Opinion ID: 835127
Heading Depth: 1
Heading Rank: 3

Heading: recoverable damages and ors 31.710

Text: Defendant's next argument, to which we now turn, is that plaintiff was not entitled to claim as economic damages amounts that he did not pay or have a legal obligation to pay. For the reasons that we explain, examining defendant's objection to plaintiff's double recovery through the lens of the damages that a plaintiff is permitted to claim, rather than those damages that a plaintiff may recover, does not lead us to a different conclusion. In support of its argument, defendant cites the definition of economic damages found in ORS 31.710. That statute provides, in part: (1) Except for claims subject to ORS 30.260 to 30.300 and ORS chapter 656, in any civil action seeking damages arising out of bodily injury, including emotional injury or distress, death or property damage of any one person including claims for loss of care, comfort, companionship and society and loss of consortium, the amount awarded for noneconomic damages shall not exceed $500,000. (2) As used in this section: (a) ` Economic damages ' means objectively verifiable monetary losses including but not limited to reasonable charges necessarily incurred for medical, hospital, nursing and rehabilitative services and other health care services, burial and memorial expenses, loss of income and past and future impairment of earning capacity, reasonable and necessary expenses incurred for substitute domestic services, recurring loss to an estate, damage to reputation that is economically verifiable, reasonable and necessarily incurred costs due to loss of use of property and reasonable costs incurred for repair or for replacement of damaged property, whichever is less. (Emphases added.) Defendant cites the dictionary definitions of monetary and loss for the proposition that, to suffer monetary loss, a plaintiff must unintentionally part with money. [10] Defendant cites the dictionary definition of incurred for the proposition that, to incur a charge, a plaintiff must become liable or subject to it. [11] We understand defendant's argument with respect to those definitions to be that, because plaintiff did not pay or have an obligation to pay the charges that his medical providers billed to him but later wrote off, plaintiff did not suffer monetary loss with respect to those charges, nor did he incur them. The first problem with that argument is that ORS 31.710(2) does not define or limit the compensatory damages that a plaintiff may recover. ORS 31.710(2) introduces the definition of economic damages with the phrase as used in this section and therefore defines economic damages for the purposes of ORS 31.710. ORS 31.710(1) indicates that the purpose of that statute is to describe the damages that are subject to a statutory cap (noneconomic damages) and those that are exempt from that cap (economic damages). Because this case does not present an issue relating to the statutory cap, the definition in ORS 31.710 is not directly applicable. Perhaps recognizing that impediment, defendant contends that ORS 31.710 is consistent with the common law and the purpose of compensatory damagesto `compensate the injured party for the injury sustained, and nothing more[.]' Tadsen v. Praegitzer Industries, Inc., 324 Or. 465, 470, 928 P.2d 980 (1996) (quoting Black's Law Dictionary 390 (6th ed. 1990)). Defendant further asserts that, for more than 100 years, Oregon law has sought to put the injured party in the same position that he or she would have occupied had no tort been committed. See Yamaha Store of Bend, Oregon, Inc. v. Yamaha Motor Corp., 310 Or. 333, 344, 798 P.2d 656 (1990) (For more than a century, the general rule in Oregon in assessing damages has been that a plaintiff should recover only such sums as will compensate a plaintiff for the injury suffered as a result of a defendant's wrong.) (citing Budd v. Multnomah St. Ry. Co., 15 Or. 413, 419, 15 P. 659 (1887)). Thus, defendant argues, where a plaintiff does not pay or have an obligation to pay an expense, the plaintiff does not suffer a loss for which a defendant may be held liable. We have no quarrel with the maxims on which defendant relies, but they do not precisely address the issue highlighted here. In this case, plaintiff suffered bodily injury as a result of defendant's tort, and he obtained the medical treatment that was necessary to restore him, to the degree possible, to his physical state before the tortuous act. The question that this case poses is not whether plaintiff suffered lossplaintiff's physical injuries certainly are a loss entitling him to compensatory damages. The question is whether the amount that defendant must pay as damages for that loss is limited to the amounts that plaintiff paid or remains legally obligated to pay for the medical care that he