Preview
FILED
10/2/2023 8:17 PM
FELICIA PITRE
DISTRICT CLERK
DALLAS CO., TEXAS
Brandon Keys DEPUTY
CAUSE NO. DC-20-06968
LA’QUASHA ROCHELLE SANDERS § IN THE DISTRICT COURT
§
vs. § 44TH JUDICIAL DISTRICT
§
KRISTA KAY GOODMAN § DALLAS COUNTY, TEXAS
PLAINTIFF’S TRIAL BRIEF ON PAID AND INCURRED MEDICAL EXPENSES
COMES NOW, Plaintiff La’Quasha Rochelle Sanders and files this Trial Brief on
Paid and Incurred Medical Expenses, and shows the Court as follows.
I. INTRODUCTION
Plaintiff objects to any of Defendant Krista Kay Goodman’s (hereafter “Defendant")
efforts to conceal any evidence of Plaintiff’s (also “Plaintiff’) paid and incurred medical
expenses from the jury through a motion in limine, motion to exclude, motion to strike, or
othenNise, and asks that the Court find that Plaintiff’s evidence of paid and incurred
medical expenses reflects those expenses allowed by law as paid and incurred.
ll. ARGUMENT
At trial, Plaintiff intends to introduce evidence of paid and incurred medical
expenses. Plaintiff anticipates that Defendant wi|| request exclusion of all or part of such
evidence. Such objections are without merit. Plaintiff respectfully asks the Court to allow
her evidence of paid and incurred medical expenses reflects those expenses allowed by
law as paid and incurred.
As a general principle, compensatory damages, like medical expenses, are
intended to make the plaintiff whole for any losses resulting from the defendant's
interference with the plaintiff's rights. Transp. Ins. Co. v. Moriel, 879 S.W.2d 10, 16 (Tex.
PLAINTIFF’S TRIAL BRIEF ON PAID AND INCURRED MEDICAL EXPENSES Page 1 of 7
1994). TEX. CIV. PRAC. & REM. CODE ANN. § 41.0105 states that, in addition to any other
limitation under law, recovery of medical or health care expenses incurred is limited to the
amount actually paid or incurred by or on behalf of the claimant. TEX. CIV. PRAC. & REM.
CODE ANN. § 41.0105; see e.g., Big Bird Tree Serv. v. Gallegos, 365 S.W.3d 173, 177
(Tex. App.—Dallas 2012, pet. denied) (holding indigent plaintiff who received medical
care free of charge entitled to recover damages for full amount billed where no evidence
of contract prohibiting hospital from charging full value and evidence demonstrated
patient required to pay if obtained recovery in law suit).
Payments made or benefits conferred by other sources are known as collateral-
source benefits. See Restatement (second) of Torts § 920A cmt. b (1977). The collateral
source rule reflects "the position of the law that a benefit that is directed to the injured
party should not be shifted so as to become a windfall for the tortfeasor." Restatement
(second) of Torts § 920A cmt. b. They do not have the effect of reducing the recovery
against the defendant. Id. The injured party's net loss may have been reduced
correspondingly, and to the extent that the defendant is required to pay the total amount
there may be a double compensation for a part of the plaintiff's injury. Id.; see Haygood
v. De Escabedo, 356 S.W.3d 390, 394-395 (Tex. 2011). Long a part of the common law
of Texas, the rule precludes any reduction in a tortfeasor's liability because of
benefits received bv the plaintiff from someone else — a collateral source. Haygood
v. De Escabedo, 356 S.W.3d 390, 394 (emphasis added); Mid-Century Ins. Co. of Tex.
v. Kidd, 997 S.W.2d 265, 274 (Tex. 1999); Brown v. Am. Transfer & Storage Co., 601
S.W.2d 931, 934 (Tex. 1980); Tex. & Pac. Ry. Co. v. Levi & Bro., 59 Tex. 674, 676 (1883).
