Consider a personal injury case in which an injured claimant requires medical treatment for which she is billed $189,978.63. Because the claimant has private medical insurance, the hospital accepts $39,691.73 in satisfaction of the bill. When
the individual sues for reimbursement of the medical bills, how much can she recover for the cost of her injuries? Is it the $189,978.63 she was billed? Or is it the $39,691.73 the hospital accepted as full payment for the treatment? A healthcare provider often accepts a lesser amount in satisfaction of the bill pursuant to a contractual agreement between the healthcare and insurance providers, Medicare, or Medicaid. The amount beyond what is accepted in full satisfaction of the bill is considered a “write-off.” In determining the amount of damages to be presented as evidence in trial to a jury, judges are often left to decide whether to admit as evidence the higher, billed amount, or the lesser amount actually paid as the cost of services rendered. This was the precise issue addressed in a 2011 case from the California Supreme Court, Howell v. Hamilton Meats & Provisions, Inc. After a very thorough examination of the issue, the court ultimately found the injured individual could only be compensated up to the amount of services for which she had actually paid…MORE.