Brethren Mutual Insurance v. Suchoza
66 A.3d 1073
Md. Ct. Spec. App.2013Background
- Appellee Suchoza sued Brethren Mutual Insurance for UM benefits under Matrix’s policy after a May 29, 2007 accident caused by an uninsured motorist.
- Trial in August 2011 yielded a verdict for Suchoza of $535,876.00, including $156,000.00 lost wages, $129,876.00 medical expenses, and $250,000.00 non-economic damages.
- Brethren sought a new trial or to amend the judgment to subtract workers’ compensation (WC) benefits Suchoza had already received.
- As of trial Suchoza had received WC benefits totaling $179,206.97 and was later awarded an additional $56,639.00 (with $9,339.00 actually paid by then).
- The UM policy provides that benefits may be reduced to the extent the insured has recovered WC benefits for the same loss, with the reduction tied to WC benefits actually recovered.
- The circuit court reduced the judgment by $179,206.97 (the WC benefits recovered as of trial) but did not deduct post-trial WC benefits; Brethren appeals challenging admissibility of certain evidence, the post-trial reduction, and future WC offsets.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Admissibility of WC payments as collateral-source evidence | Suchoza breached no rule by excluding WC payments as collateral-source evidence. | Brethren sought to prove fair value of medical services by payments accepted by providers, arguing collateral-source rule does not bar such evidence in contract case. | Evidence of WC payments is not admissible to prove reasonableness of medical expenses absent expert evidence. |
| Whether trial court properly reduced the judgment by WC benefits recovered by trial date | Reduction by WC benefits already received at trial complies with Ins. § 19-513(e). | The court should also deduct WC benefits awarded after trial to avoid double recovery. | Court correctly reduced for WC benefits actually received as of trial; post-trial WC awards not deductible. |
| Whether future WC benefits can offset UM recovery | Gable and TravCo require offset for WC benefits recovered, including future benefits. | Future WC benefits should offset UM recovery to avoid double recovery. | Rule permits deduction only for WC benefits actually recovered, not future benefits; future amounts not deductible. |
| Validity of amended judgment during pending appeal | Amended judgment after post-judgment motion should be reviewable if within appellate reach. | Amended judgment issued during pendency of appeal affects the appeal’s scope and is not reviewable. | Because Brethren did not file a timely appeal from the amended judgment, the post-judgment ruling is not reviewable; the original judgment stands. |
Key Cases Cited
- Kujawa v. Baltimore Transit Co., 224 Md. 195 (Md. 1961) (medical bills require proof of reasonableness to prove damages)
- Shpigel v. White, 357 Md. 117 (Md. 1999) (affidavits of custodians cannot suffice without proof of reasonableness)
- Desua v. Yokim, 137 Md.App. 138 (Md. App. 2001) (billing-manager testimony not competent to explain treatment choices)
- Robinson v. Bates, 112 Ohio St.3d 17 (Ohio 2006) (some jurisdictions treat medical bills as prima facie evidence of reasonableness)
- Stanley v. Walker, 906 N.E.2d 852 (Ind. 2009) (similar rationale to Robinson re: medical bill admissibility)
- Martinez v. Milburn Enterprises, Inc., 290 Kan. 572 (Kan. 2010) (write-offs and write-downs admissible to show reasonable value of medical services)
- Gable v. Colonial Insurance Co. of California, 313 Md. 701 (Md. 1988) (offset for WC benefits recovered only; future benefits not deductible)
- TravCo Insurance Co. v. Williams, 430 Md. 396 (Md. 2013) (clarifies offset interpretation under § 19-513(e) for WC benefits actually received)
- Unnamed Attorney v. Attorney Grievance Commission, 303 Md. 473 (Md. 1985) (jurisdictional principles when appeal is pending)
- Kent Island, LLC v. DiNapoli, 430 Md. 348 (Md. 2013) (pendency of appeal limits propriety of court actions but fundamental jurisdiction remains)
- Carroll Craft Retail, Inc. v. ???, 384 Md. 23 (Md. 2004) (limits on circuit court’s authority with notices of appeal during pendency)
- Cottman v. State, 395 Md. 729 (Md. 2006) (reversal on appeal where post-judgment rulings impact appeal)