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Simmons v. Cornerstone Investments, LLC

Supreme Court of Louisiana

May 8, 2019

KERRY SIMMONS
v.
CORNERSTONE INVESTMENTS, LLC, ET AL.

          ON SUPERVISORY WRITS TO THE NINTH JUDICIAL DISTRICT COURT, PARISH OF RAPIDES

          CLARK, JUSTICE

         At issue is whether, in a tort case against a third party tortfeasor, the lower courts erred in prohibiting a plaintiff from introducing the full amount of medical expenses billed and allowing only evidence of the amount actually paid by the employer through workers' compensation. We granted this writ application to determine the applicability of the collateral source rule to the instant facts. For the reasons that follow, we conclude the amount of medical expenses charged above the amount actually incurred is not a collateral source and its exclusion from the purview of the jury was proper.

         FACTS AND PROCEDURAL HISTORY

         Kerry Simmons, ("Plaintiff"), was employed by Cintas Corporation No. 2, ("Cintas"), at its warehouse in Pineville, Louisiana. Plaintiff was working in the course and scope of his employment when he was injured on October 12, 2011, while attempting to close a roll-up rear bay door that had become jammed. Plaintiff received workers' compensation benefits from Cintas, including disability and medical expenses. The medical bills charged by Plaintiff's healthcare providers totaled $24, 435; this amount was reduced to $18, 435 in accordance with the Louisiana Workers' Compensation Act Medical Reimbursement Schedule. Thus, there is a "written off" amount of $6, 000 at issue.

         Subsequently, Plaintiff filed suit against Cornerstone and its insurer ("Defendants"), as the owner of the builder. Plaintiff alleged the warehouse's rear bay door was defective, and that, but for this unreasonably dangerous defect his accident would not have occurred. Cintas and its workers' compensation carrier intervened, asserting its right to reimbursement. Plaintiff settled with Cintas, waiving his claims for additional workers' compensation benefits in consideration of Cintas waiving its intervention claim for reimbursement. Thereafter, Defendants filed a motion in limine seeking to exclude evidence of the amount of medical expenses "written off" due to workers' compensation payments and include, as evidence, only the medical expenses that were actually paid by workers' compensation. Plaintiff filed a competing motion in limine seeking to have the entire amount in medical bills admitted into evidence as a collateral source.

         The trial court granted Defendants' motion. Specifically, it prohibited evidence of the amount of medical expenses "written off" due to workers' compensation payments and found that the only evidence of medical expenses to go to the jury would be the amount paid by workers' compensation. The trial court also denied Plaintiff's motion in limine. The Court of Appeal, Third Circuit, denied the writ in a 2-1 decision. The dissent found that the application of the collateral source rule furthers the policy goal of tort deterrence and the trial court abused its discretion in granting Defendants' motion in limine. Plaintiff then applied to this court. We granted the writ application to determine the applicability of the collateral source rule to medical expenses "written off" pursuant to the Workers' Compensation reduced fee schedule. Simmons v. Cornerstone Investments, LLC, 18-735 (La. 9/21/18), 252 So.3d 491.

         DISCUSSION

         Jurisprudential Developments:

         We begin our analysis with a review of the development of the collateral source rule. In Louisiana Dept. of Transp. & Dev. v. Kansas City Southern Railway Co., 02-2349, p. 6 (La. 5/20/03), 846 So.2d 734, 739, this court held:

Under the collateral source rule, a tortfeasor may not benefit, and an injured plaintiff's tort recovery may not be reduced, because of monies received by the plaintiff from sources independent of the tortfeasor's procuration or contribution. Under this well-established doctrine, the payments received from the independent source are not deducted from the award the aggrieved party would otherwise receive from the wrongdoer.

         Subsequently, in Bozeman v. State, 03-1016 (La. 7/2/04), 879 So.2d 692, this court considered whether the collateral source rule applied to medical expenses which were "written off" under the Medicaid program. In analyzing this issue, this court noted that the plaintiff paid no consideration for the "written off" amount. The court provided:

[W]here the plaintiff pays no enrollment fee, has no wages deducted, and otherwise provides no consideration for the collateral source benefits he receives, we hold that the plaintiff is unable to recover the "write-off" amount. This position is consistent with the often-cited statement in Gordon v. Forsyth County Hospital Authority, Inc., 409 F.Supp. 708 (M.D. N.C. 1975), affirmed in part and vacated in part, 544 F.2d 748 (4th Cir. 1976), that "(i)t would be unconscionable to permit the taxpayers to bear the expense of providing free medical care to a person and then allow that person to recover damages for medical expenses from a tortfeasor and pocket the windfall." (Emphasis by the court).
After careful review, we conclude that Medicaid is a free medical service, and that no consideration is given by a patient to obtain Medicaid benefits. His patrimony is not diminished, and therefore, a plaintiff who is a Medicaid recipient is unable to recover the "write off" amounts. [Boldfacing in original].

         In Bellard v. Amer. Cent. Ins. Co., 07-1335, (La. 4/18/08), 980 So.2d 654, this court was tasked with deciding whether an employer's uninsured motorist carrier was entitled to a credit in the amount of workers' compensation payments paid to or on behalf of the plaintiff. In making the determination, we again focused on whether the plaintiff's patrimony was diminished, stating:

After Bozeman, two primary considerations guide our determination with respect to the collateral source rule. The first consideration is whether application of the rule will further the major policy goal of tort deterrence. The second consideration is whether the victim, by having a collateral source available as a source of recovery, either paid for such benefit or suffered some diminution in his or her patrimony because of the availability of the benefit, such that no actual windfall or double recovery would result from application of the rule. An analysis of these two considerations in the instant case leads to the conclusion that the collateral source rule does not apply under the circumstances presented.

Id. at 669. In Cutsinger v. Redfern, 08-2607 (La. 5/22/09), 12 So.3d 945, this court found the collateral source rule did not apply to prevent the plaintiff's uninsured motorist carrier from receiving a credit for workers' compensation benefits paid by her employer, even though the plaintiff paid for the UM coverage herself. In so ruling, this court relied on a finding of solidary liability between the UM carrier and the workers' compensation insurer and a secondary finding that the workers' compensation benefits were not paid for with consideration by the plaintiff and, ...


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