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Recoverable Medical Specials Limited to Amounts Paid

August 18, 2011

The California Supreme Court has limited a defendant's liability for damages for “medical specials” to the amounts actually paid for the medical services, not the billed amount.

“We hold . . . that an injured plaintiff whose medical expenses are paid through private insurance may recover as economic damages no more than the amounts paid by the plaintiff or his or her insurer for the medical services received or still owing at the time of trial.” 
 
The court rejected plaintiff's arguments that defendants are liable for the full “billed” amount, regardless of any discount the insurer may negotiate. “We hold no such recovery is allowed, for the simple reason that the injured plaintiff did not suffer any economic loss in that amount.” 
 
The court’s ruling prevents plaintiffs from recovering in damages more than the actual harm incurred.