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

Author: Cayce E. Lynch

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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.[i]  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.

Qaadir settles a longstanding court split regarding the admissibility of unpaid medical bills, including medical liens, in light of the groundbreaking Howell decision.  In Howell, Tyson & Mendes successfully argued plaintiffs are only entitled to recover as past medical damages the lesser of (1) the amount paid or incurred and (2) the reasonable value of the services rendered.  This ruling no longer allowed plaintiffs to recover exorbitant full billed amounts for past medical treatment when health insurance made payments on plaintiff’s behalf.[ii]

For the last 10 years, in response to the Howell decision, plaintiffs’ attorneys now regularly refer their clients to doctors who, instead of billing medical treatment to health insurance, provide medical treatment on a lien basis.  Because no payments are made towards the medical liens by the time of trial, plaintiffs now argue they are entitled to introduce full lien amounts as evidence of the reasonable value of past medical treatment.  Ultimately, plaintiffs contend they are entitled to recover the full (inflated) value of past medical liens.  Some California appellate courts have aligned with plaintiffs’ view,[iii] while others have sided with the defense’s position that unpaid medical bills (full lien amounts) are not admissible to prove the reasonable value of plaintiff’s past medical treatment.[iv]

Qaadir sides with plaintiffs’– unpaid medical bills (full lien amounts) are admissible as evidence of the reasonable value of plaintiff’s past medical treatment.  Read the full Qaadir decision here.

As a silver lining for defendants, Qaadir also held evidence that plaintiff’s attorney referred him to a medical doctor who issued lien-based treatment is relevant and admissible to show the reasonable value of plaintiff’s medical treatment.  The Court explained evidence of the attorney-doctor referral “may show bias or financial incentives on the part of the lien-physicians.”[v] Accordingly, defendants should always ask plaintiff in deposition who referred him or her to each doctor from whom they received medical treatment and be prepared to leverage this evidence at trial.

Tyson & Mendes attorneys are experts in keeping down medical damages in California.  Contact us to strategize ways to combat plaintiff’s latest lien tactics for purposes of settlement or trial.

[i] Malak Melvin Abdul Qaadir v. Ubaldo Gurrola Figueroa et al., No. B306011 (Cal. 2nd Aug. 8, 2021).

[ii] Howell v. Hamilton Meats & Provisions, Inc., 52 Cal. 4th 541, 257 P.3d 1130 (2011).

[iii] Pebley v. Santa Clara Organics, LLC, 22 Cal. App. 5th 1266, 232 Cal. Rptr. 3d 404 (2018)

[iv] Ochoa v. Dorado, 228 Cal. App. 4th 120, 174 Cal. Rptr. 3d 889 (2014)

[v] Qaadir, supra, at 22.

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