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Message
re: US District Court in NOLA has stayed a bunch of civil cases where fraud has been alleged.
Posted on 8/22/19 at 12:55 pm to Slippy
Posted on 8/22/19 at 12:55 pm to Slippy
Almost everything in Texas goes to a jury, and the Texas system is not clogged. With the big expense of a jury bond in Louisiana, I don't think reducing the jury threshold would make a big difference.
1
Posted on 8/22/19 at 1:04 pm to rumproast
(no message)
This post was edited on 8/8/20 at 9:07 am
Posted on 8/22/19 at 1:10 pm to TexasTiger39
quote:The entire thing you forget about the collateral source rule is that yes, while medicals may be paid by various carriers (health insurance, first party, etc), each of those carriers has a subrogation claim to that gross recovery.
TexasTiger39
You get rid of the collateral source rule, you might as well waive any net recovery to the patient goodbye.
Posted on 8/22/19 at 1:12 pm to TexasTiger39
In other words, exactly what we turned up here with Jessica Biel’s stunt arse as the attorney.
Posted on 8/22/19 at 1:14 pm to FearTheFish
(no message)
This post was edited on 8/8/20 at 9:07 am
Posted on 8/22/19 at 1:21 pm to TexasTiger39
quote:Fair point, but my original point in mentioning the subrogation issue is that completely invalidating and removing collateral source may actually do more harm than good.
Assuming the person that just sued someone based on fictitious injuries is honorable and tells the carrier
I see both sides of the issue - plaintiff bar likes it because it gets them a bigger paycheck; defense bar hates it because it subjects them to more exposure and the gross charges aren't "actually" damages since someone else paid for them.
Point being, I think people forget about the subrogation side of things which, IMO, nullifies both of the arguments I listed above (although I will freely admit there are more issues and my summary was a 10,000 foot view).
This post was edited on 8/22/19 at 1:22 pm
Posted on 8/22/19 at 1:22 pm to FearTheFish
quote:What are you saying?
You get rid of the collateral source rule, you might as well waive any net recovery to the patient goodbye.
Posted on 8/22/19 at 1:24 pm to FearTheFish
quote:Huh?
Point being, I think people forget about the subrogation side of things which, IMO, nullifies both of the arguments I listed above (although I will freely admit there are more issues and my summary was a 10,000 foot view).
Posted on 8/22/19 at 1:26 pm to TexasTiger39
Y'all are arguing about something that has already changed in Louisiana law, but carry on...
In Simmons v. Cornerstone Investments, LLC, et al., 2018-CC-0735 (La. 5/8/19), the Louisiana Supreme Court held in third party tort cases the collateral source rule is inapplicable to medical expenses charged above the amount actually paid by a workers’ compensation insurer pursuant to the workers’ compensation medical fee schedule.
Kerry Simmons was injured on the job and received workers’ compensation benefits, including disability and medical expenses. Invoices from healthcare providers totaled $24,435, but the charges were reduced to $18,435 in accordance with the Louisiana Workers’ Compensation Act Medical Reimbursement Schedule, resulting in a “write off” of $6,000. In Simmons’ tort suit against the third party building owner and its insurer, the defendants filed a motion in limine to exclude any evidence of medical expenses “written off” by the workers’ compensation insurer. The trial court granted the defendants’ motion and ruled that the only evidence to be presented to the jury was that of amounts actually paid under the fee schedule. The court of appeal denied the plaintiff’s writ. The Louisiana Supreme Court granted the writ to determine the applicability of the collateral source rule to the medical write off. The Court determined the collateral source rule did not apply when a plaintiff had paid no consideration for the benefits. The Court found the “written off” amount under the state workers’ compensation act was a “phantom charge that [p]laintiff has not ever paid nor one he will ever be obligated to pay.” Simmons, 2018-0735, p. 7. With this reasoning, the Court concluded there was no basis to differentiate the “written off” amount created by a reduced reimbursement fee under workers’ compensation and those of a Medicaid program or an attorney-negotiated medical discount. While acknowledging the importance of tort deterrence in the tort system, the Court found that “there is no true deterrent effect to allowing [p]laintiff to recover expenses over and above what was actually paid” and noted that a ruling allowing plaintiff to recover such a windfall would amount to an unauthorized award of punitive damages. Id. at 9. As a result, the Court ruled the collateral source rule did not apply. Id. at 9-10.
In Simmons v. Cornerstone Investments, LLC, et al., 2018-CC-0735 (La. 5/8/19), the Louisiana Supreme Court held in third party tort cases the collateral source rule is inapplicable to medical expenses charged above the amount actually paid by a workers’ compensation insurer pursuant to the workers’ compensation medical fee schedule.
