Personal Injury Medical Expenses
Issue: What medical expenses may be offered at trial where a hospital accepts payment less than the originally-billed amount?
Facts: Personal injury Plaintiffs submitted expert testimony of the billed medical expenses to establish the reasonableness of their claimed medical expenses. Defendants argued that the Tennessee Supreme Court’s decision in West v. Shelby County established a new standard in Tennessee for determining the reasonable amount of medical expenses as a matter of law, which allows proof of the amount actually accepted by the provider. The trial court granted the defendants’ motion in limine, thus excluding the testimony of the billed amount.
Appellate Decision: The intermediate court reversed, holding that West, which involved hospital liens, did not govern personal injury cases. Thus, only the supreme court could extend the holding of West to other kinds of cases through a new decision. Judge Riley, concurring, wrote that the rule in West should be extended to other cases, but agreed that only the supreme court could do so.
Review Granted: October 21, 2016.
Prediction: Ben thinks that the supreme court is likely to extend West to personal injury cases for the same policy reasons. A compromise of the competing positions could allow a Plaintiff to offer the full billed amount and a Defendant to offer the amount actually paid, but not whether an insurer paid such amount to avoid running afoul of the collateral source rule.