Howell

When a tortiously injured person receives medical care for his or her injuries, the provider of that care often accepts as full payment, pursuant to a preexisting contract with the injured person’s health insurer, an amount less than that stated in the provider’s bill. In that circumstance, may the injured person recover from the tortfeasor, as economic damages for past medical expenses, the undiscounted sum stated in the provider’s bill but never paid by or on behalf of the injured person? We hold no such recovery is allowed, for the simple reason that the injured plaintiff did not suffer any economic loss in that amount. (See Civ. Code, §§ 3281 [damages are awarded to compensate for detriment suffered], 3282 [detriment is a loss or harm to person or property].)

The collateral source rule, which precludes deduction of compensation the plaintiff has received from sources independent of the tortfeasor from damages the plaintiff “would otherwise collect from the tortfeasor” (Helfend v. Southern Cal. Rapid Transit Dist. (1970) 2 Cal.3d 1, 6 [ 84 Cal.Rptr. 173 , 465 R2d 61] (Helfend)), ensures that plaintiff here may recover in damages the amounts her insurer paid for her…

I respectfully dissent. I agree Rebecca Howell (Howell), who was insured by PacifiCare under a preferred provider organization (PPO) health insurance policy, is not entitled to recover the gross amount of her potentially inflated medical bills. However, I disagree with the majority insofar as it concludes Howell’s recovery of medical damages must be capped at the discounted amount her medical providers agreed to accept as payment in full from her insurer. Rather, Howell should be entitled to recover the reasonable value or market value of such services, as determined by expert testimony at trial, just as would be the case if the injured person had not purchased insurance or if the medical services had been donated.

The majority, while it states “we do not alter the collateral source rule as articulated in Helfend [v. Southern Cal. Rapid Transit Dist. (1970) 2 Cal.3d 1 [ 84 Cal.Rptr. 173 , 465 P.2d 61 ]] and the Restatement” (maj. opn., ante, at p. 565), creates a significant exception to this state’s long-standing collateral source rule. The majority draws a bright line and limits Howell’s recovery of medical damages to “no more than the medical providers accepted in full payment…

Horvitz & Levy, David S. Ettinger and H. Thomas Watson for American Insurance Association, Association of California Insurance Companies, Personal Insurance Federation of California, California State Automobile Association Inter-Insurance Bureau, Chartis, Inc., Farmers Insurance Exchange, Infinity Insurance Company, Interinsurance Exchange of the Automobile Club, Mercury Insurance Group, State Farm General Insurance Company and State Farm Mutual Automobile Insurance Company as Amici Curiae on behalf of Defendant and Respondent.

Cole Pedroza, Curtis A. Cole and Kenneth R. Pedroza for California Medical Association, California Dental Association and California Hospital Association as Amici Curiae on behalf of Defendant and Respondent.

Newdorf Legal, David B. Newdorf and Vicki F. Van Fleet for League of California Cities as Amicus Curiae.

WERDEGAR, J.—

When a tortiously injured person receives medical care for his or her injuries, the provider of that care often accepts as full payment, pursuant to a preexisting contract with the injured person's health insurer, an amount less than that stated in the provider's bill. In that circumstance, may the injured person recover from the…