Kerry Simmons was injured on the job and received workers’ compensation benefits, including disability and medical expenses. Invoices from healthcare providers totaled $24,435, but the charges were reduced to $18,435 in accordance with the Louisiana Workers’ Compensation Act Medical Reimbursement Schedule, resulting in a “write off” of $6,000. In Simmons’ tort suit against the third party building owner and its insurer, the defendants filed a motion in limine to exclude any evidence of medical expenses “written off” by the workers’ compensation insurer. The trial court granted the defendants’ motion and ruled that the only evidence to be presented to the jury was that of amounts actually paid under the fee schedule. The court of appeal denied the plaintiff’s writ. The Louisiana Supreme Court granted the writ to determine the applicability of the collateral source rule to the medical write off. The Court determined the collateral source rule did not apply when a plaintiff had paid no consideration for the benefits. The Court found the “written off” amount under the state workers’ compensation act was a “phantom charge that [p]laintiff has not ever paid nor one he will ever be obligated to pay.” Simmons, 2018-0735, p. 7. With this reasoning, the Court concluded there was no basis to differentiate the “written off” amount created by a reduced reimbursement fee under workers’ compensation and those of a Medicaid program or an attorney-negotiated medical discount. While acknowledging the importance of tort deterrence in the tort system, the Court found that “there is no true deterrent effect to allowing [p]laintiff to recover expenses over and above what was actually paid” and noted that a ruling allowing plaintiff to recover such a windfall would amount to an unauthorized award of punitive damages. Id. at 9. As a result, the Court ruled the collateral source rule did not apply. Id. at 9-10.
Posted on 8/22/19 at 1:28 pm to AlxTgr
(no message)
This post was edited on 8/8/20 at 9:07 am
Posted on 8/22/19 at 1:29 pm to vistajay
(no message)
This post was edited on 8/8/20 at 9:07 am
Posted on 8/22/19 at 1:33 pm to vistajay
quote:Completely not at all what we are talking about here.
Simmons v. Cornerstone Investments, LLC, et al., 2018-CC-0735 (La. 5/8/19)
Posted on 8/22/19 at 1:34 pm to TexasTiger39
quote:That's exactly what I'm talking about.
I.e., the Plaintiff wouldn't get any take home pay for medical bills if he was obligated to pay it all back to his insurer or attorney.
Where you'll get the biggest fight - and the one most difficult to get around - are ERISA plans and Medicare/Medicaid which have statutory subrogation. Made whole doesn't even apply to them. In practical application, the government plans will reduce/waive, but those private ERISA plans won't always.
Posted on 8/22/19 at 1:42 pm to TexasTiger39
quote:Exactly.
I personally see this as the correct result. Plaintiff would still recoup money for lost wages, pain and suffering, etc. You shouldn't recover more damages than were actually incurred.
Posted on 8/22/19 at 1:47 pm to vistajay
quote:That was limited to comp. My firm handled that. The monday before this dropped, I lost the same issue in the 9th as it pertained to Tricare. Plaintiff's would recover an $80,000 windfall under that ruling. $80K that no one owes and no one will ever owe.
Y'all are arguing about something that has already changed in Louisiana law, but carry on...
Posted on 8/22/19 at 1:56 pm to Slippy
Someone finally ringed the king? About a year ago an insurance defense firm based in Gretna was taking those guys on and constantly dragging Travers Mackel into covering it.
The cases themselves are going to primarily be in state court. Don't underestimate the number of cases on a CDC judge's docket. Especially accident cases. Also, keep in mind it's usually months after the initial petition before you even see exceptions filed let alone getting into discovery.
quote:
i know Nola is a lot bigger than LC but your federal court isn't THAT huge. 77 is a major number, too. how did nobody figure this out?
with 14 judges, that's an average of 5.5 cases per judge
The cases themselves are going to primarily be in state court. Don't underestimate the number of cases on a CDC judge's docket. Especially accident cases. Also, keep in mind it's usually months after the initial petition before you even see exceptions filed let alone getting into discovery.
This post was edited on 8/22/19 at 2:08 pm
Posted on 8/22/19 at 2:36 pm to AlxTgr
quote:
You get rid of the collateral source rule, you might as well waive any net recovery to the patient goodbye.
How so? It just means they can't claim medical bills already paid by another insurer. How does precluding double recovery amount no recovery?
Posted on 8/22/19 at 2:39 pm to DevilDagNS
quote:You going to eliminate subrogation as well? Because insurers that paid are going to want to recoup the money.
How so? It just means they can't claim medical bills already paid by another insurer. How does precluding double recovery amount no recovery?
Posted on 8/22/19 at 2:47 pm to FearTheFish
Who said anything about subrogation? Of course the carriers can subrogate. How is subrogation double recovery?
Posted on 8/22/19 at 3:04 pm to DevilDagNS
Can we keep this thread on topic? Legal arguments should be reserved for courtrooms.
Let's post what we learn about the investigation here.
Let's post what we learn about the investigation here.
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