Pebley v. Santa Clara OrganicsAnnotate this Case
An insured plaintiff who has chosen to be treated with doctors and medical facility providers outside his insurance plan shall be considered uninsured, as opposed to insured, for the purpose of determining economic damages. The Court of Appeal held that the trial court properly allowed the plaintiff in this case, as a plaintiff who is treating outside his insurance plan, to introduce evidence of his medical bills. The trial court also permitted defendants to present expert testimony that the reasonable and customary value of the services provided by the various medical facilities was substantially less than the amounts actually billed. The jury rejected the expert evidence and awarded plaintiff the billed amounts. The court held that defendants have not demonstrated error except with respect to two charges regarding the amounts billed by Ventura County Medical Center and American Medical Response. Accordingly, the court reduced the damage award and affirmed the judgment as modified.