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Appellate report
Who needs to know about this case: All trial lawyers who try cases involving damages for medical expenses covered by health insurance. Get business lawyer free consultation and get advice about business law.
Why it’s important: First case to acknowledge that the collateral-source rule should apply to prevent the defense from reducing the amount of its liability for medical expenses based on plaintiff’s health-insurance coverage.Â
Synopsis: Plaintiff Howell suffered severe injuries in an auto accident caused by an employee of defendant Hamilton Meats, who was acting in the course of scope of his employment. She required two spinal-fusion surgeries, as well as additional surgeries to attempt to repair her neck and hip. The jury returned a special verdict that awarded to Howell compensatory damages in the total amount of $689,978.63, which included $189,978.63 for past economic loss, including medical expenses; $150,000 for future economic loss, including medical expenses; $200,000 for past non economic loss (including physical pain, men-tal suffering, loss of enjoyment of life, disfigurement, physical impairment, inconvenience, grief, anxiety, humiliation, and emotional distress; and $150,000 for future non economic loss.
Hamilton moved post trial, under Hanif, and Nishihama v. City and County of San Francisco seeking an order reducing the jury’s special verdict for Howell’s past medical expenses by $130,286.90 (i.e., from $189,978.63 to $59,691.73), based on the amount that Howell’s medical insurers actually paid for the care she received, in light of their contracts with the health-care providers. The trial court granted the motion over Howell’s objections, grounded principally on the collateral-source rule under Helfend.
The appellate court reversed, finding that the post-trial reduction of Howell’s damages violated the collateral source rule. The court noted that Howell executed written contracts with the providers that made her financially liable for all charges incurred and explained that this liability was a compensable detriment or pecuniary loss under the Civil Code. The extinguishment of this liability by the providers under their con-tracts with Howell’s insurers was a benefit to her, that was wholly collateral to and independent of the tortfeasor; hence, it was subject to the collateral-source rule. The court distinguished Hanif, as a Medi-Cal case where the plaintiff never incurred any personal liability. The court did not distinguish Nishihama; rather, it simply disagreed with its reasoning. The court held that any changes in the collateral-source rule should come from the Legislature.
The court also held that because the collateral-source rule precludes the reduction of medical expenses awarded to a plaintiff based on the amounts paid by the plaintiff’s health insurers for that care, the post-trial reduction of jury awards is not authorized.
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Working with legal nurse-consultants
It goes without saying that legal nurse-consultants, in all their efforts, cut through both medical and legal jargon. They present their findings in clear, organized tables and compelling narratives that can provide counsel for the case foundation for a winning story-line. They’re unfazed by reams of documents, and, taking advantage of the latest technologies, they can index and organize materials so an attorney instantly can find whatever’s needed, even in the heat of a courtroom argument. The ‌‌corporate‌ ‌lawyer helps you in legal matters of your corporation.
As with all providers of professional services, counsel caveat emptor: Look at the qualifications of the individuals who will do the actual work contracted for; consider the company’s capacity and record in delivering what's needed, espe-cially with the flexibility demanded in difficult, fast-moving and challenging litigation, whether the matters seem large or small. If the point of unbundling this duty is to find someone else to assume is the handling of medical records, including billing audits and life-care plans, the central concern of this business? Or is it just one more sidelight? And what kind of customer service will you get and who will you deal with to get it?
Finally, of course, the price for all this expert effort must come into play. It ought to be considerably less than what might be racked up via in-house time and labor expenditures, or, certainly, what might be billed by a consulting physician or combination of medical experts. A quality company that specializes in medical records’ review will be open to pricing discussions for its services from beginning to end. Legal nurse consultants, billing and auditing experts and life-care planners expect to work closely with clients to provide candor, transparency and controls on costs of their services. 7’his adds to the growing enthusiasm for the medical records’ companies they’re associated with and their place in legal services, unlike, say, the reception for Bartleby, the Melville character, who, when confronted by new work, always “would prefer not to.” Of course, this isn’t the 19th century' scriveners are gone -• and sophisticated members of the legal community are tackling 21st century ways, with help from legal nurse-consultants and other medical professionals, to do vital work that adds up for the bottom line and contributes to maximizing damages for deserving clients.
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Civil courtrooms in touch the brunt of budget cuts
Matters set over for future dates accumulate over time. The backlog created by a closure in one month isn't fully cleared before subsequent closure occurs. Worse, inefficiencies created by closure-related continuances aren't linear. they're exponential. Managing a clogged system adds significant work related to unproductive “case-shuffling.” The potential for courtroom and courthouse closures greatly com-pounds the matter . the times of five- years-to-trial in civil cases that existed once I began practicing law in 1975 aren't as distant as we'd think. Before startup your business in California hire or contact business attorney orange county.
RM: Can the court avoid this by using reserves?
CM: Reserves aren't sufficient to avoid the gathering storm, but we've been ready to postpone its landfall with money stored-up over the last several years. Within the years following California’s 2002-03 recession, our court stored-up reserves that we are now spending down, as prudent as possible, to take care of court operations. This, additionally to the one- day-a-month closures, employee attrition, aggressive internal cost-cutting, and other economies, has thus far enabled us to stay our heads above water. But, time is running out on postponement strategies. The shortfalls ahead are so large we sim-ply cannot cut our answer of the crisis.
RM: When does it appear we'll have to begin permanent courtroom and courthouse closures in Los Angeles?
CM: Perhaps as soon as April of 2010.
RM: does one see any thanks to avoid doing that?
CM: Yes, I do, but the answer requires thinking as big because of the crisis we face. The Legislature passed SB 1407 in 2008 - a $5 billion courthouse construction bond bill. To support the bonds, which haven't yet been sold, the Legislature created a replacement income stream within the sort of added fees and fines. In l. a. alone, that new revenue stream is producing about $53 million per annum . SB 1407, which was a majority vote bill, are often amended to redirect this revenue stream for a brief period of your time to save lots of court operations instead of building new courthouses. Ilie Legislature recently redirected alittle portion of this money as a part of the present financial year budget solution. I'm convinced we must be willing to redirect, for a period of your time , the maximum amount of the SB 1407 revenue stream as is important to save lots of court operations - not just in l. a. , but to save lots of courtroom operations statewide.
RM: What impact would redirecting SB 1407 funds wear saving court operations in Los Angeles?
CM: $53 million per annum in l. a. is that the funding equivalent of nearly 1000 jobs. On the average , efficient court systems need about 10 employees to perform the work required to support each courtroom. Thus, about 100 courtrooms are often saved by redirecting SB 1407 funds to support courtroom operations during the continued budget crisis. Court operations must, I believe, take priority over new brick and mortar projects. When SB 1407 bonds are eventually sold, and therefore the budget crisis has abated, the SB 1407 income stream are often redirected to support the bonds and therefore the building program can shift back to full operation. In challenging times as these, people and their legal problems must tend priority over resource-intensive capital projects which will prudently be delayed or postponed.
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