JOSE CABRALES MISTY DAWN CABRALES v. JULIE HAGEN AS APPOINTED PERSONAL REPRESENTATIVE OF THE ESTATE OF JAMIE KIRCH DECEASED (2026)

Julie Hagen (“Defendant”), as the appointed personal representative of the estate (“the Estate”) of Jamie Kirch (“Decedent”), appeals the trial court's judgment awarding $2.5 million to Jose Cabrales (“Plaintiff”).¹ Defendant argues the trial court erred by: (1) excluding Plaintiff's past medical bills in that the bills were admissible under § 490.715 ² , (2) denying Defendant's motion for mistrial in that Plaintiff injected the issue of liability insurance before the jury by stating that the Estate “is not going to pay a dime[,]” and (3) allowing a non-retained treating physician to offer causation opinions based on medical records not reviewed during treatment. We affirm.

Factual and Procedural Background

On December 7, 2021, Plaintiff was driving when he was struck by Decedent. The accident resulted in Decedent's death and injuries to Plaintiff. In December 2022, Plaintiff sued Defendant for personal injuries he incurred as a result of the accident. After a three-day jury trial, Decedent was found 100% at fault for the accident. Plaintiff was awarded $2,500,000 against Defendant. We address additional facts relevant to each point as necessary.

Point 1: Exclusion of Medical Bills

Defendant's first point alleges that the trial court erred in excluding Plaintiff's past medical bills when offered into evidence by Defendant. Defendant first alleges that § 490.715 requires admission of the medical bills. In the alternative, Defendant alleges the medical bills were admissible as rebuttal evidence. We disagree.

Plaintiff's petition initially included a claim for past medical expenses of $12,228.99 related to injuries sustained from the accident (the “Medical Bills”). At the pretrial conference on August 14, 2025, Plaintiff's counsel informed the trial court and parties that Plaintiff might decline to enter the Medical Bills into evidence and strike the related allegations from the petition. If Plaintiff decided to remove the claim for Medical Bills, Plaintiff's counsel indicated that they would move to exclude the Medical Bills from being entered into evidence. Eleven days later, on August 25, 2025, Plaintiff's counsel withdrew all allegations relating to the Medical Bills. With the claim for the Medical Bills removed, Plaintiff continued to seek damages for future medical expenses, future lost wages, continuing physical pain, and continuing mental anguish.

At trial, Defendant's counsel elicited the following from Plaintiff on cross-examination:

Q. One of the things you've alleged, [Plaintiff], in your lawsuit, is mental anguish. Do you remember that? Anxiety, things like that. Does that make sense?

A. Yes.

Q. I want to ask you some questions about that, [Plaintiff]. What has given you mental anguish?

A. Just I forgot a lot. You can tell me stuff right now and I forgot.

․

Q. So did you say you've forgotten what the mental anguish is that you are claiming from this lawsuit?

A. I don't know what it means. I'm sorry.

Q. Okay. Anxiety, stress, worry.

A. Yeah, I got stress and worry. Yeah.

Q. What is giving you stress and worries?

A. All this. All this pass through the accident and give me stress and anxiety. That of anxiety for that. I been to counseling for that. And talk about it with counsel.

Q. Are there any financial issues that are giving you stress?

A. Of course there always has been. It's been years not being work. My wife is only provide - - pay the bills. I not provide anything.

Q. And [Plaintiff], you said bills. Is one of the causes of your stress, your worries, medical bills?

A. I'm not saying medical bills. It's bills that include electric bills and food. Help to provide everything now and I can't.