Thus, for example, insurance payments to or for a plaintiff are not credited to damages
PLAINTIFF’S TRIAL BRIEF ON PAID AND INCURRED MEDICAL EXPENSES Page 2 of 7
awarded against the defendant. Haygood v. De Escabedo, 356 S.W.3d 390, 395; Mid-
Century, 997 S.W.2d at 274 ("The collateral source rule bars a wrongdoer from offsetting
his liability by insurance benefits independently procured by the injured party."). The
theory behind the collateral source rule is that a wrongdoer should not have the benefit
of insurance independently procured by the injured party, and to which the wrongdoer
was not privy. Haygood v. De Escabedo, 356 S.W.3d 390, 395; Brown, 601 S.W.2d at
934.
In Haygood v. De Escabedo, 283 S.W.3d 3 (Tex. App. - Tyler 2009), aff'd, 356
S.W.3d 390 (Tex. 2011), the Supreme Court addressed the confusion that Tex. Civ. Prac.
& Rem. Code Ann. § 41.0105 created. When leaving the grocery store parking lot,
Margarita Garza De Escabedo negligently pulled in front of Aaron Haygood. See
Haygood, 356 S.W.3d at 392. As a result of the collision, Haygood sustained many
injuries. Id. Haygood underwent multiple successful surgeries, though some impairment
remained. Id. Twelve health care providers treated Haygood. In total, Haygood was billed
$110,069.12. Id. These amounts were adjusted down because Haygood was covered by
Medicare Part B, and as the court stated, that Medicare Part B pays no more for medical
and other health services than the reasonable charge for such service. Id. (quoting
federal law regarding Medicare payments, 42 C.F.R. § 405.501(a) (2013)). Additionally,
federal law forbids providers to charge Medicare patients more than what Medicare has
determined to be reasonable. Id. (citing 42 U.S.C. § 1395cc(a)(1)-(2) (2006)). As a result,
the adjusted bill equaled $27,739.43. 34 At the time of trial, Medicare had paid $13,292.41
and Haygood was still liable for $14,482.02. Id.
PLAINTIFF’S TRIAL BRIEF ON PAID AND INCURRED MEDICAL EXPENSES Page 3 of 7
At trial, De Escabedo attempted to exclude any evidence of amounts owed above
$27,739.43, pursuant to section 41.0105 of the TEXAS CIVIL PRACTICE AND REMEDIES CODE.
Haygood, 356 S.W.3d at 392. Haygood, however, asserted the collateral source rule and
moved to exclude any evidence of adjustments and payments to lower the amount owed.
Id. The trial court granted Haygood's motion and proceeded to trial barring any evidence
of adjusted or paid medical bills. The jury awarded Haygood the entire $ 110,069.12 for
past medical expenses. Id. Over De Escabedo's post-verdict objection, the court rendered
judgment on the verdict. Id. The court of appeals, however, disagreed with the trial court.
See id. As the Texas Supreme Court noted, "The court of appeals [held] that section
41.0105 precluded evidence or recovery of expenses that neitherthe claimant nor anyone
acting on his behalf will ultimately be liable for paying.” Id. at 392 (quoting De Escabedo
v. Haygood, 283 S.W.3d 3, 7 (Tex. 2009)).
The majority of the Texas Supreme Court case rejected Haygood's construction,
stating that the word "actually" modified both "paid" and "incurred." Id. The language
"actually paid and incurred" should be read actually paid and actually incurred. Id.
Moreover, the Court defined the term "actually" since "actually" modifies "incurred":
[It refers] to expenses that are to be paid, not merely included in an invoice and
then adjusted by required credits. Thus "actually paid and incurred" means
expenses that have been or will be paid, and excludes the difference between such
amount and charges the service provider bills but has no right to be paid.
Id. (emphasis added). The court focuses the attention on the amount the provider ha_s
a right to collect. Id. (emphasis added). Since Medicare Part B regulations required the
reduction of the collectable amount, the providers would only have a right to be paid this
PLAINTIFF’S TRIAL BRIEF ON PAID AND INCURRED MEDICAL EXPENSES Page 4 of 7
reduced amount. Haygood, 356 S.W.3d at 396-97. According to the court, this holding
was not groundbreaking: "All the courts of appeals that have addressed the issues have
reached the same conclusion ." Id. at 398.
