On August 11, 2021, the California Court of Appeals for the Second District delivered a blow to defendants in its Malak Melvin Abdul Qaadir v. Ubaldo Gurrola Figueroa et al., No. B306011 (Cal. 2nd Aug. 8, 2021) a published decision which undermines the protections to defendants provided by the California Supreme Court Case Howell v. Hamilton Meats & Provisions, Inc., 52 Cal. 4th 541, 257 P.3d 1130 (2011).
Pursuant to the decision in Howell, plaintiffs were only entitled to recover as past medical damages the lesser of (1) the amount paid or incurred or (2) the reasonable value of the services rendered. This decision prevented plaintiffs from recovering exaggerated and/or full billed amounts for past medical treatment when health insurance made reduced payments on plaintiff’s behalf.
As a result of the Howell decision, plaintiffs’ attorneys regularly direct the treatment of their clients through referrals to doctors who bill on liens rather than through available health insurance. Given the fact that no payments are made toward the medical liens by the time of trial, plaintiffs are permitted to argue that they are entitled to introduce the full lien amounts of the reasonable value of past medical treatment as evidence, which supports plaintiffs’ contentions regarding entitlement to recovery of inflated past medical liens.
The facts of the Qaadir case are as follows: In that case, a 15 mile-per-hour rear end motor vehicle accident resulted in alleged injuries to plaintiff. Despite the availability of health insurance through Kaiser, plaintiff elected to go outside of his health insurance network for years of treatment, therapy, injections, spinal cord stimulation, and ultimately a spinal surgery, based on attorney referrals.
Unfortunately in Qaadir, the California Court of Appeals held that unpaid medical bills, including medical treatment provided on a lien basis, are admissible to prove the reasonable value of a plaintiff’s past medical damages at the time of trial. Bear in mind this does not mean the bills are conclusive; the defense can still introduce evidence to refute the claimed reasonable value.
The Qaadir decision supports a plaintiff’s ability to incur exorbitant medical bills via attorney-directed and lien-driven medical treatment, and then attempt to recover same via the admissibility of unpaid medical bills as evidence of the reasonable value of plaintiff’s past medical treatment.
As somewhat of a silver lining, Qaadir also held that the fact that plaintiff’s counsel made the referral to the medical doctors who render treatment on liens is admissible and relevant to show “bias or financial incentives on the part of the lien-physicians” as well the reasonable value of plaintiff’s medical treatment.
Bremer Whyte Brown & O’Meara, LLP attorneys specialize in the zealous defense of our clients and consistent pursuit of reduction of plaintiffs’ medical damages. We are always available as a resource for strategizing on how to efficiently achieve the best outcome for our clients.
