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Arthur v. Catour7/21/2005
ants which relies upon-and quotes from-our decision in Peterson, and which directly implicates the application of the collateral source rule to the facts presented at bar.
The majority opinion then proceeds to analyze what it construes to be the question presented by this appeal. This analysis, and the resultant holding, consist of a single paragraph:
" laintiff cannot make a prima facie case of reasonableness based on the bill alone, because she cannot truthfully testify that the total billed amount has been paid. Instead, she must establish the reasonable cost by other means-just as she would have to do if the services had not yet been rendered, e.g., in the case of required future surgery, or if the bill remained unpaid. Defendants, of course, are free to challenge plaintiff's proof on cross-examination and to offer their own evidence pertaining to reasonableness of the charges." Slip op. at 8.
The majority then reiterates its holding by stating that " lainitff may present to the jury the amount that her health-care providers initially billed for services rendered." Slip op. at 8.
What does this mean? Although the majority answers the certified question by ruling that plaintiff may present the billed amount to the jury as the appropriate measure of damages, the majority then contradicts this statement by holding that plaintiff cannot make a prima facie case of reasonableness based upon the bill alone, as plaintiff "cannot truthfully testify that the total billed amount has been paid." Slip op. at 8. The majority also holds that plaintiff must establish the reasonable cost of her medical expenses "by other means," but those "other means" remain unspecified. Further, the majority would allow defendants "to challenge plaintiff's proof on cross-examination and to offer their own evidence pertaining to the reasonableness of the charges," but provides no insight as to what this evidence might be. Slip op. at 8.
Several questions and concerns arise from the majority's analysis and holding in this case. First, what is to become of the well-settled rule in this state that a plaintiff establishes a prima facie case that a medical expense is reasonable if that expense has been paid? Under ordinary rules of evidence, the paid bill would be the appropriate measure of damages. Yet, for unexplained reasons this is not the answer in the matter at bar.
On the other hand, the majority appears to implicitly acknowledge that "evidence of the amount charged alone does not indicate reasonableness." Victory Memorial Hospital v. Rice, 143 Ill. App. 3d 621, 624 (1986). Thus, because plaintiff's charged bill was not paid, the majority admits that plaintiff cannot use the charged bill to show that the expenses were prima facie reasonable. The majority states that plaintiff must establish reasonable costs by unspecified "other means," yet fails to elaborate on exactly what plaintiff may do.
It is well settled that " here a hospital or medical bill is unpaid, the plaintiff has the burden of proving that the charges are reasonable, as well as that he or she has become liable to pay those charges. If no evidence as to a bill's reasonableness is introduced, the bill is not admissible into evidence." 11 Ill. Jur. Personal Injury & Torts ยง5:26 (2002); see also Spurr v. LaSalle, 385 F.2d 322, 329 (7th Cir. 1967) (applying Illinois law, observing: "Common sense tells us it is most improbable that the insurer paid any medical expenses which could not have been shown to be reasonable in amount and necessary by reason of the injury. Actual payment of medical expense is prima facie evidence of reasonableness").
The majority's opinion will likely
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