ORANGE, CA -- Yesterday, the Second Appellate District, Division 3 (which covers Los Angeles County,) in the case of Corenbaum v. Lampkin (2013 Cal. App. LEXIS 342) issued a ruling which further limits evidence of an injured party's medical expenses to the amount which was actually paid.  The Corenbaum decision refined the holding of Howell v. Hamilton Meats (2011) 52 Cal.4th 541, and held essentially that the full amount of the medical specials billed is inadmissible for any purpose.

    In Howell, the California Supreme Court held a plaintiff claiming medical expense damages "whose medical expenses are paid through private insurance may recover as economic damages no more than the amounts paid by the plaintiff or his or her insurer for the medical services received or still owing at the time of trial."  The Howell opinion left open the question of whether evidence of billed, but unpaid, medical expenses could be admissible for other purposes including (1) future economic damages and (2) non-economic damages (e.g., general damages and pain and suffering.)  In Corenbaum, the Court of Appeal directly addressed this question and answered "no."

    With respect to future economic damages, the Corenbaum court noted that the full amount billed is not an accurate measure of the value of medical services.  This is because there can be significant disparities between the amounts charged by medical providers, the costs of providing services, and the fact that the price of a particular service can vary tremendously from hospital to hospital in California.  Moreover, a medical provider's billed price for a particular service is not necessarily representative of either the cost of providing those services or their market value.  For these reasons, Corenbaum found that the full amount billed for past medical services is not relevant to a determination of the reasonable value of future medical services.  Corenbaum also recognized that if a jury were to consider both evidence of the amount accepted as full payment for the purpose of determining the amount of past economic damages and the full amount billed for some other purpose, this would most certainly cause confusion and suggest the existence of a collateral source payment.  The Corenbaum court even went as far as to hold that evidence of the full amount billed for past medical services cannot support an expert's opinion on the reasonable value of future medical services.

    On the issue of general damages, Corenbaum recognized that there is no fixed standard to determine the amount of noneconomic damages.  Instead, the amount of damages for pain and suffering is a determination committed to the sound discretion of the jury.  No method is available to the jury by which it can objectively evaluate such damages and no witness may express his subjective opinion on this issue.  While plaintiffs' lawyers have often used the amount of economic damages as a point of reference in their arguments to a jury, Corenbaum held that evidence of the full amount billed is not admissible for the purpose of providing counsel an argumentative construct to assist a jury in its difficult task of determining the amount of noneconomic damages and is inadmissible for the purpose of proving noneconomic damages.

    We believe that Corenbaum will clarify and standardize the process by which trial courts handle the issue of what is admissible as to medical special damages.  Up to now, most trial judges have been allowing the full amount billed into evidence with a post-verdict adjustment by the court, if necessary.  Now, the only admissible evidence should be the amount of the medical specials actually paid.  It is our opinion that the Corenbaum decision should now place the burden on the plaintiff to prove the amount of the medical specials actually paid as a part of the plaintiff's case in chief rather than on the defense to prove the amount to claim an offset.  It should also eliminate the need for any post-trial adjustments to the jury's verdict.

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