In Big Bird Tree Service v. Gallegos, 365 S.W.3d 173, 175 (Tex. App. - Dallas
2012, pet. denied), a worker was injured on the job due to an employer's negligence. The
worker accrued significant medical expenses amounting to over $ 80,000. Id. Due to the
worker's financial situation, the worker qualified for a charity program and was required
only to pay small co-pays. Id. However, if the providers discovered the worker no longer
qualified for the charity program, the providers retained the right to bill the injured worker.
Id. at 176. Unlike in Haygood, there was no evidence of a contract between the
providers and the worker (or a third party representing the worker) that would limit
the amount the providers could collect from the worker. Id. at 177 (emphasis added).
Thouqh the providers reserved the riqht to bill the worker, no evidence of a forma_l
contract was given during trial. See id. at 176-177 (emphasis added). As a result, the
court was hesitant to say the hospital did not have a right to collect the full $80,000
pursuant to Haygood's authority. Id. at 177. Since the court determined the providers
retained a right to collect the full amount, the expenses were actually incurred
u_nder the langflge of section 41.0105. Id. (emphasis added). Consequently, the
judgment for the $ 80,000 in past medical expenses was affirmed. Id. at 175, 179. Note
that an individual who lacked health insurance was able to recover the full amount of
medical expenses.
In this case, there is similarly no evidence of a contract between the health care
providers and Plaintiff (or a third-party representing Plaintiff) that would limit the amount
PLAINTIFF’S TRIAL BRIEF ON PAID AND INCURRED MEDICAL EXPENSES Page 5 of 7
the health care providers could collect from Plaintiff. Therefore, the Defendant cannot
show that Plaintiff’s health care providers do not have a right to collect the full amount
billed pursuant to Haygood's and Big Bird’s authority. Id. at 177. In this case, the providers
retain the right to collect the full amount if Plaintiff is awarded past medical expenses
whether by lien or by a signed assignment of benefits by the Plaintiff, the expenses are
actually incurred under the language of section 41.0105. Id. (emphasis added).
Defendant has no proof othenNise. Therefore, Plaintiff asks the Court to allow the jury to
consider this element of damages and award such compensation as the Plaintiff shows
to be justly entitled.
WHEREFORE PREMISES CONSIDERED, Plaintiff La'Quasha Rochelle Sanders
prays that any of Defendant’s objections to the admission of Plaintiff’s evidence of all her
paid and incurred medical expenses allowed by law. Plaintiff seeks any other and further
relief to which she may be justly entitled.
Respectfully submitted,
KASTL LAw, P.C.
ls/ Moraley
KRISTINA N. KASTL
State Bar No. 24025467
eservice@kastllaw.com
kkastl kastllaw.com
SUSAN ANNE ALLEN
State Bar No. 01059350
sallen@kastllaw.com
RACHEL VARUGHESE MORALES
State Bar No. 24028186
rvaruqhese@kastllaw.com
4144 North Central Expressway, Suite 1000
Dallas, Texas 75204
(214) 821-0230
(214) 821-0231 Fax
PLAINTIFF’S TRIAL BRIEF 0N PAID AND INCURRED MEDICAL EXPENSES Page 6 of 7
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CERTIFICATE OF SERVICE
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hereby certify that a true and correct copy of the foregoing document has been
served on all counsel of record on this 2nd day of October, 2023, in accordance with Rule
21a of the TEXAS RULES 0F CIVIL PROCEDURE.
VIA ESERVE
Samuel J. Polak
PAYNE & BLANCHARD, LLP
717 N. Harwood Street, Suite 3350
Dallas, Texas 75201
/s/ Rachel/Varugl'wse Morale:
RACHEL VARUGHESE MORALES
PLAINTIFF’S TRIAL BRIEF 0N PAID AND INCURRED MEDICAL EXPENSES Page 7 of 7
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Filing Code Description: Brief Filed
Filing Description: PLAINTIFF‘S TRIAL BRIEF ON PAID AND INCURRED
MEIDCAL EXPENSES
Status as of 10/3/2023 3:47 PM CST
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