obtained to treat that loss. [12] One answer to that question is found in the collateral source statute and the legislative policy that it imposes. As we have explained, under ORS 31.580, a plaintiff who has medical insurance that pays his or her reasonable medical bills is entitled to recover the amount of those bills from a tortfeasor. That result obtains even though the plaintiff will not have paid the medical providers and will not remain liable to the providers or, absent subrogation rights, to the insurer. Defendant's argument that a plaintiff is not entitled to seek, as economic damages under ORS 31.710, the medical expenses that ORS 31.580 permits the plaintiff to recover presents, in different dress, the argument against double recovery that we have rejected. If a plaintiff who obtains third-party benefits that cover his or her medical expenses and who does not suffer out-of-pocket loss is entitled to recover those expenses, then that plaintiff also must be entitled to seek those expenses from the tortfeasor. If we were to accept defendant's newly clothed argument, we could not give effect to ORS 31.580. Insofar as ORS 31.710 applies to this action, we do not read its definition of economic damages to be inconsistent with the result that ORS 31.580 permits. A plaintiff who is injured and who obtains necessary medical treatment becomes liable or subject to reasonable charges for that treatment and thereby incurs them. ORS 31.710 does not require that a plaintiff also pay or otherwise satisfy those charges. Whether or by what means the plaintiff or a third party satisfies medical charges is a matter between the plaintiff, the third party, and the medical providers. ORS 31.710 does not make a plaintiff's right to assert a claim for economic damages against a tortfeasor dependent on those arrangements. A clear indication that ORS 31.710 does not limit a plaintiff's claim to charges that the plaintiff has paid or remains legally obligated to pay is that ORS 31.710 permits a plaintiff to assert a claim for medical treatment that will be necessary in the future. For example, in Clarke v. OHSU, 343 Or. 581, 586, 175 P.3d 418 (2007), the plaintiff's economic damages of $11 million included expenses for future healthcare. See also Mulligan v. Hornbuckle, 227 Or.App. 520, 522, 206 P.3d 1078 (2009) (plaintiff sought economic damages of, inter alia, $8,000 for future medical expenses). In those circumstances, a plaintiff can neither allege nor prove payment or a legal obligation to make payment. The plaintiff will not know or be able to determine whether the plaintiff or a third party will pay or otherwise satisfy those charges. Defendant does not cite an Oregon case that limits a plaintiff's claim to amounts that a plaintiff pays or remains obligated to pay and we have not discovered one. Oregon courts often have stated that plaintiffs are entitled to recover reasonable medical charges. See, e.g., Mathews v. City of La Grande, 136 Or. 426, 430, 299 P. 999 (1931) (juries may consider charges incurred, evidence of amount paid, and what would be a reasonable charge    in connection with the plaintiff's injury as evidence of the reasonable value of medical services provided); Tuohy v. Columbia Steel Co., 61 Or. 527, 532, 122 P. 36 (1912) (The rule is that a plaintiff in a case involving personal injuries can recover, as a part of his damages, his reasonable expenses for    medical treatment, but there must be some evidence that the charges are reasonable.). And, in Valdin v. Holteen and Nordstrom, 199 Or. 134, 147-48, 260 P.2d 504 (1953), the court indicated that the amount charged for medical services is admissible evidence of the reasonableness of a provider's charges: Plaintiff had the right to testify concerning the several charges made for the services performed in his care and treatment, or if he had paid for such services, as to the several amounts paid, but before such evidence could be the basis of a claim for special [economic] damages, it would be necessary to connect it by offering evidence that the charges or amounts paid, as the case might be, were reasonable for the services rendered, and, of course, that the services were performed. (Emphases added.) Cary v. Burris, 169 Or. 24, 127 P.2d 126, indicates that a plaintiff may claim medical expenses as damages although he or she will not pay or have an obligation to pay the provider of the medical services. In that case, federal law assured the plaintiff that the government would provide for his medical care and that the plaintiff would not have any obligation to his medical providers. The court characterized the government program as a gratuity and held that its existence did not relieve the defendant from liability for the worth of the care that the plaintiff received. Id. at 28-29, 127 P.2d 126. The legal authority that the