The case centers around three basic issues. However, it is the third issue that has garnered the most attention--i.e., whether the collateral source rule permits a plaintiff to recover the full amount of medical bills where a healthcare provider has provided a “write-off” for part of the bill?
The defendant, while intoxicated, rear-ended a vehicle that was stopped at a traffic light. The plaintiff received severe injuries, including a herniated disk requiring surgery. The plaintiff’s medical bills were in excess of $78,000. However, because the plaintiff was insured through Blue Cross/Blue Shield, the healthcare providers were paid less than the full amount of the bills. The defendant filed a motion in limine seeking to prevent the plaintiff from introducing any medical bills that did not reflect reductions or write-offs by the healthcare provider. The trial court refused, citing the collateral source rule. The jury returned a verdict totaling over $500,000, and the defendant appealed.
The defendant acknowledges that Ratlief vs Yokum, 167 W.Va. 779, 280 S.E.2nd 584 (1991) is the premiere case in West Virginia addressing the collateral source rule. According to the defendant, Ratlief only “preclude[s] the offsetting of payments made by health and accident insurance companies…as against the damages claimed by the injured party.” Furthermore, Ratlief prohibits inquiry into whether a plaintiff “has received payments from collateral sources.” The defendant argues that the write-offs given by the plaintiff’s health care providers were not “payments” and, therefore, were not subject to the collateral source rule. To support this view, the defendant cites cases from California, Pennsylvania, and §911 of the Restatement (Second) of Torts.
Alternatively, the defendant argues that the court should have permitted proof of the write-offs to demonstrate the true and actual value of the medical services rendered. W.Va. Code 57-5-4j provides that medical bills are prima facie proof of value. Citing cases from Ohio, Indiana and Kansas, including the oft-cited case of Robinson vs. Bates, 112 Ohio St.3d 17, 857 N.E.2d 119, the defendant argues that proof of a write-off is relevant and admissible to rebut this statutory presumption.
The plaintiff emphasizes that part of the rationale behind the collateral source rule is that the defendant should not benefit from the plaintiff’s own, independent contractual arrangements. Citing Long vs. City of Weirton, 158 W.Va. 741, 214 S.E.2d 832 (1975), the plaintiff argues that damages for medical bills are not predicated on actual payment of the bill, but, instead, on two factors unrelated to payment--i.e., (1) whether the underlying medical services were necessarily rendered, and (2) the reasonable value of those services. Proof of payment is simply irrelevant in determining value. This is confirmed by cases like Kretzer vs. Moses Pontiac Sales, Inc., 157 W.Va. 600, 201 S.E.2d 275 (1974), which authorizes recovery even where medical services are provided gratuitously.
WVAJ filed an amicus brief supporting the plaintiff. WVAJ points out that the view advocated by the defendant is the distinct minority view and that no fewer than 15 jurisdictions have expressly rejected it.
This case will have a substantial impact on personal injury practice in West Virginia. Write-offs by hospitals and other healthcare providers are becoming more and more commonplace. It is vitally important for all trial attorneys to know if these write-offs come within the protective scope of the collateral source rule.