Inability to Pay for Medical Treatment: Is This Admissible?

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I heard recently that a trial court granted a defense motion for a mistrial because a plaintiff inadvertently mentioned they had no health insurance.

How bad is this? Is a mistrial really mandated by the rules? Let’s take a look at some of the applicable provisions:

Rule 411. Liability Insurance

Evidence that a person was or was not insured against liability is not admissible upon the issue whether the person acted negligently or otherwise wrongfully. This rule does not require the exclusion of evidence of insurance against liability when offered for another purpose, such as proof of agency, ownership, or control, or bias or prejudice of a witness.

Health insurance is not “liability insurance”. The judge would appear to be dead wrong if this was the reason for the mistrial. Even liability insurance may be admissible when offered for another purpose.

Likewise, this evidence would not violate the collateral source rule. The relevant statute codifying the collateral source rule provides:

IC 34-44-1-2
Personal injury or wrongful death actions; admissibility of evidence

Sec. 2. In a personal injury or wrongful death action, the court shall allow the admission into evidence of:
(1) proof of collateral source payments other than:
(A) payments of life insurance or other death benefits;
(B) insurance benefits that the plaintiff or members of the plaintiff’s family have paid for directly; or
(C) payments made by:
(i) the state or the United States; or
(ii) any agency, instrumentality, or subdivision of the state or the United States;
that have been made before trial to a plaintiff as compensation for the loss or injury for which the action is brought;
(2) proof of the amount of money that the plaintiff is required to repay, including worker’s compensation benefits, as a result of the collateral benefits received; and
(3) proof of the cost to the plaintiff or to members of the plaintiff’s family of collateral benefits received by the plaintiff or the plaintiff’s family.

Assume, your client said they have NO HEALTH INSURANCE. The statute does not prohibit this. The collateral source rule protects the Plaintiff anyway, not the Defendant. The only colorable argument that could be made by a defense attorney, is that this is an appeal to prejudice or sympathy in violation of I.R.E. 403. This rule of evidence provides:

Rule 403. Exclusion of Relevant Evidence on Grounds of Prejudice, Confusion, or Undue Delay

Although relevant, evidence may be excluded if its probative value is substantially outweighed by the danger of unfair prejudice, confusion of the issues, or misleading the jury, or by considerations of undue delay, or needless presentation of cumulative evidence.

The financial status of the parties is generally not admissible. Koger v. Reid, 417 N.E.2d 1142 (Ind. App. 1991). However, the lack of insurance should be admissible to explain why he was no longer obtaining medical treatment and would explain away that issue. Such evidence would prevent the jury from thinking that the gap in treatment or the reason she quit seeing a doctor was because she had fully recovered. In Bumble v. Wal-Mart Stores, Inc., 407 F.3d 823, 826 (7th Cir. 2005). The trial court granted a motion in limine by the defense preventing the Plaintiff from stating or implying he had not not sought treatment for a period of time or has not undergone recommended treatment due to a lack of health insurance and financial situation unless the defendant first opened the door making it admissible.
The Court of Appeals held this ruling was not an abuse of the trial court’s discretion.

In practice, an appropriate limiting instruction should have sufficed so the evidence is used only for an appropriate and limited purpose. A mistrial is a harsh remedy unless the Court had granted an order in limine specifically on this topic. Nonetheless, it would make sense to notify the Court of your position on this topic outside the presence of the jury in order to avoid a harsh ruling and a possible mistrial.>

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About Richard A. Cook

Richard Cook graduated from Purdue University in the Economics Honor Program in 1979 and obtained his Juris Doctor degree from Valparaiso University School of Law in 1982. Following law school, Richard served as a federal law clerk in the U.S. District Court for the Northern District of Indiana, Hammond Division. In 1984, Richard began working as Deputy Prosecutor for the Lake County Prosecutor's Office and from there, served as Assistant U. S. Attorney for the Northern District of Indiana, South Bend Division. There he handled a number of complex criminal matters and jury trials. While there, Richard received the Chief Postal Inspector's Special Award and a letter of commendation from the U.S. Attorney General for his work prosecuting a major money order fraud scheme being perpetrated out of the Indiana State Prison system. Since leaving the U.S. Attorney's office in 1989, Richard has focused primarily on civil work and is currently a member of the firm Yosha Cook & Tisch in Indianapolis. Richard is also a member of the ITLA, IBA and the ABA, as well as, a fellow for the American College of Trial Lawyers. He is AV rated by Martindale-Hubbell.

Posted on April 4, 2014, in Uncategorized. Bookmark the permalink. Leave a comment.

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