Tennessee Supreme Court Clarifies Reasonable Medical Charges in Personal Injury Cases

For many accident victims, the largest category of damages that arise are medical bills. For those who are injured in an accident but are uninsured, these bills can be catastrophic. Since the true costs of health care coverage can easily total in the tens or hundreds of thousands, many hospitals and medical providers will ultimately discount their bills in order to ensure coverage, or to allow patients to make some sort of payment plan that will allow for payment. At trial in a Tennessee personal injury case, the question then becomes which proof of medical expenses plaintiffs can offer:  the original medical bills or discounted versions?

The Tennessee Supreme Court recently considered this question in a case of first impression. In this case, J.D. was seriously injured in an automobile accident and sued the other driver for negligence. As part of her claim, J.D. sought to recover past and future medical expenses, and she provided itemized medical bills from 16 different medical providers. J.D. also had her doctors testify to the reasonableness of the medical bills she incurred.

Prior to trial, the defendants filed a motion to limit the evidence of medical bills that J.D. could provide. They argued that, under recent Tennessee caselaw, J.D. was only allowed to provide evidence of what she and her insurers actually paid in medical expenses, rather than the actual medical amounts billed. According to the defendants, the amounts billed were “unreasonable” evidence of medical expenses when they were not actually what was paid. The trial court held a hearing on this issue and concluded that the defendants were correct. It limited J.D. to presenting evidence of the discounted amounts her insurer paid. J.D. sought an interlocutory appeal, and the Court of Appeals reversed the lower court’s decision, finding that while discounted amounts needed to be used when dealing with hospital liens, they did not apply to personal injury cases. The defendants then appealed this decision.

On appeal, the defendants argued that the Supreme Court’s prior decisions on which medical bills should be considered in hospital lien cases should apply equally to personal injury cases. In the Supreme Court’s recent decision in West v. Shelby County Healthcare, it held that when hospitals are suing over hospital liens, it is unreasonable for them to seek full recovery of all medical bills, since they typically accept discounts from insurers and patients anyway. Accordingly, it concluded that only discounted medical bills were “reasonable evidence” of medical damages.

The Supreme Court acknowledged that this was the standard set forth in West, but it concluded that this standard should not apply in personal injury cases. While the focus on discounted medical bills in West helped ensure that hospitals were not able to manipulate litigation to recover larger amounts of money, the Supreme Court concluded different public policies were at play in J.D.’s case. Specifically, in personal injury cases, it is for the jury to decide what a plaintiff’s overall damages from an injury or accident are, and in doing so, the jury may consider different forms of evidence, such as medical bills. But the jury need not award exactly what is included in the bills – it must only decide what is reasonable to award. Accordingly, the Supreme Court concluded that personal injury victims should not be limited to discounted medical bills. Thus, the Supreme Court concluded that J.D. was entitled to present evidence of  the actual medical bills she received from the hospital in presenting her damages claim, rather than the discounted amounts.

This case is a significant win for accident victims who have sustained significant medical expenses as a result of their injuries and are likely to continue to need ongoing medical care. They will continue to have the opportunity to present a wide variety of evidence of damages in order to make the strongest case possible. Tennessee personal injury attorney Eric Beasley can work with you to develop a comprehensive strategy for proving damages and work with your medical providers to make sure you have the evidence necessary to support your claim. For more information on seeking compensation for your medical damages, contact the Law Office of Eric Beasley today at 615-859-2223.

Related Blog Posts:

Tennessee Court Denies Claim When Medical Records Suggest No Injury, Tennessee Personal Injury Blog, October 6, 2017.

Tennessee Court Denies Prisoner’s Negligence Claim After Attack, Tennessee Personal Injury Blog, August 8, 2017

Tennessee Court Upholds Conclusion That Officer Was Not Responsible For Accident, Tennessee Personal Injury Blog, July 7, 2017.



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