San Diego, Calif. (September 16, 2021) - In Qaadir v. Figueroa (2021) 67 Cal.App.5th 790, the plaintiff sued the defendants for negligence arising from a car accident defendants caused. (Id. at p. 794.) The plaintiff sought treatment for his injuries from lien providers who did not accept his insurance plan. The plaintiff's medical bills remained unpaid at the time of the trial. (Ibid.) Prior to trial, the defendants admitted liability for the accident and the case proceeded to trial solely on damages. (Id. at p. 796.) The defendants moved in limine to exclude evidence of the plaintiff's unpaid medical bills. The trial court denied the defendants' motion. During trial, both parties had billing experts testify about the reasonableness of the medical bills. Neither of the billing experts relied upon plaintiff's unpaid medical bills to determine the reasonableness of the plaintiff's medical expenses. The jury eventually rendered a verdict against the defendants. The defendants timely appealed from the judgment. (Ibid.)
On appeal, the defendants argued that the trial court erred by
admitting the plaintiff's unpaid medical bills.
(Qaadir, supra, 67 Cal.App.5th at p. 794.) The
appellate court began its analysis by reiterating that "an
award of past medical expenses is limited to the lesser of (1) the
amount paid or incurred and (2) the reasonable value of the
services rendered." (Id. at p. 797,
quoting Howell v. Hamilton Meats &
Provisions, Inc. (2011) 52 Cal.4th 541, 556.) The
court further held that unpaid medical bills for uninsured
plaintiffs, including those plaintiffs who opt to seek treatment
outside of their insurance plans, are relevant to proving the
amount of medical bills paid or incurred. (Qaadir, at p.
804.) The unpaid medical bills were only admissible if the
uninsured plaintiff is financially liable for them.
(Id. at pp. 804–805.) The appellate court then
held that the trial court erred when it admitted the unpaid medical
bills into evidence because it did not require the plaintiff to
demonstrate he was financially liable for the unpaid bills.
(Id. at pp. 805–806.) However, the court
determined the trial court's error to be harmless because the
jury did not rely on the unpaid medical bills to support its
verdict. (Id. at p. 806.) The jury relied on the
experts' testimony to reach the damages amount it awarded to
the plaintiff. (Ibid.) The experts did not rely on the
unpaid medical bills to reach their conclusions regarding the
reasonableness of the plaintiff's medical bills. Therefore, the
appellate court affirmed the judgment against the defendants.
(Id. at pp. 805–806, 818.)
The appellate court's opinion in Qaadir is likely to be very limited in scope. Unpaid medical bills could only be admitted into evidence if either an uninsured plaintiff or a plaintiff seeking treatment outside of his insurance plan actually incurs them. (Qaadir, supra, 67 Cal.App.5th at p. 804.) A plaintiff must prove that he is financially liable for the unpaid bills before they are admitted into evidence. The opinion follows the precedent set in both Howell, supra, 52 Cal.4th 541, 556 and Hanif v. Housing Authority (1988) 200 Cal.App.3d 635, 640. The plaintiff's medical bills needed to be the lesser of the reasonable value of the medical services provided to the plaintiff and the amount actually paid or incurred by the plaintiff. (Qaadir, at p. 797.) The Qaadir court determined that the unpaid medical bills should not have been admitted because the plaintiff could not demonstrate that he had incurred the bills. (Id. at pp. 805–806.) However, the court affirmed the judgment because the damages awarded to the plaintiff were reasonable and unrelated to the unpaid medical bills. (Id. at p. 806.)
The opinion only applies to plaintiffs who are either uninsured or who sought treatment outside of their insurance plans. In addition, a plaintiff must prove that he or she actually incurred the unpaid medical bills before the trial court can admit the unpaid bills into evidence, which the Qaadir plaintiff did not manage. Thus, while the appellate court recognized another scenario where unpaid medical bills could be admitted into evidence, it did so in light of the limited nature of the case.
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