Faye, a small business owner, hired me to recover her medical expenses, lost income and other damages resulting from an injury caused by the negligence of Mega, Inc. Both names have been changed, but Faye was shocked to hear how Texas law treats her and Mega, Inc.
Faye has health insurance. The $1,200 monthly cost of insuring Faye and her husband (who are in their 50s) comes directly out of Faye’s pocket. Her health insurer has contracted discount rates with doctors and hospitals, so the $20,000 in medical bills Faye incurred because of her injury were reduced to $7,500. Of that amount, Faye paid $1,500 in deductible and co-insurance, and her health insurer paid $6,000.
Because of the “Paid or Incurred” law (passed in 2003 as HB4), Faye may only recover $7,500 (the amounts she or her health insurer “paid or incurred”) from Mega, Inc. In other words, Faye paid for the discount when she bought health insurance, and then paid for it again in her lawsuit. Mega, Inc., receives the benefit of the discount in court.
The Supreme Court of Texas recently upheld HB4, in Haygood v. Escobedo, and further ruled that evidence of the actual charges is inadmissible in a trial.
For over 120 years, the “Collateral Source Rule” has prevented wrongdoers from profiting from benefits, such as life or health insurance, purchased by or for the benefit of a plaintiff. HB4 and Haygood v. Escobedo turn that rule on its ear. In a contortion that would make Houdini proud, the Court ruled that parties must now manufacture or hide evidence to keep the jury from learning about the existence of health insurance (which is still inadmissible) and the resulting discount, so that the Collateral Source Rule remains intact.
HB4 was repealed in 2005, only to be vetoed by Gov. Perry. While the repeal vote was nearly unanimous, the veto came too late for the legislature to act to override the veto.
No one who is victimized by the negligence of another, regardless of whether the defendant is Mega, Inc., or an individual covered by liability insurance, should have to pay twice for health insurance. What has happened to Faye should not happen to anyone.
This is equally true when the health insurance is an employee benefit. That benefit is not given by the employer; it is earned by the employee.
Maybe the Texas Legislature will have a different look after 2012, and HB4 can once again be repealed.