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Name: People v. Bergin
Case #: B200999
Court: CA Court of Appeal
District 2 DCA
Division: 8
Opinion Date: 10/27/2008

Victim restitution for medical expenses should be based on the amount paid by the victim’s insurance, rather than the amount billed by the health care provider, if that amount fully reimburses the victim for her economic losses. In this People’s appeal, the prosecution argued that direct victim restitution should have been ordered at the amount billed by the victim’s medical providers rather than the amount the providers accepted from the insurance company, plus the deductible paid by the victim. The appellate court rejected the argument. It noted the only question was whether the victim had been fully reimbursed for all incurred economic losses. Here, the victim’s medical providers agreed to accept the amount her insurance paid on her behalf, and neither the victim, nor her insurer expended more money than the trial court ordered. The Court of Appeal noted trial court properly relied on Hanif v. Housing Authority (1988) 200 Cal.App.3d 635, for the proposition that an injured plaintiff may not recover from a tortfeasor more than the amount actually paid for medical services, or for which liability was incurred, even though that is a civil case because the Supreme Court has done the same thing. (See People v. Giordano (2008) 42 Cal.4th 644.) Finally, the court distinguished People v. Hove (1999) 76 Cal.App.4th 1266, where the trial court ordered restitution in the amount of the claims billed because, in that case the victim was left completely incapacitated and in a vegetative state, and the Hove court recognized he would incur continuing, long-term care costs as a result.