Personal Injury Law Topics / Health Insurance

Under the so-called “collateral source rule”, if an injured party has health insurance and a portion of their medical bills are paid for by that health insurance carrier, then the defendant would still be liable for the full amount of the medical bills.  For example, if a person is injured and incurs $10,000.00 in medical bills to treat the injury and the health insurance company, who has a contract with the medical provider, paid $6,000.00 — with the remaining $4,000.00 being written off by the health provider— the person causing the injury would still be liable to the victim for the entire $10,000.00.  This was the rule of law until the 1988 case of Hanif vs. Housing Authority came into existence.  In Hanif, a personal injury victim incurred medical bills and a portion of these bills were paid by Medi-Cal, with the balance written off by the treating facility.  The court ruled that the measure of damages that the defendant would be liable for would be only the amount paid by Medi-Cal.  To hold otherwise would provide the injured party with a “windfall” and recover more that what he or she is entitled.  This case essentially destroyed the application of the collateral source rule and seemed to penalize those who pay for health insurance to be limited in their recovery.

Thankfully, the Hanif case began to erode with the recent case of Howell vs. Hamilton Meats & Provisions, Inc. In Howell, the court reinstated the collateral source rule and held that the reduction in the medical bills because of a contractual relationship with the provider is a “benefit” within the health insurance policy that ensures only to the benefit of the policy holder (i.e. injured victim) and not the defendant, regardless whether the injured party receives a greater compensation for a part of the medical bills that were written off.

The Howell court seems to be in line with the collateral source rule, which in turn also seems to recognize the benefit to those who pay their hard earned dollars for health insurance premiums.  Given the sharp contrast amongst the appellate courts, it seems that sooner or later this matter is going to be heard before the California Supreme Court to resolve the conflict.  One could only hope that the Supreme Court sides with the holding in Howell.

If you, friend, or a family member has sustained injuries in a serious accident, fell free to call me to discuss the case.  My information can be found at my website by clicking here.