For many years now Ohio has recognized the collateral-source rule. This rule prevents a jury from learning about benefits paid to, or on behalf of, a plaintiff from sources other than the person who caused the injury. For example, it is impermissible for a defendant to inform a jury that a plaintiff’s medical bills have been paid by an insurer.
Since the collateral-source rule was first recognized in Ohio, courts have traditionally interpreted the rule to prohibit defendants from submitting medical bill discounts and write-offs agreed to by health-care providers and insurers. Instead, juries have been left to determine the “reasonable value” of a plaintiff’s treatment by looking at the original bills, regardless of what was paid. Defendants have argued that when the amount actually paid is less than what is billed, plaintiffs receive a windfall.
In Robinson, the plaintiff suffered a foot injury in a slip and fall. When the plaintiff attempted to establish the reasonable value of her medical treatment by presenting the original bills, the trial court ignored the traditional application of the collateral-source rule, and held that only evidence of amounts actually paid were admissible.
On appeal, the Supreme Court found that the trial court’s ruling was in error. The Court held that the plaintiff should have been permitted to introduce the original medical bills as evidence of the reasonable value of her treatment. Importantly, however, the Court also held that the defendant was likewise entitled to submit evidence of the amounts actually paid, as such evidence is not barred by the collateral-source rule.
Under this approach, juries may conclude that the original bills constitute the reasonable value of the medical care, or they may now determine that the reasonable value is the amount actually paid to the medical provider, or some amount in between. For example, if a plaintiff’s original bill of $10,000 is discounted to $2,000, a defendant can now submit evidence that the bill was satisfied with the payment of $2,000. Further, the jury can decide whether $10,000, $2,000 or some amount in between should be recovered for medical expenses. The jury may also consider both amounts when evaluating the seriousness of the plaintiff’s injuries and determining damages for pain and suffering.
Notably, the Court’s decision does not abolish or limit the collateral-source rule, which is still alive and well in Ohio. Rather, the Court simply found that the rule is inapplicable in the context of medical bill discounts and write-offs. Thus, while defendants may now submit evidence of the amounts actually paid, they are still not permitted to introduce evidence of who paid the reduced amount.
On a practical note, in light of the Court’s ruling in Robinson, it is important for claims representatives and lawyers alike, when evaluating a claim, to not only obtain and consider the claimant’s medical bills, but also all documentation concerning amounts discounted or written-off.
If you wish more information about this decision, or you have any other related questions, please contact any of our General Casualty Insurance Practice Group.
