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Published online by Cambridge University Press: 27 January 2021
Many states have enacted medical malpractice reforms, recognizing that their tort systems result in protracted litigation, high costs, and a large number of uncompensated victims. One proposed reform, an “early offer” system, allows a medical provider to make a financial offer covering an injured patient’s economic damages, which, if the patient accepts, precludes litigation. However, if a patient rejects an offer, he will face a higher burden of proof at trial. The early offer system seeks both to assure claimants receive prompt compensation for their economic damages, and to save insurers and providers litigation expenses and unreasonable damage payments.
1 Jeffrey OConnell, The Largest Cost Savings and Other Advantages of an Early Offer Crimtorts Approach to Medical Malpractice Claims, 17 WIDENER L.J. 835, 835-36 (2008).
2 Id. at 836.
3 Id. The burden of proof after a patient rejects an offer will be higher than if they had gone to trial without the offer.
4 Id.
5 Bill Smith, Legislature Overrides Lynch on Tort Reform, UNION LEADER, June 27, 2012, http://www.unionleader.com/article/20120627/NEWS06/120629692.
6 See N.H. REV. STAT. ANN. 519-C:1-2 (2012).
7 S.B. 406, 2012 Gen. Assemb., Reg. Sess. (N.H. 2012).
8 See N.H. REV. STAT. ANN. 519-C:2.
9 Id.
10 Id. 519-C:3
11 Id.
12 Id. 519-C:2.
13 Id.
14 Id. 519-C:1-2.
15 Id. 519-C:2.
16 Id.
17 See OConnell, supra note 1, at 836.
18 See discussion infra Part IV.
19 See discussion infra Part V.
20 Jeffrey OConnell et al., An Economic Model Costing Early Offers Medical Malpractice Reform: Trading Noneconomic Damages for Prompt Payment of Economic Damages, 35 N.M. L. REV. 259, 259 (2005).
21 See Jeffrey OConnell & James F. Neale, HMOs, Cost Containment, and Early Offers: New Malpractice Threats and A Proposed Reform, 14 J. CONTEMP. HEALTH L. & POL'Y 287, 295-98 (1998).
22 See id. at 295.
23 Joanna Shepherd, Justice in Crisis: Victim Access to the American Medical Liability System 7 (Emory Univ. Sch. Law, Legal Studies Research Paper No. 12-222, 2012), available at http://dx.doi.org/10.2139/ssrn.2147915.
24 Russell Localio et al., Relation Between Malpractice Claims and Adverse Events Due to Negligence: Results of the Harvard Medical Practice Study III, 325 NEW ENG. J. MED. 245, 248 (1991).
25 Shepherd, supra note 23, at 3.
26 Id.
27 Id. at 13.
28 Id. at 8.
29 Id. at 4.
30 OConnell, supra note 1, at 835.
31 Shepherd, supra note 23, at 8.
32 Id.
33 Id. at 3-4.
34 Id. at 9.
35 Id. at 3.
36 Michelle M. Mello et al., National Costs of the Medical Liability System, 29 HEALTH AFF. 1569, 1570 (2010). The 55.6 billion dollar amount is in 2008 dollars.
37 Jeffrey OConnell, Offers That Can't Be Refused: Foreclosure of Personal Injury Claims by Defendants Prompt Tender of Claimants Net Economic Losses, 77 NW. U. L. REV. 589 (1982).
38 Id. at 601-02.
39 See id. at 601 (I propose a statute that would give a defendant the option of foreclosing such claim by offering to pay the claimant's net economic loss. (emphasis added)).
40 Id.
41 For example, the claimant would face a higher burden of proof at trial and would have to pay the defendant's attorneys fees. Bernard S. Black et al., The Effects of Early Offers in Medical Malpractice Cases: Evidence from Texas, 6 J. EMPIRICAL LEGAL STUD. 723, 724 (2009).
42 OConnell, supra note 21, at 310.
43 W. Henson Moore & John S. Hoff, H.R. 3084: A More Rational Compensation System for Medical Malpractice, 49 LAW & CONTEMP. PROBS. 117, 118 (1986).
44 J. Brandon Giuda, What New Hampshire's Early Offer Law Really Does, UNION LEADER, July 11, 2012, http://www.unionleader.com/article/20120712/OPINION02/707129912.