court cited with approval stated that, whether third-party benefits are given as a gift or in performance of a contract, a defendant has no `equitable or legal claim to share in the benefit.' Id. at 28, 127 P.2d 126 (quoting Sedgwick on Damages ). Although the court in Cary approached the issue as a collateral source issue and not as a pleading issue, the end result was that the court permitted the plaintiff to recover the worth of the medical expenses from the defendant, regardless of the fact that he would not pay money or incur legal liability to his providers as a result of his medical treatment. The decision in Cary accords with Restatement (Second) of Torts § 924 (1979), cited with approval by this court in Zehr v. Haugen, 318 Or. 647, 656 n. 6, 871 P.2d 1006 (1994). Section 924 is entitled Harm to the Person. It provides, in part, that [o]ne whose interests of personality have been tortuously invaded is entitled to recover damages for the past or prospective    reasonable medical and other expenses[.] Comment f to that section, entitled Expenses, provides that an injured person is entitled to damages for all expenses and for the value of services reasonably made necessary by the harm. Restatement § 924, comment f (emphasis added.) Comment f then instructs that [t]he value of medical services made necessary by the tort can ordinarily be recovered although they have created no liability or expense to the injured person, as when a physician donates his services. (Referring to Restatement (Second) of Torts § 920A (1979) which describes the collateral source rule, (emphases added)). Thus, the Restatement permits a plaintiff to recover from a tortfeasor the reasonable value of the medical treatment that he or she receives whether plaintiff is liable to pay or pays the medical providers' charges for that treatment, the providers waive those charges, or a third party pays or otherwise satisfies those charges. Under that rule, and as we noted with respect to the collateral source statute, plaintiffs who incur the same injuries as a result of a defendant's tortuous actions may claim and recover the same damages. Defendant accepts that a plaintiff who is eligible for Medicare benefits and who does not pay out of pocket for the amounts that Medicare pays on his or her behalf may seek recovery of those amounts from a tortfeasor. Defendant contests, however, a plaintiff's right to seek recovery of sums that Medicare satisfies by requiring that providers accept Medicare payment as payment in full for their services. The distinction is one without a legal difference. As we have explained, a plaintiff may claim the reasonable value of the medical charges to which the plaintiff is subject without limitation to the amount that plaintiff pays or remains liable. Similarly, a plaintiff may claim the reasonable value of medical charges without limitation to the amount that a third party pays or remains liable to pay on the plaintiff's behalf. The law does not require either that a plaintiff suffer out-of-pocket loss or that a plaintiff satisfy medical charges by a particular means. Similarly, the law does not require that a third party acting on a plaintiff's behalf suffer out-of-pocket loss or satisfy medical charges by a particular means. Just as a plaintiff's claim against a tortfeasor is not dependent on whether or by what means the plaintiff satisfies reasonable medical charges, a plaintiff's claim is not dependent on whether or by what means a third party satisfies those charges. [T]he vast majority of courts to consider the issue follow the common-law rule articulated in section 924 of the Restatement and permit plaintiffs to seek the reasonable value of their expenses without limitation to the amount that they pay or that third parties pay on their behalf. See Wills v. Foster, 229 Ill.2d 393, 414, 323 Ill.Dec. 26, 892 N.E.2d 1018, 1031 (2008) (so stating). In Wills, the Illinois Supreme Court relied on its collateral source rule to hold that the plaintiff was entitled to the full amount of her medical expenses, notwithstanding the fact that she had not paid those expenses and would not be required to do so. Medicare had satisfied the plaintiff's obligation and had done so by paying less than the amounts that the plaintiff had been billed. The court noted, as this court did in Cary, 169 Or. at 28-29, 127 P.2d 126, and Reinan, 270 Or. at 213, 527 P.2d 256, that the policy behind the collateral source rulethat the wrongdoer should not benefit from the expenditures made by the injured party or take advantage of contract or other relations that may exist between the injured party and third persons, Wills, 229 Ill.2d at 413, 323 Ill.Dec. 26, 892 N.E.2d at 1030 (citation and emphasis omitted)militated a result in which the plaintiff could claim the full value of the medical treatment: Clearly, another