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March 6, 2018

Claiming Medical Bills

As part of any injury case, the plaintiff can make a claim for his or her past medical bills. Missouri law recently changed on what evidence gets to a jury with respect to claiming medical bills.

In August of 2017, Missouri changed its statute. Now, RSMo § 490.715 limits what evidence gets to a jury. Only the amount paid by the plaintiff’s insurance carrier plus any amount that he/she owes to the health care provider comes into evidence.

Prior to August of 2017, the Missouri Supreme Court allowed for the admission of both the amount charged and amount paid. Deck v. Teaslely, 322 S.W.3d 536 (Mo. banc 2010). The jury could hear both numbers (assuming the parties overcame evidentiary hurdles) and make a determination on what amount should be awarded.

Why does this matter and who does it impact most? For many who are injured, they are covered by medical insurance. Hospitals and health care providers contract with the medical insurance providers. For example, if your hospital stay and surgery cost $50,000.00 (the amount the hospital “charges”), the contract with the insurance company will “adjust” the amount charged; the insurance company will pay only $30,000.00. Before August of 2017, the jury would hear both that the charged amount was $50,000.00 and the amount paid was $30,000.00. Now, the jury only hears that the amount paid was $30,000.00.

The amendment in the statute penalizes those with good health insurance. In that same scenario, if someone went to the hospital without insurance and had the same stay/surgery, the hospital would have an outstanding balance of $50,000.00. So, in the case of someone without insurance, the jury would only hear that there is a balance of $50,000.00.

The contractual “adjustments” can be even greater than this example. Defense attorneys often use low medical bills to suggest that the injury was not very significant. With that, some cases are better suited to submit only pain and suffering for the jury to consider. In other words, you don’t submit your medical bills. Rather, you describe to the jury the pain and suffering you endured through a hospital stay, surgery, recovery, etc.

A recent Missouri Court of Appeals decision held that the defense cannot argue medical bills if they are deleted from your petition. In Schieffer, plaintiff amended his petition the morning of trial, deleting his claim for recovery of past medical expenses. Schieffer v. Decleene, ED105243, 8 (Mo. App. E.D. November 14, 2017). When Plaintiff objected to the entry of the medical bills following the amendment in the petition, “the trial court had no discretion to admit such evidence. Id. (citing International Div., Inc. v. DeWitt and Associates, Inc., 425 S.W.3d 225, 228 (Mo. App. S.D. 2014). Because past medical expenses were deleted from plaintiff’s second amended petition, evidence of same is irrelevant and prejudicial. Id. at 13. Admitting evidence of past medical bills that are not claimed in the pleadings is an abuse of discretion. Id.

Medical bills and these decisions are important. With all injuries, be it an auto accident, trucking accident, product liability case or even wrongful death, you will have incurred medical bills. Pleban & Associates can advise you on the strategies involved in whether or not you should submit medical bills to a jury. Call, email, or schedule a consultation if we can be of service — 314.645.6666

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