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Arthur v. Catour7/21/2005
f the full recovery to which he is entitled." J. Fischer, Understanding Remedies §12(a), at 77 (1999).
Clearly, to the extent the evidentiary component of the collateral source rule implicates the substantive component of the rule, the evidentiary component applies only to prevent defendants from introducing evidence that a plaintiff's losses have been compensated for, even in part, by insurance.
However, the collateral source rule is not an evidentiary rule that permits a defendant to limit a plaintiff's ability to introduce evidence of the reasonable cost of health care necessitated by the defendant's conduct.
"The usual [collateral source rule] case is one in which the plaintiff is injured by the defendant's tort but suffers no actual medial expense loss because those expenses are paid for by the plaintiff's own medical insurance or paid for as part of government benefits to veterans. In these cases the rule is quite firm that the defendant must pay for the reasonable value of medical services reasonably required even though the plaintiff's own insurance has paid for such services." 1 D. Dobbs, Remedies §3.8(1), at 373 (2d ed. 1993).
Accord Wilson, 131 Ill. 2d at 320.
In the present case, plaintiff received health-care services and became liable for the resulting expenses upon receipt of those services, not when the final bill was eventually issued. Her liability was not somehow nonexistent merely because the providers submitted bills directly to her insurer. Indeed, it is not uncommon for an insurer, upon receipt of such bills, to deny coverage, leaving the patient/plaintiff personally liable for the balance. For example, the policy might have lapsed for nonpayment of premiums, or the policy may not cover some services, such as cosmetic or reconstructive surgery.
The medical expenses for which plaintiff was liable were covered in full by her health insurance. The bill was paid in part and the balance written off pursuant to a contractual arrangement between the insurer and the provider-a contract to which the plaintiff was not a party. Thus, the collateral source was the insurance company and not the so- called "discount." To restate the obvious: plaintiff did not receive a discount from the provider. Rather, plaintiff received the benefit of her bargain with her insurance company-full coverage for incurred medical expenses.
This leads us to the certified question, which presents a question of proof rather than of entitlement, i.e., a question involving an evidentiary component of the collateral source rule and not a substantive rule of damages. Plaintiff, of course, is entitled to recover as compensatory damages the reasonable expense of necessary medical care resulting from defendants' negligence, if proved. See Chicago City Ry. Co. v. Henry, 218 Ill. 92, 95 (1905); accord Donk Bros. Coal & Coke Co. v. Thil, 228 Ill. 233, 241-42 (1907); Department of Law Enforcement v. Willis, 61 Ill. App. 3d 495, 498 (1978). The only relevant question in the litigation between plaintiff and defendants is the reasonable value of the services rendered. The certified question merely asks whether certain evidence is admissible in such cases.
The controlling principles are quite settled:
"In Illinois, the question of damages is peculiarly one of fact for the jury. Flynn v. Vancil, 41 Ill. 2d 236, 240, 242 N.E.2d 237, 240 (1968). The rules regarding the admissibility of evidence of medical expenses and the burden of proving medical expenses are well established. In order to recover for medical expenses, the plaintiff must prove that he or she has paid or become liable to pay a medical bill, that he or she nece
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