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In re Marc L.

California Court of Appeals, Third District, El Dorado
Apr 2, 2008
No. C055943 (Cal. Ct. App. Apr. 2, 2008)

Opinion


In re MARC L., a Person Coming Under the Juvenile Court Law. THE PEOPLE, Plaintiff and Respondent, v. MARC. L., Defendant and Appellant. C055943 California Court of Appeal, Third District, El Dorado April 2, 2008

NOT TO BE PUBLISHED

Super. Ct. No. PDL20050187

BLEASE, Acting P. J.

The minor, Marc L., appeals from the postjudgment order to pay $110,006.40 in victim restitution. (Welf. & Inst. Code, § 730.6.) He challenges the amount of the order, claiming it should be offset by (1) the amount of the debt written off by the provider and (2) the amount to be paid to the victim by the insurance carrier that insured the minor.

All further section references are to the Welfare and Institutions Code unless otherwise specified.

The minor’s mother appeals from the restitution order to the extent it makes her jointly and severally liable for $25,000 and contends her liability should also be off-set by the amount paid by her insurance carrier.

We agree with the minor that his restitution obligation must be offset by the amount of the debt written off by the provider. We shall therefore reverse the trial court’s order for victim restitution and direct that it be reduced to $36,856.33.

We do not reach the minor’s other claim or that of his mother because the record fails to show the parties have reached a civil settlement agreement and that the victim received payment from mother’s insurance carrier. Any opinion therefore would be purely advisory.

PROCEDURAL AND FACTUAL BACKGROUND

Because the minor admitted the allegations of the petition, the facts have been taken primarily from the probation report.

On October 4, 2005, the minor was driving his mother’s car on South Shingle Road with 16-year-old Kayleigh B. (the victim) as his passenger. He was traveling approximately 100 miles per hour when he approached a 30 mile-per-hour curve and lost control of the vehicle, causing it to roll over multiple times and crash. The minor “blanked out” but reported no injuries. Kayleigh B. however received multiple serious injuries, including memory loss, a severe concussion, broken wrist, and fracture of the second vertebrae. The impact of her injuries included severe pain, numbness in her hand, inability to concentrate, emotional distress, and potential loss of cognitive skills.

A juvenile wardship petition (§ 602) was filed alleging the minor committed the crime of reckless driving with bodily injury. (Veh. Code, § 23104, subd. (a).) The minor admitted the allegations and was ordered to serve 60 days in the juvenile hall and pay a $50 restitution fine.

The case was affirmed on appeal in Case No. C052145.

At the victim restitution hearing the evidence showed that Sutter-Roseville Hospital (Sutter or the provider) had billed the victim’s family $84,656.07 for medical care, the victim’s family applied for and was granted Medi-Cal benefits and paid Sutter a Medi-Cal copay of $6,427, and Sutter wrote off the unpaid balance ($79,577.07) as a bad debt. The victim’s family was left with an undisposed balance of $30,429.33 owed to the other providers.

NCO Financial Systems, Inc. asserted a lien on behalf of Sutter in the amount of $83,495.07 (Civ. Code, § 3045.1) and subsequently withdrew the lien.

The minor’s mother carried vehicle insurance provided by Safeco Insurance Company of America (Safeco), which named the mother as the sole rated driver. Counsel for Kayleigh B. advised the court that the total amount of the medical expenses had not been finally determined and that this is a case of continuing injuries involving additional treatment.

The minor argued that he was entitled to receive credit against the $110,006.40 for the amount written off by Sutter ($79,577.07) as bad debt and for any payments made to the victim by his mother’s insurance carrier.

The juvenile court issued a written decision finding the minor owes the victim $110,006.40 in restitution and that he and his mother are jointly and severally liable for $25,000 of that amount. (Civ. Code, § 1714.1.) The trial court based its decision on three main considerations, (1) the deterrent and rehabilitative purposes of victim restitution, (2) People v. Birkett (1999) 21 Cal.4th 226, in which the Supreme Court made clear that in determining the amount of restitution, the trial court must not consider whether the victim has or will be reimbursed by third parties, and (3) the juvenile court’s own inability “to determine the legal or practical ramifications of the fact that the hospital may have decided to write off as a bad debt a large amount of the medical expenses involved herein.” The court therefore concluded that while section “14019.4 may prevent Sutter Hospital from collecting from a Medi-Cal recipient because he is indigent, this has no bearing on the minor’s obligations or third party insurers.”

