Medical costs have been rising for many years and so have medical malpractice awards, some say disproportionately so. Physicians have complained increasingly that their medical malpractice insurance premiums have risen almost to a point of being unaffordable and they call for tort reform. Plaintiffs’ lawyers support increased awards.
In this whole situation, the Ohio Supreme Court has just given a little support to physicians in a decision that is expected to limit damages in medical malpractice and other personal injury cases.
The case in question was filed in 2005 by one Richard Jaques, who was injured in a car accident. The other driver, one Patricia Manton, collided with his vehicle and court records show that she admitted liability.
The Issue of “Write-Offs”
In the lawsuit, Jaques, the plaintiff, submitted his medical bills totaling $21,875. Manton wanted to submit information to show that Jaques’ health insurance company had only paid $7,484 for his treatments. This difference was because of what are called write-offs, where an insurance company has a contract with a medical provider with set costs for various procedures. These costs are lower than what is billed to the patient. An uninsured patient would have to pay the billed amounts.
The court would not allow Manton’s information and in 2008, the jury awarded $25,000 total damages to Jaques.
However, Manton appealed and the Ohio Supreme Court ruled that because neither Jaques nor anybody else paid the difference between $7,484 and $21,875 – it was just “written off” — defendants may submit evidence to show a reasonable value of plaintiffs’ damages. Justice Terrence O’Donnell wrote:
- “Write-offs are amounts not paid by third parties or anyone else, so permitting introduction of evidence of them allows the fact finder to determine the actual amount of medical expenses incurred as a result of the defendant’s conduct. This result supports the traditional goal of compensatory damages — making the plaintiff whole.”
In other words, Jaques had been billed for $21,875 but had never had to pay it, since his insurance company had a prior arrangement with the medical facilities and paid the contracted sum of $7,484 on Jaques’ behalf. Therefore, it is not fair compensation for him to be given $21,875 when he was never out of pocket for that amount.
The Supreme Court sent this case back to a trial court to re-decide the outcome.
Have you been injured because of another person’s carelessness? If you would like to know more about your legal situation and options, please contact our Mobile, Alabama law office for a free case evaluation.