Wednesday, November 25, 2009

Collateral Source Rule Protects Tort Plaintiff's Recovery for Health Insurance Discounts

Here is an interesting case. The plaintiff in an auto accident sued for her full damages resulting from the accident. The defendant was found liable but sought to reduce the award by the amount of the difference between what her medical insurance actually paid and the total for which she was liable to the providers. Thus, the case focused upon whether the collateral source rule protected not only the amounts paid by the medical insurer, but also the huge discounts which often reach into the stratosphere that the insurers squeeze out of the providers.

In Howell v. Hamilton Means and Provisions, 2009 DJDAR 16748 (11/23/2009), the California Fourth District Court of Appeal ruled that the plaintiff was indeed entitled to her full medical expenses and the defendant was not entitled to any reduction reflecting the negotiated price reduction obtained by the insurer. The insurance company lobby filed an amicus brief in support of the defendant. The court disagreed with the analysis of other appellate court decisions and concluded that any abrogation of the collateral source rule should be undertaken by the Legislature, not by the courts.

This case is an unusual example of a conservative leaning court (we do not legislate) ultimately filing a decision that clearly supports the plaintiff's bar.

The decision has been published. Given the conflict amoungst several appellate courts in Califonria on this subject, it will be interesting to see whether or not the California Supreme Court takes this decision for review (which effectively removes it from the books) or depublishes it. For those of you not from California, seeking depublication is a tactic that insurance companies often seek to use to remove the precedential value of adverse decisions because a depublished decision cannot be cited by others as precedent, even though it remains the law of the case. The Supreme Court could also let the decision stand. I suspect that the insurance company lobby (openly or through the defendant) will move the appellate court to de-publish the decision and, if that maneuver fails, have the defendant seek review by the state Supreme Court.

Stay tuned.

12 comments:

  1. Yes, this is a potentially huge decision. As I read the decision, the court differentiated the facts in this case from prior decisions. The court in Howell reasoned that the plaintiff could recover amounts bill, not just amounts paid, because plaintiff had insurance under a private plan, not a government plan.

    Regards,
    Dave Tate

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