Q. And my question, [Plaintiff], is, does it include medical bills?

A. Medical bills, I got insurance.

Q. Okay. So you are not stressed about having to pay medical bills at all?

A. If I have to pay in any way.

Q. I'm sorry. I couldn't understand. You said if you have to pay?

A. Some - - some of it. See insurance just got an amount with Covid. Some of it.

Q. So there is a portion of bills that you are stressed about paying?

A. Right.

Q. Your Honor, at this point, I would like to introduce the medical bills.

At this point, Plaintiff's counsel objected and requested a bench conference. During the bench conference, Plaintiff's counsel reminded the trial court that Plaintiff had voluntarily dismissed the claim for special damages from the case and alleged that Defendant's counsel was attempting to “open [his] own door.” Defendant's counsel presented the trial court with Schieffer v. DeCleene, 539 S.W.3d 798 (Mo. App. E.D. 2017). The trial court sustained Plaintiff's objection, denying admission of the Medical Bills.

Standard of Review

“Trial courts retain broad discretion over discovery and the admissibility of evidence and appellate courts will not interfere with those decisions unless there is a clear showing of abuse of discretion.” Hancock v. Shook, 100 S.W.3d 786, 795 (Mo. banc 2003). “The focus is not on whether the evidence was admissible but on whether the trial court abused its discretion in excluding the evidence.” Burns v. Elk River Ambulance, Inc., 55 S.W.3d 466, 480 (Mo. App. S.D. 2001) (quoting Aliff v. Cody, 26 S.W.3d 309, 314 (Mo. App. W.D. 2000)). A trial court abuses its discretion if “its ruling is clearly against the logic of the circumstances then before the court and is so unreasonable and arbitrary that it shocks the sense of justice and indicates a lack of careful, deliberate consideration.” Lozano v. BNSF Ry. Co., 421 S.W.3d 448, 451 (Mo. banc 2014) (internal citation omitted). “Our review of a circuit court's interpretation of a statute for purposes of determining the admissibility of evidence is de novo.” Schieffer, 539 S.W.3d at 803; see also D.K.R. v. Missouri State Highway Patrol Crim. Justice Info. Servs., 694 S.W.3d 621, 623 (Mo. App. S.D. 2024). When interpreting a statute, we are not guided only by an isolated sentence, but instead we look to the provisions of the whole law and its object and policy. Schieffer, 539 S.W.3d at 805.

Analysis

Defendant first point alleges that under § 490.715, the Medical Bills were admissible “at the discretion of either party.” Section 490.715 states:

1. No evidence of collateral sources, or payments rendered under subsection 2 of this section, shall be admissible other than such evidence provided for in this section.

2. If prior to trial a defendant or his or her insurer or authorized representative, or any combination of them, pays all or any part of a plaintiff's special damages, then any portion of a plaintiff's claims for special damages that are satisfied by a payment from a defendant or the defendant's insurer or authorized representative, or any combination of them, are not recoverable from that defendant.

3. If such payments described in subsection 2 of this section are included in a plaintiff's claim for special damages at trial, the defendant who made the payment, or on whose behalf the payment was made, shall be entitled to deduct and receive a credit for such payments from any judgment as provided for in section 490.710.

4. This section does not require the exclusion of evidence admissible for another proper purpose.

5.(1) Except as provided in subsection 2 of this section, parties may introduce evidence of the actual cost of the medical care or treatment rendered to a plaintiff or a patient whose care is at issue. Actual cost of the medical care or treatment shall be reasonable, necessary, and a proximate result of the negligence or fault of any party.

(2) For purposes of this subsection, the phrase “actual cost of the medical care or treatment” shall be defined as a sum of money not to exceed the dollar amounts paid by or on behalf of a plaintiff or a patient whose care is at issue plus any remaining dollar amount necessary to satisfy the financial obligation for medical care or treatment by a health care provider after adjustment for any contractual discounts, price reduction, or write-off by any person or entity.

Defendant contends that the phrase in § 490.715.5(1) that “parties may introduce evidence of the actual cost of the medical care or treatment rendered to a plaintiff or a patient whose care is at issue” expressly permits either party to introduce evidence of medical treatment value. Further, Defendant alleges that the Medical Bills were “relevant to the nature and extent of those claimed injuries and to the credibility of his claimed damages.”

