(2011) 52 Cal.4th 541

In Howell v. Hamilton Meats, Tyson & Mendes Founder and Managing Partner Robert Tyson successfully tried and argued before the California Supreme Court the most significant tort case in more than 40 years. Not only did Howell change the way California interprets the collateral source rule, but it also reshaped personal injury litigation across the state.

The Howell Court examined California’s “billed vs. paid” rule regarding medical damages – is plaintiff allowed to recover as past economic damages the amount plaintiff’s medical provider submits to plaintiff’s health insurance, or the much lower amount the health insurance company pays the provider in full satisfaction of those medical bills?

Howell concluded an injured plaintiff is limited to recovering the discounted amount private health insurance pays on their behalf as past medical damages, not the inflated amount medical providers bill health insurance companies for their services.

Following the Howell decision, California courts expanded the paid rule to apply to Medicare payments (Sanchez v. Strickland; Luttrell v. Island Pacific Supermarkets, Inc.), Medi-Cal payments (Sanchez v. Strickland), Workers’ Compensation payments (Sanchez v. Brooke), future medial damages (Corenbaum v. Lampkin), and noneconomic damages (Corenbaum v. Lampkin). Most recently, California extended the Howell rule to allow evidence of the Affordable Care Act when determining the cost of future care in medical malpractice cases (Cuevas v. Contra Costa County).

Tyson & Mendes is a leader in arguing damages across the nation. We frequently provide CE/CLE educational seminars on the latest Howell updates, trends we are seeing with plaintiff’s attorneys (including liens and factoring companies), and what we can do to combat plaintiff’s attorneys attempts to circumvent Howell.

Industry Insider Q&A With Robert Tyson

August 29, 2017 9:12am
The Daily Transcript – August 16, 2017 Robert Tyson is a founding partner of the law firm Tyson & Mendes. In 2011, he successfully argued before the California Supreme Court in Howell v. Hamilton Meats that an injured plaintiff may only recover the medical costs paid by his or her health insurance and not the higher amount billed to insurance companies by physicians and hospitals. In this interview, he reflects on a variety of topics, including the effect the case has had.

No Tort Liability for Insurer Underpayment of Hospital Bills

Author: Kristi Blackwell | December 3, 2021 9:00am
On November 4, 2021, the Second District Court of Appeal, Division 2, ruled against establishing tort liability for insurers who paid less than what the hospital believed to be the “reasonable and customary value.”  This partially published opinion is based on the underlying suit between plaintiffs Long Beach Memorial Medical Center and Orange Coast Memorial Medical Center (collectively “the hospitals”) and defendant Kaiser Foundation Health Plan, Inc. (“Kaiser”) stemming from alleged underpayment by Kaiser for emergency medical services rendered at the hospitals.

Howell Update: Unpaid Medical Liens Ruled Admissible in Latest California Appellate Decision

Author: Cayce E. Lynch | August 12, 2021 10:01am
Yesterday the California Court of Appeals for the Second District issued a blow to defendants in its Malak Melvin Abdul Qaadir v. Ubaldo Gurrola Figueroa et al. published decision. The Court held unpaid medical bills, including medical treatment provided on a lien basis, is admissible to prove the reasonable value of plaintiff’s past medical damages at trial.  The Qaadir decision further erodes the protections to defendants provided by Tyson & Mendes’ victory in the 2011 Howell v. Hamilton Meats California Supreme Court Case.

Nevada Howls for Howell

July 9, 2018 9:00am
When the California Supreme Court issued its opinion in Howell v. Hamilton Meats 52 Cal.4th 541, 257 P.3d 1130, 129 Cal.Rptr.3D 325 (2011), Nevada defense attorneys were hopeful Nevada would follow California’s example and prohibit plaintiff’s lawyers from introducing evidence of medical bills that had been partially or totally forgiven by medical providers.  The defense bar was hopeful the case of Tri-County Equip. and Leasing, LLC v. Klinke, 1268 Nev. Adv. Op. 33, 286 P.3d 593 (2012), would be the vehicle by which Nevada would adopt the Howell precedent.  This was not to be.

Howell Update: Class Certification Denied in Action Seeking Declaratory Relief that Hospital “Chargemaster” Rates are Unreasonable

Author: Emily Beck | December 1, 2017 4:23pm
Tyson & Mendes argued and won the landmark Supreme Court decision of Howell v. Hamilton Meats & Provisions, Inc. (2011) 52 Cal. 4th 541, which held that a personal injury plaintiff is limited to recovering the lesser of what is actually paid or the reasonable value of medical services, rather than what a healthcare provider has billed the plaintiff for the services.  A recently published decision reinforces the importance of this rule and the huge discrepancy between billed vs. paid amounts. Artur Hefczyc v. Rady Children’s Hospital-San Diego, 2017 WL 5507854 (filed 11/17/17 and certified for publication). In this case, a plaintiff sought declaratory relief (on behalf of a proposed class) to establish that (among other things) a hospital was only authorized to charge self-pay patients for the reasonable value of its services, and that it was not permitted to bill based on a master list of itemized charge rates. The Court declined to issue the relief because it found the issues were inappropriate for class action litigation.

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2022 Trending Topics & Year in Review – Webinar Series

April 21, 2022 8:00am
This is a webinar series with four webinars titled: Trending Topics 1 Employment Law Annual Update, Trending Topics 2 Emerging Issues in Medical Malpractice Claims, Annual Update: California Legal Trends & Howell Update, and Jury Verdicts Nuclear Verdicts®️ Deep Dive.

Strategies to Combat Plaintiff’s Latest Lien Tactics

December 9, 2021 8:00am
Plaintiff attorneys will not stop fighting our $10 Billion win for the insurance industry in Howell v. Hamilton Meats! A recent decision out of the California Court of Appeals is changing the landscape once again for the defense industry. In Qaadir v. Figueroa, the appellate court held unpaid medical bills, including for medical treatments provided on a lien basis, are admissible to prove the reasonable value of plaintiff’s past medical damages at trial.