Proposed Florida Law Seeks Fairness In Plaintiff Recoveries On Claims For Medical Expenses

On February 1, 2013, Florida Representative, Dave Hood (R-Daytona Beach), filed H.B. 587,1 a bill proposing to add Section 768.755 to the Florida Statutes. If passed, this statute would at last bring fairness and accuracy to the calculation of medical special damages that a plaintiff may publish to the jury at trial. This would alter current Florida case law which holds that evidence of the gross amount of medical expenses is admissible even if the health care provider accepted a reduced payment pursuant to a contractual discount with the plaintiff's health insurer.

For example in Nationwide Mutual Fire Insurance Co. v. Harrell,2 the plaintiff introduced evidence at trial of the gross amount of her medical bills even though the medical provider had accepted a discounted figure from her health insurer as payment-in-full. The defendant appealed, arguing that the admission of the amount charged rather than the amount paid misled the jury as to the true amount of the medical special damages. In its appeal, the defendant cited several precedent cases in which plaintiffs were prohibited from asking the jury to award the gross amount of medical bills when the treater had accepted a lower payment from Medicare on behalf of such plaintiffs. The First District Court of Appeal disagreed, distinguishing the scenario in which the reduced medical bills resulted from Medicare or other government benefit programs as opposed to contractual discounts negotiated by private insurers.

The Nationwide Court found that in situations where the plaintiff "earned (or paid for)" the benefit of reduced health care costs through the payment of private insurance premiums, she was entitled to present evidence of the gross amount of medical expenses charged.3 The court cited the "well-settled rule of damages" that "where the tortfeasor did not contribute to the payment of the premiums of such insurance, [he] should not benefit from the expenditures made by the injured party in procuring the insurance coverage." This rationale was taken even further in Durse v. Henn,4 where the Fourth District Court of Appeal allowed the plaintiff to present evidence of his gross medical bills - even though he had no health insurance - because he "earned in some way" the benefit of reduced charges by negotiating a compromise of the amount billed by the medical care provider.

These two cases fail to account for the inherent fiction of modern healthcare billing. Today, gross hospital bills...