relationship between an injured plaintiff and a third party could be a relationship with the government that allows the plaintiff's medical expenses to be paid because of factors such as her age or income level. Similarly, an arrangement between the plaintiff and a physician who agrees to perform free medical services is a relationship with a third party who is collateral to the tortfeasor. In either case, the benefit is intended to be for the plaintiff, not for the tortfeasor. Id. Accord Simpson v. Saks Fifth Ave., Inc., 2008 WL 3388739 (N.D. Okla. 2008) (applying Oklahoma law); McMullin v. U.S., 515 F.Supp.2d 904, 908 (E.D.Ark.2007) (applying Arkansas law); Lindholm v. Hassan, 369 F.Supp.2d 1104, 1111 (D.S.D.2005) (applying South Dakota law); Bynum v. Magno, 106 Hawai'i 81, 88, 101 P.3d 1149, 1156 (2004); Baptist Healthcare Systems, Inc. v. Miller, 177 S.W.3d 676, 682-83 (Ky.2005); Brandon HMA, Inc. v. Bradshaw, 809 So.2d 611, 618 (Miss.2001); Haselden v. Davis, 353 S.C. 481, 485, 579 S.E.2d 293, 295 (S.C.2003); Papke v. Harbert, 738 N.W.2d 510, 536 (S.D. 2007); Brown v. Van Noy, 879 S.W.2d 667, 676 (Mo.App. W.D.1994). [13] In the related circumstance of physician write-offs pursuant to agreements with private insurance companies, courts in other states also have concluded that plaintiffs are entitled to seek and recover from tortfeasors the reasonable medical expenses that their medical providers bill to them without limitation to the amounts paid by their insurers. Mitchell v. Haldar, 883 A.2d 32, 40 (Del. 2005); Hardi v. Mezzanotte, 818 A.2d 974, 985 (D.C.2003); Robinson v. Bates, 112 Ohio St.3d 17, 18, 857 N.E.2d 1195, 1196 (Ohio 2006) (but allowing defendant to adduce evidence of the amount paid to satisfy medical bills); Acuar v. Letourneau, 260 Va. 180, 192, 531 S.E.2d 316, 322 (2000); Koffman v. Leichtfuss, 246 Wis.2d 31, 630 N.W.2d 201 (2001); Lopez v. Safeway Stores, Inc., 212 Ariz. 198, 206, 129 P.3d 487, 495 (App. Div. 2, 2006); Tucker v. Volunteers of America Colorado Branch, 211 P.3d 708, 713 (Colo.App. 2008). [14] A minority of jurisdictions have held that plaintiffs can collect from tortfeasors no more than the sums actually paid by or on behalf of the plaintiffs, but, for the most part, those courts have reached their results by relying on statutes different than those in Oregon, or a section of the Restatement which does not apply to bodily injuries, but instead applies to clams for the value of services tortuously obtained. [15] See Goble v. Frohman, 901 So.2d 830, 832-33 (Fla.2005) (noting Florida statute); Dyet v. McKinley, 139 Idaho 526, 529, 81 P.3d 1236, 1239 (2003) (relying on Idaho Code); Moorhead v. Crozer Chester Medical Center, 564 Pa. 156, 162, 765 A.2d 786, 789 (Pa 2001) (relying on Restatement § 911); Hanif v. Housing Authority, 200 Cal.App.3d 635, 246 Cal.Rptr. 192, 194-96 (3 Dist. 1988) (citing Restatement § 911 and California code); Cooperative Leasing, Inc. v. Johnson, 872 So.2d 956, 958 (Fla.App. 2d Dist. 2004) (citing Restatement § 911); Terrell v. Nanda, 759 So.2d 1026, 1031 (La.App.2000); Kastick v. U-Haul Co. of Western Michigan, 292 A.D.2d 797, 798, 740 N.Y.S.2d 167, 169 (4 Dept. 2002). The dissent disagrees with the Restatement rule that a plaintiff may recover the value of medical services made necessary by a tortuous act without regard to whether the plaintiff is liable for that sum. As the dissent explains it, a plaintiff can seek and recover the reasonable value of services rendered only if the plaintiff (or someone) was, at the time the services were rendered, legally obligated to pay that value. The dissent reasons that no one incurs an obligation if no one is obligated legally to pay it. 347 Or. at 245, 219 P.3d at 584-85 (Kistler, J., dissenting). Under that reasoning, if a plaintiff receives medical services, and, after the services are rendered, the medical provider gratuitously discharges an express or implied obligation to pay for those services, the plaintiff may recover their full reasonable value from a tortfeasor. If, however, the medical provider informs the plaintiff prior to treatment that the plaintiff will have no obligation to pay for medical services, the plaintiff is not entitled to recover any sum from a tortfeasor for those necessary services. Similarly, under the dissent's reasoning, if a plaintiff receives medical services and a bill for their full reasonable value, but the medical provider has an agreement with an insurer to accept less than that sum as payment in full, and to write off the remainder, thus discharging the plaintiff from an express or implied contractual obligation, the plaintiff can recover from a tortfeasor the full sum charged. However, if the law, rather than an insurer's agreement, requires the write-off, the plaintiff cannot recover the amount written off. The only reason that the dissent gives for its position, other than that it is compelled by the legislature's use of the word incurred, is that no compensatory purpose is served by holding a defendant responsible for more than [costs incurred]. 