Tennessee Supreme Court Holds that Full, Non-Discounted Medical Expenses May Be Admitted at Car Accident Trial, But Discounted Amount Due to Insurance May Not

People who have been injured in a Knoxville car accident caused by the negligence or reckless conduct of another person, business, or governmental entity may be able to recover damages such as medical expenses, lost earnings, and compensation for pain and suffering. However, calculating the exact amount to which the injured person (or a deceased person’s family) is entitled is a complex endeavor.

A recent case highlights one of the issues that frequently arises in such cases: how are the reasonable and necessary medical expenses suffered by an injured person to be determined?

Facts of the Case

The plaintiff was a woman who was seriously injured in an automobile accident in 2010. She and her husband filed a lawsuit in the Circuit Court for Crockett County against the driver whose negligence allegedly caused the crash. The defendant later passed away, and the personal representatives of his estate were substituted as defendants. While the case was pending, the plaintiffs deposed one of the physicians who had treated the (female) plaintiff; this doctor testified that all of the plaintiff’s medical expenses (both her own and those from several other medical providers) were reasonable and necessary to a reasonable degree of medical certainty; these medical expenses totaled $52,482.87.

Thereafter, the state’s highest court issued a ruling in another case to the effect that, under the Tennessee Hospital Lien Act, a hospital’s “reasonable charges” under Tennessee Code Annotated § 29-22-101(a) were the amount the hospital accepted from the patient’s private insurer, rather than the amount set forth in the medical bills sent to the patient. Based on this case, the defendant in the current case filed a motion in limine to exclude evidence of unreasonable medical charges, which they argued were any medical bills in excess of the $18,255.42 paid by the plaintiffs’ health insurer. The trial court granted the defendants’ motion. The court of appeals granted an interlocutory appeal and reversed the trial court’s decision, holding that the full, non-discounted medical bills were admissible to prove the female plaintiff’s reasonable medical expenses resulting from the accident but that evidence of the discounted amounts accepted by her medical providers was admissible to rebut the plaintiffs’ proof that the non-discounted medical bills were reasonable, as long as “insurance” was not mentioned.

Decision of the Supreme Court of Tennessee

The state supreme court affirmed in part, reversed in part, and remanded the case to the trial court for further proceedings. According to the court, the definition of “reasonable charges” under the Hospital Lien Act set forth in the case and used by the defendants did not apply directly to the determination of “reasonable medical expenses” in a personal injury case. Declining to alter existing Tennessee law regarding the “collateral source rule,” the court went on to hold that the plaintiffs could submit evidence of the full, non-discounted medical bills as proof of her “reasonable medical expenses” and that the defendants were precluded from submitting evidence of any discounted rates for medical services accepted by medical providers as a result of the plaintiff’s insurance. The court noted that the defendants were free to submit any other competent evidence to rebut the plaintiffs’ proof on the reasonableness of the medical expenses, as long as the defendants’ proof did not contravene the collateral source rule.

Have Questions About an East Tennessee Accident Involving Injuries?

Knoxville car accident attorney Mark Hartsoe at the Hartsoe Law Firm, P.C., is here to serve your family if you or someone you love has been involved in a motor vehicle accident. As this case illustrates, getting all of the monetary compensation to which you are entitled due to another party’s negligence can be an uphill battle. We work hard to make sure our clients pursue every penny they may be owed for medical costs, lost wages, pain and suffering, and other losses resulting from an accident. For a free consultation in our Knoxville or Maryville offices, call us today at (865) 804-1011.

Related Blog Posts: Prior Case Law Interpreting “Reasonableness” of Medical Expenses Under Tennessee Hospital Lien Act Did Not Apply in Car Accident Personal Injury Case Memphis Appeals Court Affirms Damages Award in Favor of Shelby County Car Accident Victim