45 Handlin's Early Offer Medical Malpractice Reform Saves Time, Money, & Hassel for Doctors & Patients, POLITICKERNJ (Oct. 2, 2012), http://www.politickernj.com/60110/handlin-s-early-offer-medical-malpractice-reform-saves-time-money-hassle-doctors-patients.
46 Joni Hersch et al., An Empirical Assessment of Early Offer Reform for Medical Malpractice, 36 J. LEGAL STUD. S231, S236 (2007) [hereinafter Hersch et al., Empirical Assessment].
47 Id. at S255-56.
48 Id. at S256.
49 JONI HERSCH ET AL., U.S. DEP't OF HEALTH & HUMAN SERVS., EVALUATION OF EARLY OFFER REFORM OF MEDICAL MALPRACTICE CLAIMS: FINAL REPORT 1 (2006), available at http://aspe.hhs.gov/daltcp/reports/2006/medmalcl.htm.
50 Hersch et al., Empirical Assessment, supra note 46, at S256.
51 HERSCH ET AL., supra note 49, at 4.
52 Id.
53 Id.
54 See Black, supra note 41, at 724 (noting a substantial overlap between the cases in which an early offer program will reduce payouts and the cases in which a cap on noneconomic damages already does so).
55 Hersch et al., Empirical Assessment, supra note 46, at S256.
56 Black, supra note 41, at 724-25.
57 Id. Hersch et al. replied to Black et al.'s critique, challenging their assumptions and asserting that Black misunderstood the early offer proposal. See Black, supra note 41; Joni Hersch et al., Reply to The Effects of Early Offers in Medical Malpractice Cases: Evidence from Texas, 7 J. EMPIRICAL LEGAL STUD. 164 (2010). In response, Black defended his assumptions and analysis. See Bernard S. Black et al., OConnell Early Settlement Offers: Toward Realistic Numbers and Two-Sided Offers, 7 J. EMPIRICAL LEGAL STUD. 379 (2010).
58 These different assumptions could include things like the proportion of paid damages that are noneconomic damages, for example. Id.
59 OConnell, supra note 21, at 312.
60 Id.
61 This overdeterrence could, for example, cause excessive spending on medical care that provides insufficient safety benefits. Shepherd, supra note 23, at 3.
62 Press Release, Governor John Lynch, Governor's Veto Message Regarding SB 406 (June 20, 2012); available at http://votesmart.org/public-statement/709973/governors-veto-message-regarding-sb-406.UnLj_3DBN8E.
63 Id.
64 Smith, supra note 5.
65 S.B. 406, 2012 Gen. Assemb., Reg. Sess. (N.H. 2012).
66 Id.
67 Id.
68 Id.
69 Id.
70 Id.
71 Id.
72 Id.
73 Under the law, early offer payment is payment for an injured person's economic loss related to a medical injury, and reasonable attorney fees and costs incurred in representing the injured person. N.H. REV. STAT. ANN. 519-C:2 (2012).
74 Id. 519-C:1.
75 Id. 519-C:7.
76 Id. 519-C:1.
77 Id. 519-C:2.
78 Id.
79 Id.
80 Id.
81 Id. 519-C:3.
82 Id.
83 Id.
84 Id. 519-C:2.
85 Id.
86 Id.
87 See generally id. 519-C:10.
88 Id.
89 Id.
90 Id. 519-C:13.
91 Id. 519-C:2.
92 Id.
93 Id.
94 See generally id. 519-C:13.
95 Id.
96 Id.
97 Id.
98 Id.
99 See Holly B. Haines & William D. Woodbury, The Early Offer Alternative in Medical Malpractice Litigation: A Statutory Trap to Limit Liability, 53 N.H. B.J. 6, 11 (2012).
100 See, e.g., Carson v. Maurer, 424 A.2d 825, 829 (N.H. 1980) (applying intermediate scrutiny to restrictions imposed on the right to recover for personal injuries).
101 N.H. CONST. pt. 1, art. 12.
102 Carson, 424 A.2d at 830.
103 Id. at 829.
104 Id. at 830.
105 Id.
106 Id.
107 Id.
108 Id. at 829-30.
109 Id. at 830 (citing Estate of Cargill v. City of Rochester, 119 N.H. 661, 665 (1979)).
110 Id.
111 Id.
112 Id.
113 Id. at 831 (citing State v. Scoville, 113 N.H. 161, 163 (1973)).
114 Id.; see, e.g., State v. Scoville, 113 N.H. 161, 163 (1973); Allen v. Manchester, 99 N.H. 388, 390-91 (1955); State v. Moore, 91 N.H. 16, 22 (1940).