Defendant's first argument fails as § 490.715 does not modify the proposition that “Missouri abides by the longstanding rule that trial is limited to the scope of the issues raised by the pleadings.” Schieffer, 539 S.W.3d at 804 (internal quotations and citations omitted); see also Williams v. Decker, 732 S.W.3d 473, 476 (Mo. App. S.D. 2026). “Thus, in the face of an objection, evidence must conform to the pleadings[, and] ․ where objected-to evidence is outside the scope of the pleadings, the trial court has no discretion to admit such evidence.” Schieffer, 539 S.W.3d at 804 (internal quotations and citations omitted). “When items of special damage are claimed, they shall be specifically stated in the petition.” Id.; § 509.200; Rule 55.19 Missouri Court Rules (2025). It has long been settled that expenses for medical services are special damages. Schieffer, 539 S.W.3d at 804 (citations and quotations omitted).

Defendant's contention concerning § 490.715 was addressed by the Eastern District of this Court in Schieffer. There, the plaintiff initially pled a claim for special damages relating to past medical expenses. On the morning of trial, the plaintiff amended his complaint to remove the claim for special damages and sought only general damages. The trial court allowed the defendant to admit the medical bills into evidence over the plaintiff's objection. An award was entered for plaintiff, but plaintiff appealed on the basis of an inadequate award of damages following improperly admitted evidence. Plaintiff alleged that the trial court improperly admitted medical bill evidence that was beyond the scope of the pleadings. In contrast, the defendant argued that the bills’ admission was proper because, in part, as § 490.715.5 ³ expressly allows defendants to enter medical bills.

In response to this argument, the Eastern District explained that reliance on § 490.715 is misguided because that statute “addresses and applies to evidence of collateral sources.” Schieffer, 539 S.W.3d at 805. The Schieffer Court went on to hold that:

[The plaintiff's] deletion of his past medical expenses claim eliminated from the litigation the concern that [the defendant] might mitigate his damages by presenting evidence that [the plaintiff's] insurance company paid for part of his medical bills. This is because, since [the plaintiff] sought only general damages for pain and suffering as well as the cost of future surgery, which was pleaded, neither his medical expenses nor what his insurance company paid against those bills was put at issue. In fact, [the defendant] himself provided that the reason for introducing the medical bills was not to show that [the defendant's] insurance company paid for a portion of the expenses, but rather to clarify which parts of [the plaintiff's] body received treatment and at what time relative to the 2011 collision. Neither [the plaintiff's] second amended petition nor [the defendant's] reasoning for putting on evidence of the bills implicates Section 490.715.5(1), and the trial court abused its discretion in relying upon that provision to admit evidence of [the plaintiff's] medical expenses.

Schieffer, 539 S.W.3d at 805-06.

In the instant case, Defendant argues, as was argued in Schieffer, that § 490.715 expressly allows admission of medical bills by a defendant without further analysis. Defendant asks this Court to reject Schieffer and it's holding that medical bill evidence must conform to the pleadings to be admissible. We decline that offer. We agree with the Schieffer decision in that it correctly determines that § 490.715 relates to collateral sources as expressly stated in § 490.715.1. See Schieffer, 539 S.W.3d at 805. Accordingly, admission of the Medical Bills in this instance would exceed the scope of the pleadings and that would be an abuse of discretion. Certainly, the trial court did not abuse its discretion in sustaining the objection to the Medical Bills.

Defendant next argues that the Medical Bills were admissible as rebuttal evidence to Plaintiff's assertion that he had mental anguish and some of that was related to financial stress. Schieffer noted that “A party may introduce evidence to rebut that of his or her adversary, and for this purpose any competent evidence to explain, repel, counteract, or disprove the adversary's proof is admissible.” Id. at 806 (citing Govreau v. Nu-Way Concrete Forms, Inc., 73 S.W.3d 737, 743 (Mo. App. E.D. 2002)). Such rebuttal evidence is evidence tending to disprove new points first opened by the opposite party. Id. (quoting Aliff, 26 S.W.3d at 315). However, the Schieffer Court ultimately found that using medical bills as rebuttal evidence was improper in that instance “because [the plaintiff] never made any claim that his mental anguish stemmed from the stress of financial hardship associated with the costs of his treatment.” Id. We find a similar situation in this case.

