Courts Allow Defendants to Introduce Medical Bills Absent a Claim for Medical Expenses from Plaintiffs
by James L. Pattillo, Partner
February 13, 2020
The South Carolina Supreme Court issued a pivotal opinion in 2019 in Nestler v. Fields, 824 S.E.2d 461 (Ct. App. 2019) regarding the introduction of medical expenses by a defendant in trial. At the trial of that case, the plaintiff claimed damages for pain and mental anguish but not medical expenses, despite the fact they existed. The Court stated “[w]e see no reason [the jury] should be kept ignorant of the cost of Nestler’s medical treatment in determining the facts.” Nestler at 464. The Court allowed this testimony over the plaintiff’s objection as to the relevance of those bills.
This serves as a correction and instruction to Alabama courts where the recent tactic is for plaintiffs to present personal injury cases to a jury without evidence of medical expenses. This nebulous approach leaves the jury with no objective measure or anchor to buttress a fair and reasonable verdict. Alabama Pattern Jury Instruction 11.10 acknowledges there is little guidance for jurors to determine appropriate compensation for pain: “There is no legal rule or yardstick that tells you how much money to award for physical pain (and mental anguish)…” 1 Ala. Pattern Jury Instr. Civ. 11.10 (3d ed.). The result of this campaign by plaintiffs has been widely varying and inconsistent verdicts that bear little relation to the actual injury, treatment, and related non-economic damages. The correction and re-centering of what is relevant evidence in personal injury cases by the Nestler Court should serve as a guide to other jurisdictions combating this same tactic.
Courts in other jurisdictions have provided support for the fact that medical bills are helpful to jurors in awarding fair and reasonable verdicts. In Chapman v. Mazda Motor of America, Inc., the Court held that although the plaintiff could not recover amounts disallowed and not paid by Medicaid, evidence of the total past medical bills was admissible to show the severity and extent of plaintiff’s injuries. See 7 F. Supp. 2d 1123, 1124–25 (D. Mont. 1998). Similarly, in Brice v. National Railroad Passenger Corp., although the amount of medical expenses paid through an insurance policy procured by the defendant was not recoverable, the court found that evidence of the bills and expenses for medical care was “relevant to the determination of the full extent and nature of plaintiff’s injuries.” 664 F. Supp. 220, 224 (D. Md. 1987). In McGee v. River Region Medical Center, the Court found that amounts of past medical bills may be relevant and admissible because the amounts “can serve as an aid in [the jurors’] deliberations with respect to the seriousness and extent of the injuries complained of.” 59 So. 3d 575, 581–82 (Miss. 2011). In another decision, Luther v. Lander, the plaintiff appealed the trial court’s exclusion of medical expenses that had been paid by her insurer, claiming that it misled the jury into believing that her injuries were minor. See 373 P.3d 495, 500 (Alaska 2016). The Supreme Court of Alaska determined that the amount of medical expenses should have been admitted because “evidence of the amount of medical bills is relevant to the severity of a plaintiff’s injuries.” Id. at 502. See also Barkley v. Wallace, 595 S.E.2d 271, 273–74 (2004) (finding that past medical bills were relevant “because they tended to establish the probability of [the plaintiff]’s claim that she experienced pain and suffering as a result of the accident,” and therefore, they were admissible “to support non-monetary elements of her compensatory damages claim”).