115 Id.
116 Id. at 838.
117 Id. at 836.
118 Id. at 837 (citing R. Scott Jenkins, California's Medical Injury Compensation Reform Act: An Equal Protection Challenge, 52 S. CAL. L. REV. 829, 960-61 (1979)).
119 Id. at 836.
120 Id. (citation omitted).
121 Id. at 838.
122 Cmty. Res. for Justice, Inc. v. City of Manchester, 917 A.2d 707, 718-21 (N.H. 2007).
123 Id. at 718 (emphasis added).
124 Id. at 721 (quoting United States v. Virginia, 518 U.S. 515, 533 (1996)) (emphasis added).
125 Id.
126 Id.
127 Id.
128 Id.
129 Id.
130 Id. (quoting United States v. Virginia, 518 U.S. 515, 533 (1996)).
131 Id.
132 Carson v. Maurer, 424 A.2d 825, 836 (N.H. 1980).
133 Id.
134 Brannigan v. Usitalo, 587 A.2d 1232, 1236 (N.H. 1991) (citing Carson, 424 A.2d at 837).
135 Id. at 1236; Carson, 424 A.2d at 837.
136 N.H. REV. STAT. ANN. 519-C:1 (2012).
137 Brannigan, 587 A.2d at 1236 (citing Carson, 424 A.2d at 837).
138 N.H. REV. STAT. ANN. 519-C:7.
139 Id.
140 Id. 519-C:1.
141 Id. 519-C:7.
142 Id. 519-C:1; Holly B. Haines & William D. Woodbury, The Early Offer Alternative in Medical Malpractice Litigation: A Statutory Trap to Limit Liability, 53 N.H. B.J. 6, 11, 15 (2012).
143 See Haines & Woodbury, supra note 142, at 15.
144 See id.
145 Id.
146 Amy Widman, Liability and the Health Care Bill: An Alternative Perspective, 1 CAL. L. REV. CIRCUIT 57, 64-65 (2010).
147 N.H. REV. STAT. ANN. 519-C:2 (2012).
148 Id.
149 Carson v. Maurer, 424 A.2d 825, 836 (N.H. 1980).
150 Brannigan v. Usitalo, 587 A.2d 1232, 1236 (N.H. 1991).
151 Cmty. Res. for Justice, Inc. v. City of Manchester, 917 A.2d 707, 721 (N.H. 2007) (quoting United States v. Virginia, 518 U.S. 515, 533 (1996)).
152 N.H. REV. STAT. ANN. 519-C:1.
153 In re George, 7 A.3d 1184, 1189 (N.H. 2010).
154 Id. at 1186.
155 Id.
156 N.H. REV. STAT. ANN. 519-C:1.
157 Id. 507-E:1.
158 Id. 507-E:1, 519-C:1.
159 See Carson v. Maurer, 424 A.2d 825, 825 (N.H. 1980).
160 Abolishing the collateral source rule generally results in an injured party's insurance company compensating the victim despite the negligent tortfeasor being insured. BLACK's LAW DICTIONARY 299 (9th ed. 2009). The rule may lower malpractice insurance rates for healthcare providers, but it may also increase the insurance burden on the victim's insurer and increase the cost of insurance for the public.
161 Carson, 424 A.2d at 836.
162 Id. at 837.
163 Mohseni v. Rahman, No. 05-C-343, 2006 WL 5436893, at 18 (N.H. Super. June 5, 2006) (finding the argument speculative because the panel has not rendered findings).
164 Press Release, Governor John Lynch, supra note 62.
165 N.H. REV. STAT. ANN. 519-C:1 (2012).
166 HERSCH ET AL., supra note 49, at 4.
167 N.H. REV. STAT. ANN. 519-C:3.
168 Id.
169 Id. 519-C:2.
170 Haines & Woodbury, supra note 142, at 9.
171 N.H. REV. STAT. ANN. 519-C:2.
172 Haines & Woodbury, supra note 142, at 15.
173 N.H. REV. STAT. ANN. 519-C:9
174 Id.; Haines & Woodbury, supra note 142, at 8-9.
175 Cmty. Res. for Justice, Inc. v. City of Manchester, 917 A.2d 707, 721 (N.H. 2007) (citing United States v. Virginia, 518 U.S. 515, 533 (1996)).
