California Appellate Court Permits Insurance Eligibility Evidence

A recent decision from the Court of Appeal, Fourth District of California upheld a trial court’s ruling that permitted evidence of future Medicare eligibility in the context of determining reasonable value of medical expenses. (Audish v. Macias, D081689, Superior Court No. 37-2018-00017566-CU-PA-CTL, decided May 21, 2024.)

In Audish, the plaintiff complained of injuries, including a mild traumatic brain injury, as a result of a motor vehicle accident. The plaintiff retained life care planner Brooke Feerick to opine on the cost of future care needs, who opined that future costs would be $1,417,146. Consistent with most life care planners retained by plaintiffs, Ms. Feerick calculated future costs based on the average amounts that medical providers charge; not the amounts they actually receive as payment.

Prior to trial, the plaintiff filed a motion in limine to preclude any mention of the availability of healthcare coverage after the accident. The trial court granted in part and denied in part, ruling that an expert witness with a proper foundation could testify concerning the reasonable value of medical care based on the rates insurers pay for medical treatment.

During cross-examination, and over objections from the plaintiff, the defense asked Ms. Feerick questions concerning the plaintiff’s future eligibility for Medicare. Ms. Feerick confirmed that her estimates did not factor in amounts that Medicare would pay for those future services and she also admitted that insurers sometimes pay less for medical treatment than the amounts that providers bill for those services.

On verdict, the jury awarded the plaintiff $32,790.56 in future medical costs. The plaintiff appealed, claiming that the court violated the collateral source rule by admitting evidence that he would have been eligible for Medicare at age 65.

On appeal, the Court of Appeal upheld the trial court ruling finding that “the trial court in the present case acted well within the bounds of its discretion when it permitted the defense to question Audish’s life-care planner briefly about his future eligibility for Medicare and the anticipated costs of his recommended medical treatment if he were to obtain Medicare coverage. These evidentiary rulings did not violate the collateral source rule or amount to an abuse of discretion [emphasis added].”

This decision has been certified for publication and defense counsel can, and should, rely on it in defense of similar motions in limine filed by plaintiffs in future cases.