Lopez v. Daimler Chrysler Corp.

179 Cal. App. 4th 1373, 102 Cal. Rptr. 3d 285, 2009 Cal. App. LEXIS 1968
CourtCalifornia Court of Appeal
DecidedNovember 5, 2009
DocketC058592
StatusPublished
Cited by8 cases

This text of 179 Cal. App. 4th 1373 (Lopez v. Daimler Chrysler Corp.) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lopez v. Daimler Chrysler Corp., 179 Cal. App. 4th 1373, 102 Cal. Rptr. 3d 285, 2009 Cal. App. LEXIS 1968 (Cal. Ct. App. 2009).

Opinion

Opinion

RAYE, J.

At age seven, plaintiff Ruben Lopez suffered permanent brain damage in a rear-end freeway accident. Lopez filed suit against several car manufacturers that produced the car Lopez rode in at the time of the accident. Lopez settled his suit for $2 million.

*1376 Between the accident and the subsequent settlement, defendant State Department of Health Care Services (Department) paid for Lopez’s medical expenses in the amount of $547,680.08. Pursuant to Welfare and Institutions Code section 14124.76, the trial court reduced the Department’s lien for medical expenses paid to $63,216.69. The Department appeals, arguing the court improperly placed the burden on it to establish the portion of the settlement that was allocated to medical expenses and erred in reducing the Department’s lien. We shall affirm the judgment.

FACTUAL AND PROCEDURAL BACKGROUND

On September 1, 2003, Lopez suffered serious injuries in an automobile accident. Lopez was sitting in the backseat of a Chrysler Sebring coupe when it was struck by a Chevrolet Trailblazer. As a result of the accident Lopez is permanently brain damaged.

The following year, Lopez filed a products liability suit against several car manufacturers (collectively referred to as DaimlerChrysler). DaimlerChrysler alleged comparative fault on Lopez’s part stemming from his failure to properly wear his seatbelt. Lopez tentatively settled his suit for $2 million in December 2006, pending approval of a minor’s compromise.

From the date of the accident to January 2007, the Medi-Cal program paid $547,680.08 to treat Lopez’s injuries. As required by Welfare and Institutions Code section 14124.72, subdivision (d), 1 the Department reduced its lien by 25 percent, representing the Department’s share of Lopez’s attorney fees and litigation costs. After the reduction, the lien totaled $367,768.47.

Pursuant to the settlement, Lopez filed a petition to approve the compromise of a disputed claim of a minor (minor’s compromise) and a motion to expunge and/or reduce the Medi-Cal lien. Lopez notified the Department of the motions.

On April 9, 2007, at a minor’s compromise hearing, the trial court approved the settlement of Lopez’s personal injury suit. On July 6, 2007, the trial court heard Lopez’s motion to expunge and/or reduce the Medi-Cal lien.

*1377 Lopez argued the Department’s lien ran afoul of Arkansas Dept, of Health and Human Servs. v. Ahlborn (2006) 547 U.S. 268 [164 L.Ed.2d 459, 126 S.Ct. 1752] (Ahlborn) by attempting to collect more than that portion of the settlement that constituted reimbursement for past medical payments. The Department contended Ahlborn did not adopt a universal formula for determining the amount of a Medicaid lien that is recoverable from the settlement of a beneficiary’s third party lawsuit.

On July 26, 2007, the trial court denied Lopez’s motion, concluding Ahlborn did not establish a mandatory formula for reducing a Medi-Cal lien. Effective August 24, 2007, the California Legislature amended section 14124.76, expressly incorporating the Ahlborn decision. (Stats. 2007, ch. 188, § 71.)

Following the effective date of the amendment to section 14124.76, Lopez filed a renewed motion and a motion to reconsider under Code of Civil Procedure section 1008, subdivisions (b) and (c). The trial court granted Lopez’s motion.

The trial court determined that the recent amendment to section 14124.76 provided an appropriate framework to determine the amount of the outstanding lien. The court directed the parties to attempt to agree to a determination as to what portion of Lopez’s settlement represented payment for medical expenses on his behalf. If the parties failed to reach agreement, either party could seek a resolution by filing a motion under section 14124.76.

The parties failed to agree on the medical expense allocation, and Lopez filed a new motion to reduce the lien. 2 In conjunction with his motion, Lopez offered a declaration by Deborah L. Doherty, M.D., director of neurological rehabilitation at Kentfield rehabilitation hospital, who provided an estimate of Lopez’s lifetime medical needs and life expectancy. Lopez also provided a life care plan by a certified nurse life care planner that estimated Lopez’s future lifetime medical costs, and a letter from a certified public accountant that provided an estimate of Lopez’s future loss of earning capacity. The total economic damages were estimated at $11,635,132.82. The Department did not offer any evidence in rebuttal.

The trial court issued a tentative ruling, stating: “No later than January 11, 2008, [the Department] shall file and serve a supplemental brief supporting its *1378 request the [sic] the court determine Plaintiff’s settlement attributable to payments for medical expenses to be $350,000 or offering an alternative method by which the Court should determine that amount.”

Following further briefing, the trial court ruled: “Section 14124.76(a) limits [the Department’s] recovery to the past medicals portion of the settlement, in accordance with the Ahlborn decision. Unlike Ahlborn, however, the parties in the present case have not stipulated to the past medicals portion or to a method by which that amount can be determined. While the Supreme Court recognized in Ahlborn that its mling could create difficulties in determining the past medicals portion of tort settlements, it noted that such difficulties could be alleviated by state-adopted rules and procedures for allocating settlements where the state’s right to recovery is at issue. [Citation.] No such rales have been adopted by California; § 14124.76(a) charges the Court with determining the past medicals portion but provides merely that the Court is to be ‘guided’ by Ahlborn in determining that amount.”

The trial court considered Lopez’s contention that the Department is entitled to only $37,767.54 under the formula enunciated in Ahlborn. Under Lopez’s calculation, the settlement amount is divided by the total value of his case, unreduced by potential comparative fault. The resulting percentage is multiplied by the total lien amount to obtain the past medicals portion. The court noted Lopez presented evidence of economic damages of $11,635,132.82,.but also noted that Lopez failed to support his claim that his case had a total value of $20 million. Lopez calculated the Department was entitled to a lien of $37,767.54.

The trial court found the Department failed to provide any evidence refuting Lopez’s evidence of damages or an alternative method for determining the past medicals portion “despite being given several attempts to do so.” The court concluded: “Consequently, the Court finds that it is reasonable to apply the formula used in Ahlborn, as requested by Plaintiff.”

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Cite This Page — Counsel Stack

Bluebook (online)
179 Cal. App. 4th 1373, 102 Cal. Rptr. 3d 285, 2009 Cal. App. LEXIS 1968, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lopez-v-daimler-chrysler-corp-calctapp-2009.