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Appellate Court Gives Personal Injury Plaintiffs A Choice Regarding Admission Of Low Medical Expenses In A Post-Tort Reform Era

The State Appellate Court for the Eastern District of Missouri recently issued an opinion in Schieffer v. DeCleene, No. ED 105243 (Mo. E. Dist. November 14, 2017) which allows personal injury plaintiffs to keep the amount of their medical expenses from the jury by omitting any request for recovery of medical expenses from their petitions. This issue arises when the amount paid for the plaintiff's medical treatment is relatively small when compared to their alleged injury and treatment due to the medical provider's contractual rates with the plaintiff's health insurer or the involvement of Medicare or Medicaid.

Prior to 2005 defendants in Missouri courts were prohibited by the "Collateral Source Rule" from telling the jury that some third-party, other than the defendant's insurer, had paid some or all of the plaintiff's medical bills. This rule was intended to prevent tortfeasors from benefiting from a plaintiff's health insurance coverage or other third-party sources. See Lampe v. Taylor, 338 S.W.3d 350, 359-361 (Mo S. Dist. 2011). However, the rule led to situations where the jury was told that the Plaintiff had incurred and was seeking recoupment of large medical bills as a result of the defendants' actions even though the medical provider had accepted as complete payment a much smaller amount. In 2005 Missouri, as part of a larger tort reform effort, amended its Collateral Source Rule statute to try to eliminate these situations.

The 2005 amendments to the Missouri Collateral Source Rule statute established a presumption that the amount the medical provider accepted as full payment for their services was the true value of those medical services. However, this 2005 provision still allowed the plaintiff to rebut this presumption by presenting evidence that the amount the medical provider accepted was less than the true value of the medical services provided. Deck v. Teasly, 322 S.W. 3d 536 (Mo 2010). Then, in 2017, Missouri passed a new amendment to the Collateral Source Rule statute which eliminates the ability of a personal injury plaintiff to get into evidence any medical bill amounts which are greater than the amount the provider accepted as full payment of that bill. See current version of RSMo ยง 490.715.

The Plaintiff's attorney in the Schieffer case tried to eliminate the whole issue of the low cost of his client's medical treatment by amending his petition prior to trial to eliminate any request that the plaintiff be reimbursed for those medical expenses. Thus, the plaintiff's attorney sought to limit the evidence presented to the jury to the facts of the alleged injury, the medical treatment and the related past and future pain and suffering in the hope that the jury would award more to the plaintiff based on that evidence alone (he asked for $300,000 in his closing argument) than if they were told that the medical treatment had cost only around $14,000. However, the trial court, over plaintiff's objection, still allowed the defendant's attorney to tell the jury the amount actually paid for plaintiff's medical treatment and the jury's verdict for plaintiff was only $25,000.

On appeal the Schieffer plaintiff argued the amount paid for the medical treatment was immaterial since he had not sought recovery of medical expenses in his amended petition. The appellate court agreed and reversed the trial court's ruling on the issue necessitating a retrial. Thus, pursuant to Schieffer, plaintiffs in personal injury cases where the alleged injuries are significant but the medical expenses are relatively small now appear to have the choice of keeping the whole issue of low medical expenses away from the jury in the hope that the jury will award a larger amount based solely on the evidence of the injuries and the related pain and suffering. It will be interesting to see how Plaintiffs' attorneys react to this choice.

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