347 Or. at 245, 219 P.3d at 584 (Kistler, J., dissenting). If the dissent means to argue that a plaintiff can only recover as damages the amount necessary to compensate him or her for out-of-pocket loss, then the dissent's construct does not accomplish that purpose. Whether a plaintiff does not incur a legal obligation or incurs a legal obligation that is discharged or satisfied, the plaintiff does not suffer out-of-pocket loss. To hold a defendant responsible in the latter instance and not in the former serves no greater compensatory purpose. Although the collateral source statute, ORS 31.580, does not directly address the issue of the damages that a plaintiff in a personal injury action may seek, it reflects a legislative decision to permit plaintiffs to recover damages from tortfeasors even if, due to insurance and or benefits, including Medicare benefits, they do not suffer out-of-pocket loss, and the damages therefore serve no compensatory purpose. In enacting ORS 31.580, the legislature chose to make tortfeasors who cause the same injuries liable to the same extent and to leave arrangements between plaintiffs and their providers and insurers to other law. Furthermore, we do not necessarily agree with the dissent's premisethat federal law makes clear that no costs were incurred in this case over the Medicare cap[,] 347 Or. at 252, 219 P.3d at 588 (Kistler, J., dissenting), and thus that the bills that plaintiff's medical providers sent and the contracts that they required plaintiff to execute violated federal law. 347 Or. at 249, 219 P.3d at 586-87 (Kistler, J., dissenting). [16] The Social Security Act more reasonably may be interpreted to limit not the amounts a beneficiary may incur but the amounts that Medicare will pay to [injured beneficiaries] or on their behalf.  42 U.S.C. §§ 1395d(a), 1395k(a)(1) (emphasis added). [17] See also 42 U.S.C. § 1395(y)(a)(2) (no payment by Medicare may be made under part A or part B    for any expenses incurred for items or services    for which the individual furnished such items or services has no legal obligation to pay). Because we decide that an injured person who receives medical services and who is billed for those services may seek the reasonable value of that treatment in a claim against a tortfeasor, a definitive interpretation of the Social Security Act is not crucial to our holding. But we do point out that all of the medical providers that rendered services to plaintiff billed him for the full reasonable value of that treatment, and defendant reasonably did not contend that plaintiff, by contract, had not agreed to pay those bills. Whether the Medicare laws benefitted plaintiff by providing that he was not legally obligated to pay those bills or instead provided a means for their discharge is of no legal consequence in this tort action. In either instance, plaintiff obtained treatment with the same reasonable value. In either instance, plaintiff received the benefits of the Medicare program that he earned through employment or payment of premiums, and those benefits do not reduce the amount that he can seek or recover from defendant. In sum, the common-law rule, as it has been articulated in the Restatement and the majority of jurisdictions, is that the plaintiff in a personal injury action is entitled to claim and recover from a tortfeasor the reasonable value of the medical services charged without limitation to the sums for which plaintiff is legally liable, that plaintiff has paid for those services, or that a third party has paid on plaintiff's behalf. Tying a plaintiff's claim to the amount that a third party has paid or satisfied undermines the collateral source rule by effectively linking the tortfeasor's obligation to the plaintiff's relationship with a third-party benefit provider. Moreover, exclusion of write-offs from the amount that a plaintiff may claim creates the anomaly that a defendant will be liable for the full reasonable charges that a medical provider makes to an uninsured person who is injured, but may have more limited liability if the injured person is insured or the beneficiary of other third-party benefits. We conclude that ORS 31.580 and the law of economic damages should and do work in harmony and permit plaintiff to claim and recover from defendant the reasonable value of the medical expenses for which he was billed and which were necessary to treat his injuries, viz., the same amount that plaintiff would have been entitled to claim and recover were he not eligible for Medicare benefits. Plaintiff's claim is not limited to the amounts that he paid or that Medicare paid on his behalf.