A summary of the Supreme Court’s Opinion on Kerry Simmons v. Cornerstone Investments

In this case, the court was tasked with deciding if it should be allowed to introduce evidence of medical bills charged versus medical bills paid in an action against a tortfeasor when the plaintiff has received workers’ compensation benefits. Both the plaintiff and the defendant argued the applicability of the collateral source rule in their favor.

The collateral source rule, as defined in the Louisiana Dept. of Transp. & Dev., states that 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 tortfeasors’ procuration or contribution.” (846 So.2d at 739). The Supreme Court has previously established a two-consideration test to determine the applicability of the collateral source rule.

1. Whether the application of the rule will further the policy goal of tort deterrence.
2. Whether the victim, by having a collateral source available as a source of recovery, either paid for such benefit or suffered some reduction in his or her patrimony because of the availability of the benefit, in such a way that no double recovery would occur.

Since the collateral source rule is tied to the monies received by the plaintiff, the exclusion of the amount billed in favor of the admission of the actual amount paid, is in keeping with the rule. The amount billed had to be reduced to be in compliance with the workers’ compensation fee schedule and therefore, the difference was not actually paid. The billed amount was $24,435 whereas the paid amount was $18,435. The $6,000 difference was the result of a discount to keep with the workers’ compensation fee schedule. The discount is not considered a payment or benefit.

Additionally, the plaintiff being subjected to workers’ compensation scheme is not considered a payment as workers’ compensation was established for the benefit of both the employer and the employee. Finally, because the basis of tort recovery is to make the plaintiff whole, current law and jurisprudence do not allow the plaintiff to profit from the tortfeasor. As such, allowing the introduction of an amount that was billed but not paid, would be profitable to the plaintiff.

The full opinion can be found on the Louisiana Supreme Court’s website.

Allen & Gooch is providing this legal update for informational purposes only. This article should not be construed as legal advice or a legal opinion as to any specific facts or circumstances. You should consult your own attorney concerning your particular situation and any specific legal questions you may have.