Indiana Court of Appeals Refuses to Adopt Rule That Medical Bills Are Always Inadmissible When Not Claimed as Damages

Can a plaintiff’s medical bills be introduced as evidence by a defendant when the plaintiff is not seeking reimbursement for the medical bills as an item of damages? Yes, according to the Indiana Court of Appeals’ recent opinion in Gladstone v. W. Bend Mut. Ins. Co.

Daniel Gladstone (“Gladstone”) filed a lawsuit against Christina Carli (“Carli”) and his own insurance company, West Bend Mutual Insurance Company (“West Bend”), seeking damages for injuries he sustained, including a Colles fracture, in an automobile accident with Carli. Carli paid her automobile liability policy limits of $50,000.00 and was dismissed from the case. Gladstone sought damages from West Bend under his underinsured insurance coverage, which had a policy limit of $250,000.00. Gladstone’s medical bills were $14,000.00 but had been reduced to just under $2,000.00. The trial court allowed West Bend to introduce evidence of Gladstone’s reduced medical bills at trial, over Gladstone’s objection and despite the fact that Gladstone was not seeking medical expenses in the case, and the jury returned a verdict of $0.00 for Gladstone.

Gladstone appealed the trial court’s decision admitting his medical bills into evidence. Under Indiana law, a trial court’s decision to admit or exclude evidence is reviewed for an abuse of discretion resulting in prejudicial error, which is very deferential to trial courts. A party seeking reversal of a trial court’s evidentiary ruling must show the trial court’s decision was clearly against the logic and effect of the facts and circumstances, or that the trial court misinterpreted the law.

Indiana Evidence Rule 401 provides that evidence is relevant if “it has any tendency to make a fact more or less probable than it would be without the evidence” and “the fact is of consequence in determining the action.” Ind. R. Evid. 401. “Irrelevant evidence is not admissible.” Ind. R. Evid. 402. Under Indiana Evidence Rule 403, a court may exclude relevant evidence if its probative value is substantially outweighed by a danger of unfair prejudice, confusing the issues, misleading the jury, undue delay, or needlessly presenting cumulative evidence. Ind. R. Evid. 403.

Gladstone argued the trial court abused its discretion when it admitted his medical bills at the trial of his car accident case because his medical bills were irrelevant to the question of his pain and suffering and he was not claiming them as damages, and even if they were relevant, any probative value was substantially outweighed by the danger of unfair prejudice or misleading the jury. It is common, for instance, for attorneys, insurance companies, judges and juries, wisely or not, to use objective medical bills as an anchor or multiplier or reference point for calculating subjective damages like pain and suffering. Here, because Gladstone’s reduced medical bills were so low, he wanted to have them excluded as evidence because they might tend to bring down any jury award. West Bend argued that medical bills are generally relevant to the question of pain and suffering, and in this case, their probative value was not substantially outweighed by the danger of unfair prejudice or misleading the jury.

In a matter of first impression in Indiana, the Indiana Court of Appeals refused to adopt any bright line rule that evidence of medical bills is irrelevant in all cases in which they are not sought as damages. The Court opined that “[c]ommon sense and experience dictate that a more serious injury generally brings with it greater medical expenses as well as greater pain and suffering.”  The Court found Gladstone’s low medical bills “tend[ed] to establish that he has not experienced extensive pain and suffering from his injuries” and that Gladstone was free to, and did, counter that argument with other evidence. As to Gladstone’s argument that the probative value of the medical bills was substantially outweighed by the danger of unfair prejudice or misleading the jury, the Court noted that exclusion of evidence on this basis under Indiana Evidence Rule 403 is an extraordinary tool to be used sparingly and found Gladstone had failed to establish the danger of unfair prejudice or misleading the jury substantially outweighed the relevance of his medical bills.

Ultimately, under the facts of this case, the Court found that the trial court did not abuse its discretion in admitting evidence of Gladstone’s medical bills into evidence. The Court also found that, even if it was error for the trial court to admit the medical bills, Gladstone could not show any prejudicial error because he could not establish the jury found him entitled to no compensation for his pain and suffering, as the jury heard during trial that he had already received $50,000.00 from Carli. Furthermore, the Court found that Gladstone had waived any error on appeal with regards to evidence of settlement negotiations presented at trial by not seeking an admonition or mistrial and that he waived any error with regards to evidence of insurance payments in his medical bills because he failed to make a specific objection with regards to collateral source evidence.

You can read the full opinion here.