DISCUSSION

I.

The Provider’s Cancelled Debt

The minor contends his victim restitution obligation should be offset by the amount of the debt written off by Sutter as a bad debt. Respondent attempts to distinguish this court’s recent decision in In re Anthony M. (2007) 156 Cal.App.4th 1010 (hereafter Anthony M.) and argues that an offset is improper where as here the provider did not accept a reduced payment from Medi-Cal as “payment in full” but rather elected to temporarily write off the unpaid balance as a “bad debt.” We find the minor has the better argument.

Although an order of restitution will not be overturned in the absence of an abuse of discretion (People v. Fortune (2005) 129 Cal.App.4th 790, 794), an abuse of discretion will be found when the court’s order rests upon a “‘demonstrable error of law.’” (People v. Draut (1999) 73 Cal.App.4th 577, 581, quoting In re S.S. (1995) 37 Cal.App.4th 543, 550.)

Section 730.6, subdivision (a)(1) declares that “[i]t is the intent of the Legislature that a victim of conduct for which a minor is found to be a person described in Section 602 who incurs any economic loss as a result of the minor's conduct shall receive restitution directly from that minor.” Economic loss includes medical expenses. (§ 730.6, subd. (h)(2).)

In determining the amount of the victim’s economic loss, subdivision (h) of section 730.6 states the measure of restitution. It “shall be imposed in the amount of the losses, as determined. . . . A restitution order . . . shall be of a dollar amount sufficient to fully reimburse the victim or victims for all determined economic losses incurred as the result of the minor's conduct for which the minor was found to be a person described in Section 602 . . . .” (Italics added.)

The purpose of victim restitution is to make the victim whole, rehabilitate the minor, and deter future delinquent behavior by the juvenile and others. (In re Brittany L. (2002) 99 Cal.App.4th 1381, 1387.) Consistent with the statutory language and purpose, the restitution order must be in an amount sufficient to fully reimburse the victim for economic losses incurred as a result of the juvenile’s criminal conduct without regard to potential reimbursement to the victim from sources distinct and independent of the defendant (People v. Bernal (2002) 101 Cal.App.4th 155, 166), such as payment by the victim’s private insurance carrier (People v. Birkett, supra, 21 Cal.4th at p. 246; In re Brittany L., supra, 99 Cal.App.4th at p. 1389) or by Medi-Cal. (People v. Hove (1999) 76 Cal.App.4th 1266, 1272.)

In the civil context, this principle is known as the collateral source doctrine. (Lund v. San Joaquin Valley Railroad (2003) 31 Cal.4th 1, 8 [If an injured plaintiff receives compensation for the injury from a collateral source such as an insurance carrier, that payment is not deducted from the damages the plaintiff may collect from the tortfeasor in a personal injury action].)

However, because the victim is not entitled to receive a windfall (People v. Fortune, supra, 129 Cal.App.4th at pp. 794-795; People v. Thygesen (1999) 69 Cal.App.4th 988, 995), this court recently held that the amount of a victim restitution order is limited to the amount of the loss actually incurred by the victim. (Anthony M., supra, 156 Cal.App.4th at p. 1015.) In Anthony M., the victim was a Medi-Cal recipient who received medical care from a provider that submitted charges of $1,056,600.94 but accepted partial payment from Medi-Cal as payment in full. We held that victim restitution for the victim’s medical expenses is limited to the amount actually paid by Medi-Cal rather than the amount billed by the provider. This is because the victim recipient is not liable to the provider for the unpaid balance. Instead, his liability for medical expenses is limited to reimbursing Medi-Cal for the amount it paid the provider. (Id. at pp. 1018-1019; §§ 14019.3, subd. (d), 14019.4, subd. (a); Olszewski v. Scripps Health, supra, 30 Cal.4th at p. 820.) Because Medi-Cal had only made partial payment at the time of the restitution hearing, we remanded the matter to determine the full amount Medi-Cal paid the provider.

Medi-Cal, California’s medical assistance program, pays medical costs for financially needy persons. (Olszewski v. Scripps Health (2003) 30 Cal.4th 798, 804.)

