Florida’s collateral source rule prohibits defendants in personal injury cases from benefiting when plaintiffs receive payments for things like medical bills or lost wages through collateral sources, such as health insurance or disability insurance. The idea is that a wrongdoer shouldn’t have to pay less just because the plaintiff is insured. knees

There is an exception for governmental benefits, like Medicare or Medicaid. The collateral source rule is somewhat similar to the principle that plaintiff’s can’t introduce evidence that defendant has liability insurance that will cover the judgment. The idea is juries may be more likely to find a defendant liable – or to increase the amount of that liability – if they know an insurer is paying the cost, as opposed to an individual.

Still, the Florida legislature has modified the rule somewhat to hold that injured plaintiffs can’t obtain double recovery. So for example, if a plaintiff wins $100,000 in damages, but health insurance already paid $25,000 in medical bills, plaintiff doesn’t get to keep that extra $25,000. Rather, it goes to the insurance company. However, plaintiff could be reimbursed for the cost of insurance premiums.

Every state has varying laws when it comes to the collateral source rule. In the recent case of Uspenskaya v. Meline, the California Court of Appeal for the Third Appellate District denied a defense motion to reduce damages for medical expenses to the amount actually paid by a third-party assignee. The appeals court, like the trial court before it, rejected this assertion.

It’s a situation that’s not unfamiliar to experienced car accident lawyers in Fort Myers, so we detail it here. According to court records, defendant’s vehicle struck plaintiff’s at a busy intersection, causing severe injuries to plaintiff. Those injuries included spinal damage, and plaintiff ultimately had to undergo surgery for repair of a herniated lumbar disc.

Plaintiff sued the at-fault driver and the case went to trial. Jury found defendant negligent and awarded plaintiff nearly $430,000 in damages. That figure included more than $260,000 in past medical expenses. This was the amount reflected in the medical bills she provided as evidence to the court.

From the start, defendant had objected to admission of these expenses because it didn’t reflect the amount plaintiff had actually paid for the services, nor did it reflect the amount paid by a third-party assignee who purchased the hospital’s lien against plaintiff. You see, plaintiff didn’t have health insurance, but she needed treatment and the trial was still pending. So, she reached an agreement with her health care providers: They would treat her in exchange for a lien on whatever she might recover from defendant in her pending lawsuit. Later, a third-party assignee purchased that lien for far less than the original amount billed. However, plaintiff remained directly and fully liable for the full amount of that lien, regardless of the outcome of the lawsuit.

Because plaintiff remained personally liable for the total amount billed, the court rejected the assertion that defense should be able to admit into evidence the amount paid for the lien by the third-party assignee. Jurors awarded plaintiff the total amount of her medical bills, and defendant appealed.

The state appeals court affirmed. Justices ruled defense had offered no evidence to show the reduced payment represented the true reasonable value of plaintiff’s care, and further, the probative value of that evidence substantially outweighed the chances it would create undue prejudice against the plaintiff. Plus, it was misleading, and plaintiff had no part in the agreement between the third-party and the health care providers. She was still responsible for the total amount. But now, it will be up to defendant to pay it.

If you have been a victim of a traffic accident, call Chalik & Chalik at (954) 476-1000 or 1 (800) 873-9040.

Additional Resources:

Uspenskaya v. Meline, Oct. 28, 2015, California Court of Appeal for the Third Appellate District

More Blog Entries:

Chand v. Bolanos – Third-Party Accident Claims, Subrogation and Liens, Oct. 27, 2015, Fort Myers Car Accident Lawyer Blog