176 The effects of the classifications include reducing damage awards, imposing a short timeframe for pursuing an early offer, not penalizing providers for making low offers but penalizing claimants for contesting adequate offers, and limiting the claimant to an early offer from one medical care provider.
177 S.B. 406, 2012 Gen. Assemb., Reg. Sess. (N.H. 2012).
178 Cmty. Res. for Justice, 917 A.2d at 721 (quoting Virginia, 518 U.S. at 533).
179 Id.
180 Carson v. Maurer, 424 A.2d 825, 830 (N.H. 1980).
181 Gould v. Concord Hosp., 493 A.2d 1193, 1196 (N.H. 1985); see also Michaud v. McAnaney, No. 2007 DNH 118, 2007 WL 2790672 (D.N.H. Sept. 25, 2007); Coffey v. Bresnahan, 506 A.2d 310, 312 (N.H. 1986).
182 N.H. REV. STAT. ANN. 519-C:1 (2012).
183 See, e.g., Carson, 424 A.2d at 830.
184 See, e.g., Brannigan v. Usitalo, 587 A.2d 1232 (N.H. 1991); Carson, 424 A.2d at 825.
185 See discussion supra Part IV.A.1-5.
186 N.H. CONST. pt. 1, art. 14.
187 N.H. CONST. pt. 1, art. 20.
188 In re K, 561 A.2d 1063, 1071-72 (N.H. 1989) (comparing the striking of temporal and procedural limitations on the very right to bring action with a case upholding a statute that merely rendered a limited category of evidence inadmissible).
189 Gould v. Concord Hosp., 493 A.2d 1193, 1196 (N.H. 1985) (Our constitution provides that all citizens have a right to the redress of their actionable injuries.).
190 Mohseni v. Rahman, No. 05-C-343, 2006 WL 5436893 (N.H. Super. June 5, 2006).
191 Id. at 22 (citations omitted).
192 Id.
193 Id. at 10.
194 N.H. REV. STAT. ANN. 519-C:2 (2012).
195 Id. 519-C:3.
196 Id. 519-C:2.
197 Id. 519-C:13.
198 Haines & Woodbury, supra note 142, at 16-17.
199 N.H. REV. STAT. ANN. 519-C:2.
200 Haines & Woodbury, supra note 142, at 9, 16-17.
201 Mohseni v. Rahman, No. 05-C-343, 2006 WL 5436893, at 20 (N.H. Super. June 5, 2006) (stating that a disparity of resources will always create imbalances in litigation).
202 Eaton v. Fleet, No. 2008-CV-074, 2009 WL 4768131, at 10 (N.H. Super. Nov. 3, 2009).
203 Id.
204 Id. at 10.
205 N.H. REV. STAT. ANN. 519-C:2 (2012).
206 Eaton, 2009 WL 4768131, at 10.
207 Id. (citing Opinion of the Justices, 304 A.2d 881, 887-88 (N.H. 1973)).
208 Opinion of the Justices, 304 A.2d at 887.
209 Haines & Woodbury, supra note 142, at 15-16.
210 N.H. REV. STAT. ANN. 519-C:2.
211 Id. 519-C:3.
212 Id. 519-C:1. The early offer statute already provides that parties may choose a hearing officer to resolve disputes regarding an early offer from a list of neutral persons that the Judicial Branch Office of Mediation and Arbitration maintains.
213 Haines & Woodbury, supra note 142, at 15-16.
214 Id. at 9.
215 See Widman, supra note 146, at 64-65.
216 Widman, supra note 146, at 64 (citing Lucinda M. Finley, The Hidden Victims of Tort Reform: Women, Children, and the Elderly, 53 EMORY L.J. 1263, 1265 (2004)).
217 N.H. REV. STAT. ANN. 519-C:2.
218 Haines & Woodbury, supra note 142, at 16.
219 H.B. 582, 2013 Gen. Assemb., Reg. Sess. (N.H. 2013).