Arthur v. Catour

Case Date: 12/31/1969
Court: Supreme Court
Docket No: 97920, 97946 cons.  Rel

Docket Nos. 97920, 97946 cons.-Agenda 17-November 2004.

JOYCE ARTHUR, Appellee, v. LAURIE CATOURet al., Appellants.

Opinion filed July 21, 2005.

JUSTICE FREEMAN delivered the opinion of the court:

We are presented with the following certified question:

"Whether the Plaintiff who was charged $19,355.25 in medical bills for medical services related to her injuries can present that amount of bills as medical expenses in the case or, whether the Plaintiff shall be limited to presenting only $13,577.97 in medical bills to the jury because that is the amount that was paid by the Plaintiff and Blue Cross/Blue Shield, who was an insurance carrier for the Plaintiff and who paid the Plaintiff's medical bills pursuant to insurance contracts at a substantially reduced rate with the medical providers and which the providers accepted as payment in full."

We hold that a plaintiff may present to the jury the amount that the plaintiff's health-care providers initially billed for services rendered.

BACKGROUND

Plaintiff, Joyce Arthur, brought a personal injury action in the circuit court of Henry County against defendants Laurie Catour and Stenzel Brothers Auction Services, Inc. Plaintiff alleged that on October 2, 1999, defendant Stenzel Brothers was conducting an auction on a farm that defendant Catour owned. Plaintiff further alleged that, while attending the auction, she stepped in a hole in Catour's yard, fell, and was injured. Plaintiff alleged negligence on the part of each defendant and sought damages. Each defendant filed an answer denying negligence or liability.

Discovery ensued. In her answers to defendant Stenzel Brothers' interrogatories, plaintiff stated that she fractured her leg just below the knee, which required surgery. Plaintiff also disclosed the categories of damages that she sought. Included in this list was: "Incurred medical to date-$19,314.07." The following facts are undisputed. Through February 2002, plaintiff received services from various health-care providers valued at $19,355.25. Plaintiff had private, group health insurance with Blue Cross/Blue Shield (Blue Cross) through her husband's employer.

Further, Blue Cross had contractual agreements with plaintiff's health-care providers. Through this arrangement, many of the charges for health-care services rendered were discounted. Several examples are illustrative. Plaintiff received health-care services from Orthopedic Specialists valued at $4,308.70. However, based on their arrangement, Blue Cross actually paid the provider only $1,800.90 and plaintiff personally paid $375.10, for a total actual payment of only $2,176, which satisfied the bill. The provider discounted the remaining $2,132.70.

Likewise, plaintiff received health-care services from Genesis Medical Center valued at $7,425.49. However, $4,642.06 from Blue Cross and $522.51 from plaintiff, a total of $5,164.57, satisfied the bill. The provider discounted the remaining $2,260.92. Plaintiff received health-care services from Hammond-Henry Hospital valued at $5,299.56. However, $4,218.67 from Blue Cross and $59.64 from plaintiff, a total of $4,278.31, satisfied the bill. The provider discounted the remaining $1,021.25. Plaintiff received health-care services from St. Joseph Medical Center valued at $1,214.70. However, $877.90 from Blue Cross and $258.49 from plaintiff, a total of $1,136.39, satisfied the bill. The provider discounted the remaining $78.31. Plaintiff received health-care services from Heart Care Midwest valued at $117. However, $88.80 from Blue Cross satisfied the bill. The provider discounted the remaining $28.20. In this manner, plaintiff's health-care providers discounted a total of $5,777.28; Blue Cross and plaintiff actually paid a total of only $13,577.97 to satisfy the $19,355.25 of billed health-care services rendered.

Defendants filed a motion for partial summary judgment, seeking to limit plaintiff's claim for medical expenses to the amount paid rather than the amount billed. Granting defendants' motion, the circuit court's order stated in part:

"The court does not find that the collateral source rule applies to the present set of facts, and to allow the plaintiff to seek and recover $19,355.25 worth of medical damages when she was only charged for and became liable for $13,577.97 would only serve to punish the defendants punitively and provide a windfall for the plaintiff."

The court ruled that "plaintiff will be limited to seeking compensatory damages not exceeding those actually paid to her medical providers."

The circuit court certified the above-quoted legal question for immediate appeal. The appellate court allowed plaintiff's application for leave to appeal pursuant to Supreme Court Rule 308 (155 Ill. 2d R. 308).

The appellate court, with one justice dissenting, reversed the circuit court's entry of partial summary judgment for defendants. 345 Ill. App. 3d 804. The appellate court majority held that "plaintiff's damages are not limited to the amount paid by her insurer, but may extend to the entire amount billed, provided those charges are reasonable expenses of necessary medical care." 345 Ill. App. 3d at 808.

Presiding Justice Holdridge dissented, reasoning as follows: "Here, the amount received from the plaintiff's insurance company in full payment of plaintiff's past medical expenses-$13,577.97-will be fully protected by the collateral source rule. The additional $5,777.28 needs no such protection, as the plaintiff never incurred or became obligated for that expense." (Emphasis in original.) 345 Ill. App. 3d at 809 (Holdridge, P.J., dissenting). He concluded: "I see no legal reason to allow the plaintiff to recover for expenses she never paid nor ever became obligated to pay as a result of the negligence of the defendant." 345 Ill. App. 3d at 810 (Holdridge, P.J., dissenting).

Each defendant petitioned for leave to appeal. 177 Ill. 2d R. 315(a). We allowed each petition and consolidated the appeals. We granted the Illinois Trial Lawyers Association leave to submit an amicus curiae brief in support of plaintiff. We also granted the Illinois Association of Defense Trial Counsel leave to submit an amicus curiae brief in support of defendants. See 155 Ill. 2d R. 345. We now affirm the judgment of the appellate court and reverse the circuit court's entry of partial summary judgment in favor of defendants.

ANALYSIS

We note at the outset our standard of review. In this case, we review the propriety of the appellate court's answer to the certified question. The pertinent facts being undisputed, the certified question essentially asked whether the trial court's grant of partial summary judgment in favor of defendants was legally correct. "If the facts are uncontroverted and the issue is the trial court's application of the law to the facts, a court of review may determine the correctness of the ruling independently of the trial court's judgment." Norskog v. Pfiel, 197 Ill. 2d 60, 70-71 (2001); seeWoods v. Cole, 181 Ill. 2d 512, 516 (1998) (stating rule that questions of law are reviewed de novo); Adams v. Northern Illinois Gas Co., 211 Ill. 2d 32, 43 (2004) (stating rule that summary judgment rulings are reviewed de novo). Accordingly, our review is de novo.

"Under the collateral source rule, benefits received by the injured party from a source wholly independent of, and collateral to, the tortfeasor will not diminish damages otherwise recoverable from the tortfeasor."Wilson v. The Hoffman Group, Inc., 131 Ill. 2d 308, 320 (1989); see Beaird v. Brown, 58 Ill. App. 3d 18, 21 (1978), quoting Bireline v. Espenscheid, 15 Ill. App. 3d 368, 370 (1973); 11 Ill. Jur. Personal Injury & Torts