California Court Of Appeal Opinion Re: Howell Issues With An Uninsured Plaintiff

The California Court of Appeal, Fourth Appellate District, Division Three (Orange County) issued an opinion in Bermudez v. Ciolex (2015) 237 Cal.App.4th 1311, analyzing Howell issues in a case involving an uninsured plaintiff. (Id. at p. 1316.) The court analyzed three questions: "(1) what is the proper measure of medical damages; (2) what evidence is admissible to prove the proper measure of medical damages; and (3) what evidence is sufficient to affirm an award of medical damages based on the proper measure?" (Id. at p. 1328, italics in original.)

The court first held that "the measure of medical damages is the lesser of (1) the amount paid or incurred, and (2) the reasonable value of the medical services provided. In practical terms, the measure of damages in insured plaintiff cases will likely be the amount paid to settle the claim in full. It is theoretically possible to prove the reasonable value of services is lower than the rate negotiated by an insurer. But nothing in the available case law suggests this will be a particularly fruitful avenue for tort defendants. Conversely, the measure of damages for uninsured plaintiffs who have not paid their medical bills will usually turn on a wide-ranging inquiry into the reasonable value of medical services provided, because uninsured plaintiffs will typically incur standard, nondiscounted charges that will be challenged as unreasonable by defendants." (Bermudez, supra, 237 Cal.App.4th at pp. 1330-1331.)

The court then determined that plaintiff's "uninsured status meant that billed amounts were relevant to the amount he incurred (unlike insured plaintiffs, who really only incur the lower amount negotiated by their insurer)." (Bermudez, supra, 237 Cal.App.4th at p. 1335.) According to the court, with an uninsured plaintiff, the billed amounts are also relevant and admissible with regard to the reasonable value of plaintiff's medical expenses. In a footnote, the court "express[ed] some reservations about" Corenbaum v. Lampkin (2013)...