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Arthur v. Catour7/21/2005
it court of Henry County, is reversed; and the cause is remanded to the circuit court for further proceedings.
Certified question answered; appellate court affirmed; circuit court reversed; cause remanded.
CHIEF JUSTICE McMORROW, dissenting:
This appeal revolves around the following question certified by the trial court:
"Whether the plaintiff who was charged $19,355.25 in medical bills for medical services related to her injuries can present that amount of bills as medical expenses in the case or, whether the plaintiff shall be limited to presenting only $13,577.97 in medical bills to the jury because that is the amount that was paid by the plaintiff and Blue Cross/Blue Shield, who was an insurance carrier for the plaintiff and who paid the plaintiff's medical bills pursuant to insurance contracts at a substantially reduced rate with the medical providers and which the providers accepted as payment in full."
In sum, the trial court asked whether an injured plaintiff could recover as compensatory damages the entire amount billed by health-care providers for medical services, or whether a plaintiff would be limited to recovering the discounted amount of medical expenses actually paid for the medical services by the plaintiff's insurance carrier. The majority answers this certified question by holding that plaintiff may present to the jury the amount that her health-care providers initially billed for services rendered. Despite this holding, however, the majority finds that, because plaintiff's health-care providers accepted a discounted amount from her insurance carrier as payment in full, plaintiff "cannot truthfully testify that the total billed amount has been paid." Therefore, the majority concludes that plaintiff must establish the reasonable cost of the health-care services provided to her by employing unspecified "other means." The majority also holds that defendants are free to challenge plaintiff's proof on cross-examination and "to offer their own evidence pertaining to reasonableness of the charges." For the reasons that follow, I respectfully dissent from the opinion of the majority.
As stated, in this case, plaintiff received services from various health-care providers billed in the amount of $19,355.25. However, plaintiff's insurer-Blue Cross/Blue Shield (Blue Cross)-had contractual agreements with plaintiff's health-care providers under which many of the health-care services rendered were discounted. Thus, although the health-care providers billed plaintiff for their services in an amount in excess of $19,000, Blue Cross actually paid them a discounted amount of $13,577.97 as a result of the various contracts. This discounted amount was accepted as payment in full by the health-care providers, and plaintiff was not responsible for the difference.
Prior to trial, defendants filed a motion for partial summary judgment, seeking to limit plaintiff's claim for medical expenses to the amount actually paid to the health-care providers, rather than the amount billed to plaintiff. In opposition to the motion, plaintiff, invoking the protections of the collateral source rule, took the position that it was the amount of health-care expenses billed, rather than the amount actually paid, that should be presented as the measure of damages to the jury.
The circuit court disagreed with plaintiff and granted defendants' motion for partial summary judgment. In its written order, entered on June 18, 2002, the circuit court found that there was "no genuine issue as to whether the plaintiff or her insurance company was liable to any health care provider for more than $13,577.97." The circuit court also found that the re
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