Massachusetts Personal Injury Cases: What Kind of Medical Bills Should Juries See?

I have a favorite saying (which my wife Debbi would readily tell you,) that “The devil is in the details.” Along those lines, the Massachusetts Supreme Judicial Court is now considering a case that has very serious implications for anyone filing a Massachusetts personal injury suit in the future. The entire focus of the case that the SJC is weighing, (Law v. Griffith; SJC No. 10463) centers on medical bills and how juries assess damages that they may award to plaintiffs.

You see, juries are allowed to take into consideration a number of factors when assessing and awarding damages when they find in favor of a plaintiff. Some of these factors can include:
• Evidence of conscious pain and suffering • Evidence of lost income – past and future • Past medical bills
• Expert testimony regarding future medical bills • Loss of consortium – that is, the sense of society, companionship that a married person enjoys with a spouse • And other factors
Juries in Massachusetts are allowed to consider all these factors, if and when they award damages to a plaintiff in a personal injury action. Of these, however, one of the most important is the amount of (past) medical bills that were generated to provide for hospital and/or medical care for the plaintiff, as the result of the injuries that were caused by a particular defendant’s negligence. The medical costs that are involved to treat a plaintiff’s injuries are heavily relied upon by juries when assessing total damages, and at issue in the case under review by the SJC, is whether medical bills that are issued – as opposed to medical expenses that are actually paid – should be admitted into evidence for a jury to consider. This is not a small, technical matter – it is an extremely important difference, which could affect the value of every single personal injury suit filed in Massachusetts in the future.

A little history as to what brought this case before the SJC: In February 2001, a Ms. Joanne Law (the injured party and plaintiff) was struck by a Mr. Daniel Griffith (the defendant,) in a car accident in Woburn. The evidence indicated that Griffith caused the accident by running a stop sign. In July 2003, Ms. Law commenced a personal injury suit against Griffith in Superior Court, alleging negligence. As a result of the accident, Ms. Law suffered neck, arm and wrist pain and later underwent neck surgery to treat these injuries. Although Law incurred a total of $112,269.94 in medical bills by the time the trial began, MassHealth, the state agency who was her health insurer, paid her health care providers only $16,387.14. Note: It is not at all unusual for a health insurer, private or public, to pay a medical a provider far less than the amount actually billed. You may have seen this yourself, if you’ve ever reviewed or compared statements between what a doctor or hospital billed you for care, and what your health insurer actually paid that provider. Health insurers use their large size and economic muscle to “negotiate” these bills down to a lump-sum payment that is usually cents on the dollar. As a great many hospitals and health care providers operate under great financial stress, health insurers can usually succeed with this tactic. Most hospitals these days are hurting financially.

I’ll detail what happened once the jury in this case saw these medical “expenses”, in my next post. Until then, Happy Christmas!

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