Robinson v. Bates

• Decision Date: 20 December 2006
• Docket Number: No. 2005-0998.,2005-0998.
• Citation: 112 Ohio St.3d 17,857 N.E.2d 1195,2006 Ohio 6363
• Parties: ROBINSON, Appellee, v. BATES, Trustee, Appellant.
• Court: Ohio Supreme Court

Page 1195

857 N.E.2d 1195

112 Ohio St.3d 17

2006-Ohio-6362

ROBINSON, Appellee, v. BATES, Trustee, Appellant.

No. 2005-0998.

Supreme Court of Ohio.

Submitted March 29, 2006.

Decided December 20, 2006.

Ulmer & Berne, L.L.P., Marvin L. Karp, and David L. Lester, Cleveland, for appellant.

Scott A. Best, for appellee.

Bricker & Eckler, L.L.P., Catherine M. Ballard, and Anne Marie Sferra, Columbus, for amici curiae Ohio Hospital Association, Ohio State Medical Association, and Ohio Osteopathic Association.

Thompson Hine, L.L.P., and Alan F. Berliner, Columbus, urging reversal for amici curiae Property Casualty Insurers Association of America and Ohio Insurance Institute.

Weston Hurd, L.L.P., Daniel A. Richards, and Ronald Rispo, Cleveland, urging reversal for amici curiae Ohio Association of Civil Trial Attorneys.

LANZINGER, J.

{¶ 1} In this case, accepted on a discretionary appeal, we conclude that the collateral-source rule does not apply to bar evidence of the amount accepted by a medical care provider from an insurer as full payment for medical or hospital treatment. Both the amount originally billed by the provider and the amount paid by the insurer are admissible to prove the reasonable value of the medical treatment.

{¶ 2} On the evening of April 21, 2001, the appellee, Carolyn Robinson, broke a bone in her foot when she fell in the driveway of the residence she rented from the appellant, Helen Gist Bates, Trustee. Three to five days before Robinson's injury, an outside contractor, hired by Bates's grandson to do repair work, had removed a deteriorating retaining wall on the side of Robinson's driveway, exposing the concrete footer. Although she was aware of the construction, Robinson stepped onto an uneven slab of the footer and injured her foot.

{¶ 3} Robinson sued Bates for personal injury. During the trial, Robinson proffered her medical bills of $1,919. She stipulated that her insurance company had negotiated the amount of $1,350.43 as payment in full. The trial court refused to admit the original bills and limited her proof of damages to the amount that was actually paid for her medical treatment. At the conclusion of Robinson's case, the trial court granted a directed verdict for the defense, finding that Robinson had not established that Bates was negligent since the existence of the concrete footer was open and obvious.

{¶ 4} The Court of Appeals for Hamilton County reversed the judgment, stating that a jury should have determined the matter because reasonable minds could conclude that Bates, as the landlord, had violated her duty under R.C. 5321.04(A)(2) to repair the leased premises and that she had therefore committed negligence per se. Robinson v. Bates, 160 Ohio App.3d 668, 2005-Ohio-1879, 828 N.E.2d 657, ¶ 13, 15. The court of appeals also held that the trial court had erred in refusing to admit the original medical bills. Id. at ¶ 27. Citing R.C. 2317.421 only in passing, it relied on the collateral-source rule to hold that Robinson was entitled to seek recovery of the entire amount of her medical bills, rather than simply the amount paid by her insurer. Id. at ¶ 85. The case was remanded for a new trial.

{¶ 5} The two issues before us in this discretionary appeal are (1) whether evidence of the amount accepted as full payment of a medical bill is barred by the collateral-source rule and (2) whether a landlord's statutory duty under R.C. 5321.04(A)(2) is excused if a hazardous condition results from the landlord's efforts to comply with that statute.

{¶ 6} The judgment of the court of appeals is affirmed with respect to the remand of this case, albeit for a different reason. Although the collateral-source rule does not bar evidence of the amount accepted as full payment for medical services, we hold that both the original medical bill rendered and the amount accepted as full payment for medical services should have been admitted pursuant to R.C. 2317.421. Furthermore, the jury must determine whether Bates violated her statutory duty to repair.

Admissibility of Medical Bills

{¶ 7} We first consider what evidence a jury may consider in evaluating the reasonable value of medical expenses. In personal-injury cases, an injured party is entitled to recover necessary and reasonable expenses arising from the injury. Wagner v. McDaniels (1984), 9 Ohio St.3d 184, 9 OBR 469, 459 N.E.2d 561. Since those expenses include the reasonable value of the medical care required to treat the injury, the question is raised as to how to determine the reasonable value of the medical care. In Wagner, we held that "[p]roof of the amount paid or the amount of the bill rendered and of the nature of the services performed constitutes prima facie evidence of the necessity and reasonableness of the charges for medical and hospital services. (De Tunno v. Shull, 166 Ohio St. 365, 143 N.E.2d 301 [2 O.O.2d 281, 143 N.E.2d 301], modified.)" (Emphasis added.) Id., paragraph one of the syllabus. Thus, either the bill itself or the amount actually paid can be submitted to prove the value of medical services.