Similarly, because the victim in this case was a Medi-Cal recipient, she did not become liable to the provider for medical expenses. When a Medi-Cal recipient presents his or her Medi-Cal card or other proof of eligibility, the “provider shall submit a Medi-Cal claim for reimbursement” (§ 14019.3, subd. (c)) and “payment received from the state in accordance with Medi-Cal fee structures shall constitute payment in full . . . .” (§ 14019.3, subd. (d).) Moreover, a provider that has received proof of Medi-Cal eligibility by one of its patients is precluded from seeking reimbursement or attempting “to obtain payment for the cost of those covered health care services from the eligible applicant or recipient, or any other person other than the Department of Health Services. (§ 14019.4, subd. (a), see also § 14019.3, subd. (d); Olszewski v. Scripps Health, supra, 30 Cal.4th at p. 820.)

Anthony M., supra, 156 Cal.App.4th 1010 is dispositive. As stated, the undisputed evidence shows the victim was a Medi-Cal recipient, Sutter submitted charges of $84,656.07 for its services, the victim’s family paid Sutter a Medi-Cal copay of $6,427, and Sutter wrote off as a bad debt the remaining balance of its charges ($79,577.07). The fact Sutter made a business decision to write off the unpaid balance does not change its rights and obligations under the law. Evidence that it received the victim’s Medi-Cal co-payment raises an inference it also received proof of her Medi-Cal eligibility. Once that proof was received, Sutter was precluded from seeking reimbursement from the victim or her family for the cost of the covered health care services. (§ 14019.4, subd. (a).)

Moreover, while Medi-Cal may seek reimbursement from a recipient or other responsible party for the amount it paid the provider (42 U.S.C. §§ 1396a, subd. (a)(25)(B), (a)(45), 1396k, subd. (a)(1)(A), (b); Anthony M., supra, 156 Cal.App.4th at pp. 1018-1019), where as here Medi-Cal makes no payment to the provider, the predicate for reimbursement fails to occur. As a result, the state has no basis upon which to seek reimbursement and the victim’s liability for Medi-Cal covered expenses never arises.

Therefore, to compensate the victim for the cost of the medical expenses actually incurred, the restitution order may only compensate the victim for the amount her family paid to Sutter ($6,427) and for the medical expenses owed to the other health care providers ($30,429.33). Since that sum is substantial and will remain collectable into the minor’s adult life (In re Michael S. (2007) 147 Cal.App.4th 1443, 1456-1457), the order will continue to serve the salutary purposes of rehabilitation and deterrence. Accordingly, we shall direct that the order of restitution be reduced to $36,856.33.

II.

Credit For Payments To Be Made by

Mother’s Insurance Carrier

The minor and his mother both seek a decision from this court directing the juvenile court to offset their liability by the amount to be paid by mother’s insurance carrier at some later date. Respondent concedes mother has standing to appeal and that her claim is valid.

Respondent argues that the minor’s claim for an insurance offset has no merit. (But see People v. Jennings (2005) 128 Cal.App.4th 42 .)

Respondent properly concedes mother has standing under In re Michael S., supra, 147 Cal.App.4th 1443, which held that a parent has standing to appeal a juvenile court’s disposition order holding the parent of a minor jointly and severally liable for victim restitution. (Id. at pp. 1448-1449; see also In re Jeffrey M. (2006) 141 Cal.App.4th 1017, 1021.)

See In re Michael S., supra, 147 Cal.App.4th 1443, which held that acceptance by the victim of a settlement payment from the parent’s insurer in full release of all tort claims against the parent precludes her liability for victim restitution under section 730.7.

We may not issue a purely advisory opinion or consider a hypothetical state of facts in order to give general guidance rather than to resolve a specific legal dispute. (Hunt v. Superior Court (1999) 21 Cal.4th 984, 998.) Since the record fails to show the parties have reached a settlement agreement, we decline to reach either the minor’s claim or mother’s claim because both claims are based upon facts yet to be determined.

DISPOSITION

The order for victim restitution is reversed. The juvenile court is directed to modify its order by reducing the amount of restitution owed by the minor to $36,856.33. In all other respects, the order of restitution is affirmed.

We concur: BUTZ, J., CANTIL-SAKAUYE, J.


Summaries of

In re Marc L.

California Court of Appeals, Third District, El Dorado
Apr 2, 2008
No. C055943 (Cal. Ct. App. Apr. 2, 2008)
Case details for

In re Marc L.

Case Details

Full title:THE PEOPLE, Plaintiff and Respondent, v. MARC. L., Defendant and Appellant.

Court:California Court of Appeals, Third District, El Dorado

Date published: Apr 2, 2008

Citations

No. C055943 (Cal. Ct. App. Apr. 2, 2008)