How SB 68 Changed Medical Damage Calculations in Georgia
On this page
For injuries from crashes on or after April 21, 2025, Georgia limits recoverable medical expenses to “the reasonable value of medically necessary care, treatment, or services”, with the amount determined by the trier of fact. If the injured person has health insurance, the jury hears both what the providers charged and what was actually necessary to satisfy those charges under the insurance. That replaced the old practice of keeping insurance payments out of the case. Crashes before that date stay under prior law for this rule.
The statute, subsection by subsection
Senate Bill 68 added O.C.G.A. § 51-12-1.1:
| Subsection | What it says |
|---|---|
| (a) | In a civil action for injury or death, medical and healthcare special damages are recoverable "only as provided in this Code section" |
| (b) | They are limited to the reasonable value of medically necessary care, and the amount "shall be determined by the trier of fact" |
| (c) | If the plaintiff has public or private health insurance, including governmental workers' compensation benefits, the evidence "shall include both the amounts charged" and "the amounts actually necessary to satisfy such charges pursuant to the insurance contract" (or the workers' compensation program), whether or not the insurance was used |
| (d) | For treatment under a letter of protection or similar arrangement, the letter, itemized and coded charges, any sale of the account to a third party (buyer and price), and any referral for treatment are relevant and discoverable |
| (e) | The collateral source rule is abrogated "to the extent necessary to introduce the evidence described", and the court may instruct the jury about the role of collateral source payments |
| (f) | Either side may still challenge the reasonableness of the expenses or the medical necessity of any treatment |
Which crashes it covers
Section 9 of the act provides that Section 7, which enacted § 51-12-1.1, applies “only with respect to causes of action arising on or after the effective date of this Act,” which was April 21, 2025. A claim from a crash on April 20, 2025, is governed by prior law on this point even if the lawsuit is filed later. Other parts of the act reach pending cases; the full map is in Georgia SB 68 tort reform and car accident claims.
What changes in the numbers
For example, imagine an injured person whose providers billed $60,000. The person’s health plan, under its contract with the providers, satisfied those charges with $22,000. Under the common law collateral source rule, which subsection (e) abrogates to the extent necessary, the health plan’s payment was not part of the jury’s evidence. For a crash covered by the statute, the jury hears both the $60,000 charged and the $22,000 necessary to satisfy the charges, and it decides the reasonable value of the medically necessary care. The statute does not tell the jury to pick either figure; it decides from the evidence, and either side can offer evidence on what the care was reasonably worth. The figures are illustrative only.
Health insurance, no insurance, and letters of protection
The statute treats three situations differently:
- Plaintiff with health insurance. Subsection (c) applies: the evidence includes both the charged and the satisfied amounts, “regardless of whether the health insurance has been used, is used, or will be used to satisfy such charges.”
- Plaintiff without health insurance. Subsection (c) does not apply by its terms. The recovery is still limited to reasonable value under subsection (b), and either side may challenge reasonableness under subsection (f).
- Treatment under a letter of protection. Subsection (d) makes the letter, the itemized charges, any sale of the account receivable and its price, and the referral source discoverable. How these arrangements work is explained in letters of protection in Georgia personal injury cases.
Records that answer the statute’s questions
- Itemized bills from every provider, with billing codes.
- Explanation-of-benefits statements or remittance records showing what the insurer allowed and paid and what the patient owed.
- Records of any account sold to a third party, if the treatment was under a letter of protection.
- The treating physicians’ records and opinions on medical necessity and future care.
Health plans and government programs that paid for care may also seek reimbursement from the recovery, which is a separate question covered in how medical liens affect your Georgia car accident settlement.
Sources
- Senate Bill 68 (2025), as passed, LC 49 2362S, § 7 (O.C.G.A. § 51-12-1.1) and § 9; Office of Legislative Counsel, 2025 Summary of General Statutes Enacted (effective April 21, 2025).
This page describes Georgia law as of October 2026 for general information. It is not legal advice and does not create an attorney-client relationship.