a lawyer about your situation before you rely on a deadline or rule described here.