Here, the record does not reflect any direct-examination testimony by Plaintiff regarding mental anguish stemming from difficulty managing medical costs. Because Plaintiff never testified to suffering mental anguish from the Medical Bills, admission of the Medical Bills “does not explain, repel, counteract, or disprove any such claim first opened by him.” Id. (internal quotations and citation omitted, emphasis added). Plaintiff did not open such a claim in either the pleadings or on his direct examination. On cross-examination, Defendant attempted to elicit this testimony but was unsuccessful. When asked about whether the Medical Bills were causing him mental anguish, Plaintiff stated, “I'm not saying medical bills. ․ I got insurance.” Plaintiff's response indicated that his medical bills were not a source of his mental anguish. Plaintiff clarified, “It's bills that include electric bills and food.” These statements align with Plaintiff's decision not to pursue recovery for the Medical Bills. In addition, Defendant complains of an error they invited by attempting to inject the issue on cross-examination. See Rinehart v. Missouri Dep't of Corr., 669 S.W.3d 679, 686 (Mo. App. W.D. 2023) (“It is axiomatic that a [party] may not take advantage of self-invited error or error of [his] own making.” (Internal citations omitted)). Point 1 is denied.

Point 2: Statements Regarding Payment of Judgment

Defendant's second point alleges that the trial court erred in denying Defendant's motion for mistrial. Specifically, Defendant contends a mistrial was necessary in that Plaintiff's counsel injected the issue of liability insurance before the jury by stating that the Estate “is not going to pay a dime[.]” We disagree.

Factual and Procedural Background

Prior to trial, the trial court granted a motion in limine by Plaintiff to exclude “any evidence, arguments, suggestions, relating to the plea of poverty by [Defendant.]” This motion included any remark implying the Estate could not satisfy a judgment. In response to the motion, Defendant stated, “No objection, as long as it covers both [D]efendant and [P]laintiff.”

At trial, Defendant called Levi Brubaker (“Brubaker”), Decedent's boyfriend, and father of their two children as a witness. Brubaker was in Decedent's vehicle at the time of the accident along with the two children. During direct examination, Brubaker briefly testified about his limited knowledge of the accident. Plaintiff's counsel then asked Brubaker the following on cross-examination:

Q. You don't know how the crash happened, do you? You were looking down, right?

A. I don't know.

․

Q. At the time this crash, [sic] you were looking down at your phone, true statement?

A. True.

Q. You don't have any idea how the crash really happened; do you?

A. Not really.

Q. Do you have any idea why you're here?

A. No.

Then, the following exchange occurred on redirect examination:

[Defendant's counsel]: You have kids with [Decedent] - -

[Plaintiff's counsel]: Judge, we've got a motion on this and we've talked about this extensively, I guess we can do this, side bar.

․

The Court: All right, I'll sustain the objection.

․

[Defendant's counsel]: At the time of the accident, there were kids in the car, weren't there?

[Brubaker]: My two youngest.

[Defendant's counsel]: Okay. And the Estate of [Decedent] has been sued, has it not?

[Brubaker]: I couldn't tell you.

[Defendant's counsel]: Okay. And that would affect you and your children, wouldn't it?

[Plaintiff's counsel]: Judge.

The Court: Hold on.

[Plaintiff's counsel]: Go ahead. Go ahead, you want an answer. Go ahead.

[Defendant's counsel]: Okay. I have no further questions, [for you]. Thanks for coming in today.

Recross-examination by Plaintiff's counsel ensued:

[Plaintiff's counsel]: [Brubaker], no matter what verdict this jury enters, [Decedent's] Estate is not going to pay a dime are they?

[Defendant's counsel]: Objection, Judge.

[Defendant's co-counsel]: Objection.

[Plaintiff's counsel]: He opened the door.

[Defendant's counsel]: Objection. I asked how it would affect him.

Outside the hearing of the jury, