Daily Blast October 21, 2016

Today, the Court of Appeal, Third Appellate District (Sacramento) published its opinion in Moore v. Mercer (Oct. 21, 2016, C073064) __ Cal.App.5th __, analyzing whether Howell v. Hamilton Meats & Provisions, Inc. (2011) 52 Cal.4th 541 (“Howell”) limits a plaintiff’s recovery of past medical expenses when a medical finance company purchases a plaintiff’s accounts receivable and medical liens from the healthcare provider at a discounted rate. The court concluded that a plaintiff’s recovery in this situation is not limited to the amount paid by a medical finance company without further evidence that the plaintiff is no longer responsible for 100 percent of the billed amount. (Slip opn., p. 2.) 

In Howell, the plaintiff’s recovery was limited to the lower rate her insurer paid for medical expenses. (Slip opn., p. 18.) In this case, the court distinguished Howell, noting the distinction between pre-negotiated payments by an insurer and third-party purchase of a medical lien. (Ibid.) In the first instance, “the plaintiff’s health insurer has obtained a discount for its payments on the plaintiff’s behalf,” thus the plaintiff is not liable for any amount above the insurer’s pre-negotiated rate. (Ibid.) However, when a third-party purchases an uninsured plaintiff’s medical lien, the plaintiff may still be liable to the medical finance company for the full billed amount. (Ibid.) If the plaintiff remains liable to the finance company for the full billed amount, reducing the plaintiff’s recovery to the amount paid by the medical finance company would result in a windfall for the tortfeasor and undercompensation for the plaintiff. (Id. at p. 17.) For this reason, the court held that the amount a medical finance company pays for an uninsured plaintiff’s medical lien might be probative, but not determinative of the damages a plaintiff can recover for past medical expenses. (Id. at p. 20.)

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