4 Cal. App. 5th 424
Cal. Ct. App.2016Background
- Moore, an uninsured motor-vehicle plaintiff, underwent extensive treatment (including complex disk-replacement surgery) after Mercer admitted negligence; jury awarded $122,689 for past medical expenses (appeal contests that amount).
- Many providers sold their bills/liens to MedFinManager (MedFin); MedFin typically purchases accounts receivable at a steep discount (often ~50¢ on the dollar).
- Plaintiff introduced summary lists of billed charges (~$191,232) and testimony that she incurred liability; defense billing expert opined a much lower reasonable value (~$71,106).
- Trial court denied defense discovery request for the written MedFin–provider agreement, awarded $2,500 sanctions to plaintiff for the motion to compel, and granted plaintiff’s in limine motion excluding evidence of MedFin payments/agreements under Evid. Code §352.
- Trial court granted a directed verdict on causation in favor of plaintiff; on appeal the court affirmed (causation), affirmed exclusion of MedFin payment evidence as within §352 discretion, reversed sanctions for the denied discovery as erroneous.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the amount a medical finance company paid providers caps plaintiff’s recoverable past medical damages | Moore: Katiuzhinsky allows admission of full billed amounts and plaintiff may recover up to amounts she actually incurred (she remained liable) | Mercer: Relying on Howell, the amount actually paid (what MedFin paid) is the only relevant measure of damages | Court: Howell does not extend to third‑party purchases; Katiuzhinsky remains sound — MedFin payments do not automatically cap damages |
| Whether trial court abused discretion in excluding evidence of MedFin–provider agreements/payments under Evid. Code §352 | Moore: Such agreements are minimally probative and would introduce collateral issues; exclusion was proper | Mercer: Agreements are discoverable and relevant to show market/value and should be admissible | Court: Trial court acted within §352 discretion to exclude the evidence at trial because probative value was low and collateral litigation would unduly consume time |
| Whether discovery denial (motion to compel Dr. Orisek’s MedFin contract) and sanctions were proper | Moore: Agreement was irrelevant so denial and sanctions justified | Mercer: Agreement was discoverable and denial was error; sanctions improper | Court: Denial of discovery was erroneous (agreement is discoverable), but error harmless because court would have excluded evidence at trial; sanctions reversed because motion was meritorious |
| Whether directed verdict on causation was proper | Moore: All experts agreed collision caused injury; directed verdict appropriate | Mercer: Earlier accident may have caused injuries; directed verdict improper | Court: Directed verdict proper — defense produced no evidence tying earlier accident to current injuries; experts uniformly attributed injuries to Mercer collision |
Key Cases Cited
- Howell v. Hamilton Meats & Provisions, Inc., 52 Cal.4th 541 (Cal. 2011) (insurer‑negotiated discounted payments limit a plaintiff’s recoverable past medical expenses when plaintiff bears no prospective liability)
- Katiuzhinsky v. Perry, 152 Cal.App.4th 1288 (Ct. App. 2007) (when plaintiff remains liable, full billed charges are admissible and third‑party purchase of liens does not automatically limit recovery)
- Hanif v. Housing Authority, 200 Cal.App.3d 635 (Ct. App. 1988) (recovery limited to amount plaintiff paid or incurred — focus on plaintiff’s economic loss)
- Nishihama v. City & County of San Francisco, 93 Cal.App.4th 298 (Ct. App. 2001) (applies Hanif to private insurer‑negotiated discounts)
- Parnell v. Adventist Health System/West, 35 Cal.4th 595 (Cal. 2005) (related to measure of hospital damages and discounts)
- Corenbaum v. Lampkin, 215 Cal.App.4th 1308 (Ct. App. 2013) (applies Howell in insured/negotiated‑rate context)
- Ochoa v. Dorado, 228 Cal.App.4th 120 (Ct. App. 2014) (disagreed with Katiuzhinsky — treated Howell as limiting evidence of full bills)
- Bermudez v. Ciolek, 237 Cal.App.4th 1311 (Ct. App. 2015) (distinguishes Howell from Katiuzhinsky; Howell did not disapprove Katiuzhinsky)
- Uspenskaya v. Meline, 241 Cal.App.4th 996 (Ct. App. 2015) (upheld exclusion of MedFin payment evidence under §352 because factor’s purchase price reflects collectability/risk more than service value)
- Children’s Hospital Central California v. Blue Cross of California, 226 Cal.App.4th 1260 (Ct. App. 2014) (quantum meruit and value‑of‑services analogies: a variety of evidence may be admissible to show reasonable value)