Collateral Source Rule Bars Evidence Of Amount Paid By Health Insurer

The Wisconsin Supreme Court has ruled that a plaintiff is entitled to prove the full amount of medical charges, despite the fact that plaintiff’s insurer actually paid a less amount.  The lesser amount cannot be used to prove that it is the "reasonable" value of the services.

This is how the Court expressed its holding:  " the collateral source rule prohibits parties in a personal injury action from introducing evidence of the amount actually paid by the injured person’s health insurance company, a collateral source, for medical treatment rendered to prove the reasonable value of the medical treatment."

The majority opinion is 37-pages long, but here is a brief statement of the reason for the Court’s holding:  "Although an injured person may experience double recovery when the collateral source rule is applied, one recovery from the collateral source and a second recovery from the tortfeasor, the purpose of the collateral source rule is not to provide the injured person with a windfall, but rather to prevent the tortfeasor from escaping liability because a collateral source has compensated the injured person. The injured person, not the tortfeasor, benefits from the collateral source."  [Footnotes omitted.]

If you want to read that opinion and the 15-page dissent in Leitinger v. DBart, Inc., 2005AP2030 (WI. S. Ct. Jul 3, 2007)  click here.