The EIA participated in an amicus brief in 2011 regarding the application of Howell v. Hamilton with regard to paid versus billed medicals specifically discussing which a plaintiff should be allowed to collect. The brief was successful in assisting the Appellate Court with finding that a plaintiff should not be allowed to collect the billed amount of medicals, rather that they are entitled to recover only the paid medicals. The Court left open, however, whether billed or paid medicals could be presented at trial.
Last week, the Second Court of Appeals answered that question. The Second Court of Appeal concluded that Howell v. Hamilton applies to future medicals and that the amount billed may not be introduced for any reason, including for determining pain and suffering damages, nor as the basis of expert opinions as to future medicals. The two cases that recently came down from the Appellate Court that address this issue are Corenbaum v. Lampkin and Carter v. Lampkin.
The basis/finding of the Court of Appeal’s ruling is below:
(1) Evidence of the full amount billed for a plaintiff’s medical care is not relevant to the determination of a plaintiff’s damages for past medical expenses, and therefore is inadmissible for that purpose if the plaintiff’s medical providers, by prior agreement, had contracted to accept a lesser amount as full payment for the services provided.
(2) Because an injured plaintiff can recover as damages for past medical expenses no more than the amount incurred for those past medical services (Howell, supra, 52 Cal.4th at p. 555), evidence that the reasonable value of such services exceeded the amount paid is irrelevant and inadmissible on the issue of the amount of damages for past medical services.
(3) Evidence of the full amount billed for plaintiffs’ medical care is not admissible for the purpose of determining plaintiffs’ damages for their past medical expenses.
(4) For the same reason, the full amount billed for past medical services is not relevant to a determination of the reasonable value of future medical services. Moreover, for a jury to consider both evidence of the amount accepted as full payment, for the purpose of determining the amount of past economic damages, and the full amount billed, for some other purpose, would most certainly cause jury confusion and suggest the existence of a collateral source payment, contrary to the evidentiary aspect of the collateral source rule. Therefore, the full amount billed for past medical services is not relevant to the amount of future medical expenses and is inadmissible for that purpose.
(5) Because the full amount billed for past medical services provided to a plaintiff is not relevant to the value of those services, the full amount billed for those past medical services can provide no reasonable basis for an expert opinion on the value of future medical services. Evidence of the full amount billed for past medical services provided to a plaintiff therefore cannot support an expert opinion on the reasonable value of future medical services.
(6) In an issue left open by the Howell Court, the Court of Appeals held that evidence of the full amount billed is not admissible for the purpose of providing plaintiff’s counsel an argumentative construct to assist a jury in its difficult task of determining the amount of noneconomic damages and is inadmissible for the purpose of proving noneconomic damages.
These holdings will change the face of calculating damages as we know it, and it will be vital for defense counsel to assert this new law moving forward.
