Frisk v. Cowan CA3, C077975

Frisk was injured in a head-on collision caused by Cowan (who suffered hypoglycemia); Frisk underwent surgery financed via a lien sold to a private lienholder.
Jury awarded Frisk ~$3.7 million including $109,162.59 (past medical) and $1,084,457 (future medical); Cowan appealed evidentiary rulings on medical damages.
Pretrial and 402 hearing: Cowan sought to admit evidence of typical insurance/government payments; trial court excluded average payment data but allowed testimony about amounts billed.
Frisk’s expert (Lievense) testified billed amounts fell within usual/customary ranges but did not tie billed amounts to market/exchange value; Cowan’s expert (Sells) would have testified about average reimbursements but was barred from referencing insurer/government payment averages.
Trial evidence included lienholder testimony and Frisk’s acknowledgment she agreed to be liable for the full billed amounts; court found sufficient proof she incurred liability for full billed amounts.
Court of Appeal: trial court erred in admitting billed amounts as evidence of reasonable value without expert linkage and erred in excluding evidence of amounts typically paid; remanded for retrial limited to past and future medical damages only.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Admissibility of billed medical charges to prove reasonable value	Billed amounts are the amount incurred and therefore admissible to prove medical damages	Billed amounts do not reflect actual market value; admission of billed amounts is improper without evidence tying them to reasonable value	Error to admit billed amounts here because plaintiff’s expert did not tie billed charges to market/exchange value;
Exclusion of average payments by insurers/government as evidence of reasonable value	N/A (plaintiff objected to insurer-payment evidence being offered by defendant)	Insurer/government payment data shows market value and is relevant to rebut billed amounts	Error to exclude evidence of amounts typically paid by insurers/government where plaintiff is uninsured and such evidence is probative of market value;
Proof plaintiff was liable to pay full billed amount to lienholder	Frisk liable to pay full billed amount based on signed agreements and her testimony	Cowan argued lack of signed documents in evidence meant no proof of liability for full billed amount	Court found substantial evidence (lienholder rep testimony and Frisk’s statements) that Frisk agreed to repay full billed amount, so amount was "incurred";
Scope of remedy for evidentiary errors	N/A	Cowan sought new trial on all issues/compensatory damages	Retrial limited to past and future medical expenses only; liability and non-medical damages affirmed

Hanif v. Housing Authority, 200 Cal.App.3d 635 (Cal. Ct. App. 1988) (measure of recovery for medical expenses is reasonable value of care; collateral source rule principles)
Katiuzhinsky v. Perry, 152 Cal.App.4th 1288 (Cal. Ct. App. 2007) (where plaintiff is liable for full billed amount, billed charges may be admissible to prove amount incurred)
Howell v. Hamilton Meats & Provisions, Inc., 52 Cal.4th 541 (Cal. 2011) (insured plaintiffs limited to amounts paid/accepted as full payment; billed amounts do not reflect economic loss if plaintiff not liable for full bill)
Corenbaum v. Lampkin, 215 Cal.App.4th 1308 (Cal. Ct. App. 2013) (billed amounts inadmissible to prove past/future medical damages where providers accepted lesser amounts by prior agreement)
Bermudez v. Ciolek, 237 Cal.App.4th 1311 (Cal. Ct. App. 2015) (distinguishes uninsured plaintiffs; billed amounts may be relevant for uninsured but require expert linkage to reasonable value)
Uspenskaya v. Meline, 241 Cal.App.4th 996 (Cal. Ct. App. 2015) (payments to purchase liens may be relevant but require nexus evidence to reasonable value)