Medical Bills in Personal Injury Litigation

Medical bills are a crucial element to proving damages in a personal injury lawsuit. They tell a judge and jury how serious your injuries are. Even more critical, they remove most of the speculation about how much money a jury should award for your case. This article discusses the importance and use of medical bills in litigation. If you receive treatment for injuries caused by another person’s negligence or wrongdoing, you must keep track of any paperwork you receive.

Medical expenses from an injury like a product defect or a car accident are considered economic damages. Economic damages compensate for measurable economic loss. Medical bills are economic damages because they are an expense that you would not have to pay if you hadn’t been injured. Other common forms of economic damages are property damages or lost wages. In each of these situations there should be a documented dollar amount that will make a plaintiff “whole” again from an economic perspective. This could be the bills from repairing your car after an accident, the wages your boss should have paid you in overtime, or the medical bills following an injury.

Legally, a plaintiff who wins their case should be entitled to at least this amount of money in damages. However, other factors can affect this award like noneconomic damages or the various legal limitations on medical bills specifically.

Noneconomic damages are general damages awarded for emotional injuries. This includes depression and anxiety from an accident, but it also includes pain and suffering. Medical bills don’t fall here. Generally, these damages enhance the economic damages a person can receive. In some situations, they can be much larger than the medical bills themselves. Noneconomic damages are more speculative so it can be difficult to evaluate up front.

Limitations on Medical Expenses as Damages

The California Civil Jury Instructions (“CACI”) provide that to recover damages for past medical expenses, a plaintiff must prove the reasonable cost of reasonably necessary medical care that they have received. See CACI – 3903A. This is the most basic limitation upon recovering medical expenses in personal injury actions. The idea is that a person who is injured by another’s wrongful conduct is entitled to the reasonable value of the medical care and services that are required to repair the injury caused by the act. Hanif v. Housing Authority of Yolo County, 200 Cal. App. 3d 635, 640 (1988).

The effect of this limitation is that it is not necessary for the jury to award the full cost of your medical bills. “[I]t has long been the rule that the costs alone of medical treatment and hospitalization do not govern the recovery of such expenses. Dimmick v. Alvarez, 196 Cal. App. 2d 211, 216 (1961). This means a jury could decide to award less than the full cost of your medical bills. To recover the full amount, a plaintiff must show that the medical expenses were attributable to the injury causing act, that they were necessary, and that they were reasonable.

In California, the Supreme Court has made this inquiry more onerous. Howell v. Hamilton Meats & Provisions, Inc., 52 Cal. 4th 541 (2011).  In Howell, the court held that plaintiffs can only recover the medical expenses that are reasonable and actually “incurred.” This means California plaintiffs have an even harder time recovering the full amounts billed by their medical providers.  Rather their recovery of medical expenses can be limited to amounts accepted by the medical service providers as payments in full.

Howell effectively limited California plaintiffs’ recovery to whatever their insurance company agreed to pay the medical service provider for the services. Since insurance companies tend to have negotiated discounts on services with each doctor and hospital, this lowered the amount that California plaintiffs can recover.

Medical Liens

Medical liens are not necessarily a limitation on damages. Medical liens are often used to fund medical services when someone without insurance has been hurt in an accident or if an injured person doesn’t want to use their own health insurance for medical treatment for whatever reason. The uninsured plaintiff allows the medical service providers to take a lien out against their claim.

A California Court of Appeals held that plaintiffs who are treated on medical liens are entitled to recover the full amount of the lien. Uspenskaya v. Meline, 241 Cal. App. 4th 996 (2015). In order to recover the full amount of the medical bills paid, the plaintiff must remain liable for the whole amount. This can be risky because a jury could find against the plaintiff or award less than is required in some rare cases. However, it can be worth it to take care of required medical treatment and to utilize this medical lien option if available.

Future Medical Expenses

The requirement of certainty for economic damages can make it seem like future medical expenses would be difficult to earn. After all, they seem speculative. A person could recover suddenly and no longer need treatment, or maybe they could need more treatment than expected. Fortunately, a court will allow juries to award future medical expenses in certain situations.

“To entitle a plaintiff to recover present damages for apprehended future consequences, there must be evidence to show such a degree of probability of their occurring as amounts to a reasonable certainty that they will result from the original injury.” Bellman v. San Francisco High School Dist., 11 Cal. 2d 576, 588 (1938). Accomplishing this can be done by showing a scheduled surgery in the future or a doctor’s records saying that another operation will be necessary to complete treatment. Every document a medical service provider gives you is potentially important.

If you or a loved one suffered an injury, wrongful death or wrongful termination (getting fired from a job for a legally protected reason such as your race, gender, ethnicity, sexual orientation, disability and/or medical condition, age, complaining about unlawful or illegal conditions, whistleblowing, etc.), you may be entitled to compensation. Please Contact us at 310-923-7839 for a free, no obligation consultation so we can help determine the best path for you.