Health insurance companies commonly satisfy medical bills by paying a discounted rate that is less than the amount actually billed by the medical provider. This raised an interesting question in civil cases where medical expenses were at issue: can an injured person recover damages for the full value of medical services, i.e. the amounts billed by a medical provider, or is the injured party's recovery limited to the amounts that an insurance company actually paid on his or her behalf?
The West Virginia Supreme Court answered this question in Kenney v. Liston in 2014 and held that the "collateral source rule" dictated that an injured person's recovery for medical expenses in a civil case was not limited to the amounts that his or her insurance company paid on the injured party's behalf. Rather, the injured party could recover the full amount of medical expenses billed by a medical provider, even if the injured party's insurance company satisfied the medical expenses at a discounted rate.
Senate Bill 296 seeks to supersede Kenney v. Liston and establish a statutory rule that an injured party may not recover the full value of amounts billed by a medical provider, but can only recover (1) the sums actually paid to the medical provider; (2) the sums necessary to satisfy unpaid charges by the medical provider; and (3) the amounts sufficient to provide for future medical care.
Senate Bill 296 would also limit the evidence at trial in a civil case to prove past medical expenses to evidence of the sums actually paid by or on behalf of the injured party and/or the sums required to satisfy any unpaid medical bills. Under this proposal, a party may only offer evidence regarding the "value" of medical expenses in order to establish the cost of future medical care.
These are dramatic changes to our current law and will have a profound impact on the damages available in personal injury cases. If enacted, Senate Bill 296 will reduce the amounts that a plaintiff in a personal injury case can claim and/or potentially recover, thereby reducing the overall value of personal injury claims.