The Massachusetts Supreme Judicial Court announced today that injured people will be allowed to introduce the full charges on their medical bills as evidence of their damages at trial despite the Superior Court’s ruling otherwise. The case, Law v. Griffith, was argued by Kathy Jo Cook of KJC Law Firm LLC in Boston. Professor Timothy Wilton, from Suffolk University Law School, served as a consultant on both the brief and the oral argument.
Joanne Law was injured in an automobile accident when Daniel Griffith ran a stop sign and crashed into her car. By the time of the trial, Ms. Law had received extensive medical treatment for which the providers billed Ms. Law $112,269.94. Ms. Law’s medical insurance provider, Mass Health, however, had paid the providers $16,387.14 in full satisfaction of those bills. Ms. Law was not personally responsible for any further payment.
The rates MassHealth will pay for medical treatments are set by statute and are far lower than that which doctors and hospitals charge. By law, providers are not permitted to bill the patient for the balance. Although private health insurers generally pay a higher rate than the government operated MassHealth, they also usually pay less than the amount the providers bill. People without health insurance, however, are responsible for payment of the full charge.
At trial, the defendant argued that the medical bills presented “distorted” evidence of Ms. Law’s damages. The trial judge ruled that Ms. Law could not introduce evidence of the amount “charged” for any of the services, but rather, could only offer evidence of the amount “paid.” Ms. Law was permitted to introduce only the payments of $16,387.14 as her medical expenses, rather than the charges of $112,269.94. The jury was instructed that it could award damages for “medical and hospital bills, as proved,” as well as for scarring, loss of function, impairment of enjoyment of life, and pain and suffering. The jury found for Ms. Law, but in a general verdict for all of the items, it awarded only $48,500.00.
On appeal, attorney Kathy Jo Cook argued that the statute governing the admission of medical bills as evidence of an injured party’s damages for medical expenses required a trial judge to allow the admission of medical bills in the full amount charged. The Supreme Judicial Court unanimously agreed, the majority writing that the statute “states unambiguously that medical bills are admissible to establish the reasonable value of services rendered.”
Cook also argued that the defendant should not be permitted to counter with evidence of the amount paid by the insurance company on the plaintiff’s behalf because of the “collateral source” rule. That rule prohibits consideration of payments made to or for the plaintiff from sources other than the defendant. Such payments are thought to be something the plaintiff has contracted for or a gift to the plaintiff that the defendant should not get the advantage of.
The majority of the Court agreed. The Court said it would allow a defendant to call witnesses to describe generally the practice of discounting bills for insurers, but ruled that no reference may be made to whether the plaintiff in any particular case was insured, or to the amount that was actually paid in each case.
Since the defendant had not challenged the jury’s finding that he was liable, the case was sent back to the Superior Court for a new trial on the damages issue only.
The Boston personal injury lawyers at KJC Law Firm, Kathy Jo Cook and Timothy Wilton, have more than 50 years of experience litigating serious personal injury cases. KJC Law Firm handles litigation and appeals for clients all across the state of Massachusetts.