This paper focuses on damages a plaintiff can recover for past medical expenses in personal injury cases in Texas courts.[1] We note damages for future medical expenses raise different issues and that discussion is outside the scope of this paper. To recover for past medical expenses in a Texas personal injury case, the plaintiff must prove the past medical expenses were medically necessary due to the injury that is the subject of the litigation. The plaintiff must also prove the reasonable value of the past medical expenses. We discuss how the courts define reasonable value. We then discuss the discovery courts permit from plaintiffs, their health care providers, and health plans to determine reasonable value. While plaintiffs have a duty to mitigate damages by timely seeking reasonable medical treatment, no Texas court has to date ruled they have a duty to mitigate damages by using their insurance coverage. We discuss the interaction between mitigation of cost and the reasonable value limits on the amount a plaintiff may recover. We discuss how Texas Senate Bill (SB) 1264 and the federal No Surprises Act may affect the determination of reasonable value in personal injury cases. Lastly, we discuss how Texas Civil Practice and Remedies Code (TCPRC) §18.001 affects the recovery of past medical expenses.
[1] Dana Cottone, LLB, MRes, provided substantial research assistance for this paper, and her help is gratefully acknowledged.