The legal community in Indiana, specifically those involved in both sides of personal injury cases, has been enthralled in a lively debate concerning whether Defendants should be able to admit Plaintiff’s medical bills when the Plaintiff him/herself isn’t claiming medical expenses as part of their damages. Of course, this debate didn’t arise out of thin air. It’s another repercussion of the infamous Stanley v. Walker case, which allowed defendants to introduce the reduced amounts paid for medical bills after health insurance discounts were applied, despite the collateral source statute clearly stating such payments couldn’t be introduced. As a result, Plaintiffs began removing the claim of medical expenses from cases where the paid amount of the medical bills was low, despite the injuries being significant in order to allow the jury to decide the case based on the injuries, as opposed to deciding it based on the amount of the paid medical. Now Defendants are attempting to introduce the medical bills at trial, despite them not being claimed as damages by the Plaintiff, in order to trick juries into focusing on the amount of the bills instead of the extent of the Plaintiff’s injuries.
In a recent article published in The Indiana Lawyer DTCI (Defense Trial Counsel of Indiana) attorneys argued the medical bills are or should be admissible in these situations. The article even went as far as to say they’re being used as an anchor, to bring the jury’s valuation of the claim down. The article cites case law from other states, where the courts determined the bills to be relevant because they helped the jury determine the seriousness and extent of the Plaintiff’s injuries. The issues with this line of reasoning are pointed out in a letter to the editor written by an ITLA (Indiana Trial Lawyers Association) member, Scott Faultless.
Scott began his rebuttal by analyzing the introduction of medical expenses in cases like this based on the Indiana Rules of Evidence 401, 402, and 403. His conclusion was, “[e]vidence of medical cost is irrelevant because it does not make the pain and suffering and general damages flowing from the injuries any more or less probable than it would be without the evidence of the cost.” He goes on to state Model Jury Instruction 703 directs jurors to consider the listed elements of damages in deciding the amount of money they award. Medical expenses aren’t listed as one of the elements they consider when they aren’t claimed, so they’re irrelevant as an element of damages. Further, the 7th circuit has already decided this in Varhol v. National Railroad Passenger Corporation, 909 F.2d 1557 (7th Cir. 1990). There a Plaintiff tried to introduce the medical bills in a case where he couldn’t recover them. The judge refused to allow them to be admitted and the court of appeals unanimously upheld the decision. The rational was that, “since Varhol could not recover the expenses reflected in those bills, the amounts of those expenses bore little, if any, relevance to this case.” The article goes on to examine a Pennsylvania case that examines the issue and the excerpt was so profound I thought it would be important to include here as well:
“… (T)here is no logical or experiential correlation between the monetary value of medical services required to treat a given injury and the quantum of pain and suffering endured as a result of that injury. First, the mere dollar amount assigned to medical services masks the difference in severity between various types of injuries. A very painful injury may be untreatable, or, on the other hand, may require simpler and less costly treatment than a less painful one. The same disparity in treatment may exist between different but equally painful injuries. Second, given identical injuries, the method or extent of treatment sought by the patient or prescribed by the physician may vary from patient to patient and from physician to physician. Third, even where injury and treatment are identical, the reasonable value of that treatment may vary considerably depending upon the medical facility and community in which care is provided and the rates of physicians and other health care personnel involved. Finally, even given identical injuries, treatment and cost, the fact remains that pain is subjective and varies from individual to individual.”
Martin v. Soblotney, 502 Pa. 418, 466 A.2d 1002, 1025 (1983). That quote accurately sums up our opinions on the issue. If we represent a client and determine that it’s in our client’s best interest to drop any claim for medical expenses because ntroducing his medical bills may unfairly “anchor” the jury’s valuation of the case, then that’s our client’s right. We have clients who are permanently injured who will suffer for the rest of their lives, but had limited treatment because there was nothing that could be done. Attempting to downplay the significant, lifelong impacts of such injuries by introducing the minimal medical bills to anchor the jury’s valuation is just another way for insurance companies to undermine the legitimate injury claims.