Amount that insurer is expected to pay value of future medical care is relevant in determining damages for auto accident

DAVID AUDISH, Plaintiff and Appellant, v. DAVID MACIAS et al., Defendants and Respondents. (Cal. Ct. App., May 21, 2024, No. D081689) 2024 WL 2860272

Summary: Plaintiff Audish appealed a civil judgment after a jury verdict in an automobile collision case. The jury found Audish and defendant David  both operated their vehicles negligently and each party’s negligence was a substantial factor in causing harm to Audish. The jury found Audish suffered $65,699.50 in damages, including $29,288.94 for past medical expenses, $3,620 for past non-economic losses, and $32,790.56 for future medical expenses, and it assigned each party 50 percent of the responsibility for these losses.

On appeal, Audish contends the trial court abused its discretion by admitting evidence that he would have Medicare medical insurance at the age of 65. He also argues the jury returned an impermissible compromise verdict and erred by failing to award him damages for future non-economic losses. The Court of Appeal rejected these claims and affirmed the judgment.

Procedural Background

Audish and his wife filed suit against Macias for negligence, negligent entrustment, and loss of consortium.

The jury returned a special verdict finding Audish and Macias were both negligent in the operation of their vehicles. The jury assigned Audish and Macias each 50 percent of the responsibility for their losses.

The Trial Court did not Err by Admitting Medicare-Related Evidence

Audish argues the trial court violated the collateral source rule by admitting evidence that he would have Medicare insurance at age 65.

Audish challenges the evidentiary rulings allowing an expert to testify that she “assume[d]” he would be eligible for Medicare at age 65, her future medical cost estimates did not account for the amounts Medicare would actually pay for the medical treatments recommended by his medical professionals, and insurers sometimes pay less for medical treatments than the amounts health care providers charge for them.  Audish does not explicitly refer to the collateral source rule, he effectively argued that collateral source rule by allowing evidence that Medicare would pay at least a portion of his future medical expenses, which supposedly encouraged the jury to reduce his overall award of future medical expenses.

“A trial court’s evidentiary ruling is reviewed for abuse of discretion.  A trial court abuses its discretion if its ruling exceeds ‘ “ ‘the bounds of reason, all of the circumstances before it being considered.’ ” ’ [Citation.] ‘ “ ‘A decision will not be reversed merely because reasonable people might disagree.’ ” ’ ” (Jones v. Solgen Construction, LLC (2024) 99 Cal.App.5th 1178, 1188–1189; see Lurner v. American Golf Corp. (2023) 97 Cal.App.5th 121, 138 [“An abuse of discretion occurs only if ‘ “the trial court’s decision exceeds the bounds of reason and results in a miscarriage of justice.” ’ ”].)

The trial court did not violate the collateral source rule, or otherwise abuse its discretion, in allowing testimony about Medicare.

The collateral source rule

“The collateral source rule states that ‘if an injured party receives some compensation for his injuries from a source wholly independent of the tortfeasor, such payment should not be deducted from the damages which the plaintiff would otherwise collect from the tortfeasor. Put another way, ‘Payments made to or benefits conferred on the injured party from other sources [i.e., those unconnected to the defendant] are not credited against the tortfeasor’s liability, although they cover all or a part of the harm for which the tortfeasor is liable.’  The rule thus dictates that an injured plaintiff may recover from the tortfeasor money an insurer has paid to medical providers on his or her behalf.” (Howell v. Hamilton Meats & Provisions, Inc. (2011) 52 Cal.4th 541, 551 (Howell).)

The Howell court concluded a tort plaintiff is only permitted to recover the discounted rate that the health care provider accepted as payment, given that the plaintiff did not suffer economic loss in the full amount charged by the health care provider.

The Howell court concluded this limitation on recovery did not violate the collateral source rule; instead, it found the rule was inapplicable. As the court explained, the collateral source rule “has no bearing on amounts that were included in a provider’s bill but for which the plaintiff never incurred liability because the provider, by prior agreement, accepted a lesser amount as full payment. Such sums are not damages the plaintiff would otherwise have collected from the defendant. They are neither paid to the providers on the plaintiff’s behalf nor paid to the plaintiff in indemnity of his or her expenses. Because they do not represent an economic loss for the plaintiff, they are not recoverable in the first instance. The collateral source rule … does not expand the scope of economic damages to include expenses the plaintiff never incurred.” (Howell, supra, 52 Cal.4th at pp. 548–549.)

It is permissible—or even necessary—for a trial court to admit evidence concerning a tort plaintiff’s future eligibility for health insurance and the anticipated amounts the insurer would be expected to pay for the patient’s future medical needs, evidence that is relevant to the reasonable value of future medical care.

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