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Tag Archives: medical expenses

Workers’ Compensation – Medical Expenses – California Hospitalization – Usual, Customary & Reasonable Charges (access required)

Smith v. Lee Construction The defendant-insurer failed to show that it was a party to a preferred provider agreement with the intervenor-hospital. Since the N.C. fee schedule does not apply and there is insufficient evidence of a contractual fee agreement, based on our Medical Fees Section’s determination that the entire balance of $891,904.32 is owed, the Industrial Commission concludes that the $891,904.32 balance represents the usual, customary, and reasonable charges for the services provided to plaintiff by the California hospital.

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Workers’ Compensation – Causation – Pre-Existing Condition – Aggravation – Medical Expenses (access required)

Wells v. Coastal Cardiology Associates Plaintiff’s doctors both testified that her pre-existing condition was exacerbated by her fall at work, necessitating surgery, and both doctors said they could not apportion plaintiff’s current condition between her pre-existing condition and the fall. This evidence supports the Industrial Commission’s order that defendants pay for plaintiff’s surgery. We affirm the Commission’s award of medical expenses.

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Tort/Negligence – Personal Injury – Damages – Medical Expenses – Stipulation – Causation – Civil Practice – Offer of Judgment – Expenses (access required)

Martin v. OSI Restaurant Partners, LLC Even though the parties stipulated “that the past medical expenses of Plaintiff in this case total $110,000.00,” the parties did not stipulate that those expenses were a result of defendants’ negligence. Since defendants presented evidence that only some of those expenses arose out of the accident in defendants’ restaurant, the evidence supports the jury’s award of $5,500 in damages.

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Domestic Relations – Separation Agreement – Contract – Specific Enforcement – Medical Expenses – Assisted Living Facility (access required)

Bryan v. Mattick In the parties’ separation agreement, the defendant-husband agreed to pay the plaintiff-wife’s medical expenses indefinitely, knowing she was suffering from progressive multiple sclerosis. Now that the wife is unable to live on her own, the husband is responsible for paying her expenses at an assisted living facility, minus her ordinary living expenses. We affirm the trial court’s order requiring the husband to reimburse the wife $2690 per month plus $41,476 in prior unreimbursed medical expenses. We remand for clarification of one expense item.

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Tort/Negligence – Motor Vehicle Accident – Damages – Motorcycle Repair Costs – Medical Expenses – Pain & Suffering – Rule 68 Offer of Judgment – Costs (access required)

Smith v. White Even though defendant paid for repairs to plaintiff’s motorcycle before trial, the cost of the repairs was admissible as some evidence of the difference in the value of the motorcycle before the accident and immediately after the accident. Since the trial court did not allow plaintiff to present such evidence, the court correctly granted plaintiff a new trial on the issue of diminution of the value of his motorcycle. We affirm the trial court’s (1) grant of plaintiff’s motion for a new trial as to the value of his motorcycle, (2) denial of plaintiff’s motion for a new trial based on the jury’s alleged compromise verdict, and (3) award of costs to defendant.

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