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The Reasonability Rule for Medical Damages in Tort: In Defense of Chargemaster Recovery

Abstract: In a personal injury suit, Washington law requires the plaintiff to prove that their medical costs are reasonable to recover damages for those costs. Tort reform proponents attempt to use this reasonability rule to limit tort damages awards. They argue that a plaintiff should only recover a portion of a hospital’s bill because most people do not pay a hospital’s sticker price—or the “chargemaster rate”—for medical care. Some reformers argue that recovery rates should instead be based on a set figure. Others argue in favor of eliminating the collateral source rule, which prohibits juries from reducing tort damages awards in light of plaintiffs’ insurance coverage. The critics share a common belief: that chargemaster rates are not an accurate measure of damages.

This Comment defends the use of chargemaster rates by juries in determining damages awards. A hospital may always charge patients its chargemaster rate, so any limit on recovering the chargemaster rate places plaintiffs at risk of incurring medical debt as a result of necessary medical care secondary to an injury. The problem lies not with the tort damages system, but with unregulated and skyrocketing medical costs. Legislative action preventing providers from billing at their chargemaster rate or other safeguards that ensure plaintiffs cannot lose their recoveries to medical bill repayment could combat this problem. But, barring such actions, courts should interpret the reasonable rate of medical billing to be the hospital’s chargemaster rate.

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