{¶ 8} Medical bills are admissible in a personal-injury case, for "[a]ll relevant evidence is admissible." Evid.R. 402. "`Relevant evidence' means evidence having any tendency to make the existence of any fact that is of consequence to the determination of the action more probable or less probable than it would be without the evidence." Evid.R. 401. Original bills are certainly evidence of the value that the medical providers themselves place upon their services.

{¶ 9} Furthermore, R.C. 2317.421 makes the bills prima facie evidence of the reasonable value of charges for medical services. R.C. 2317.421 states: "In an action for damages arising from personal injury or wrongful death, a written bill or statement, or any relevant portion thereof, itemized by date, type of service rendered, and charge, shall, if otherwise admissible, be prima-facie evidence of the reasonableness of any charges and fees stated therein * * *." Properly submitted medical bills are rebuttable evidence of reasonableness. Once medical bills are admitted, a defendant may then present evidence to challenge their reasonableness. Wood v. Elzoheary (1983), 11 Ohio App.3d 27, 28, 11 OBR 40, 462 N.E.2d 1243; see, also, Stiver v. Miami Valley Cable Council (1995), 105 Ohio App.3d 313, 320, 663 N.E.2d 1310. The trial court thus erred in refusing to allow the original medical bills to be admitted into evidence.

{¶ 10} In reversing and remanding this case, the Court of Appeals for Hamilton County remarked that Ohio courts generally admit proffered medical bills, allowing defendants to then rebut their prima facie evidence of necessity and reasonableness. 160 Ohio App.3d 668, 2005-Ohio-1879, 828 N.E.2d 657, ¶ 27. However, the court then continued its analysis to consider whether plaintiffs may recover the "written-off" portion of their medical bills under the collateral-source rule. A "write-off" is the difference between the original amount of a medical bill and the amount accepted by the medical provider as the bill's full payment. After examining the law of other jurisdictions and concluding that Ohio has no law limiting the collateral-source rule,¹ the court of appeals held that the "rule applies to any written-off amount agreed to by a plaintiff's health-care provider and insurer." Id. at ¶ 83. The court of appeals reasoned that the collateral-source rule applied to the write-off because the amount written off was a benefit to the plaintiff. Although the court of appeals correctly held that the excluded bills were prima facie evidence of reasonable value under R.C. 2317.421, it improperly applied the collateral-source rule in this case.

{¶ 11} The collateral-source rule was identified in Ohio in Pryor v. Webber (1970), 23 Ohio St.2d 104, 52 O.O.2d 395, 263 N.E.2d 235. The rule is an exception to the general rule that in a tort action, the measure of damages is that which will compensate and make the plaintiff whole. Id. at 107, 52 O.O.2d 395, 263 N.E.2d 235, citing Lawrence RR. Co. v. Cobb (1878), 35 Ohio St. 94, and Mahoning Valley Ry. Co. v. DePascale (1904), 70 Ohio St. 179, 71 N.E. 633; see 25 Corpus Juris Secundum (2002) 1012, Damages, Section 99(1). Pryor involved a plaintiff who received reduced wages from her employer while she was unable to work because of a tortfeasor's negligence. We explained that under the collateral-source rule, the plaintiff's receipt of benefits from sources other than the wrongdoer is deemed irrelevant and immaterial on the issue of damages. Id. at 109, 52 O.O.2d 395, 263 N.E.2d 235. The rule prevents the jury from learning about a plaintiff's income from a source other than the tortfeasor so that a tortfeasor is not given an advantage from third-party payments to the plaintiff. Id. at 108, 52 O.O.2d 395, 263 N.E.2d 235.

{¶ 12} When the collateral-source rule has been raised as an issue, other jurisdictions have come to different conclusions about the amount that a plaintiff may recover for medical expenses. Ten state courts have concluded that plaintiffs are entitled to claim and recover the full amount of reasonable medical expenses charged, including amounts written off from the bills pursuant to contractual rate reductions. E.g., Lindholm v. Hassan (D.S.D.2005), 369 F.Supp.2d 1104, 1110; Mitchell v. Haldar (Del.2005), 883 A.2d 32, 40; Hardi v. Mezzanotte (D.C.App.2003), 818 A.2d 974, 985; Olariu v. Marrero (2001), 248 Ga.App. 824, 825, 549 S.E.2d 121; Bynum v. Magno (2004), 106 Hawaii 81, 92, 101 P.3d 1149; Arthur v. Catour (2004), 345 Ill.App.3d 804, 807, 281 Ill.Dec. 243, 803 N.E.2d 647; Wal-Mart Stores, Inc. v. Frierson (Miss.2002), 818 So.2d 1135, 1139-40; Brown v. Van Noy (Mo. App.1994), 879 S.W.2d 667, 676; Haselden v. Davis (2003), 353 S.C. 481, 483, 579 S.E.2d 293; Acuar v. Letourneau (2000), 260 Va. 180, 192, 531 S.E.2d 316; Koffman v. Leichtfuss (2001), 246 Wis.2d 31, 45-46, 630 N.W.2d 201...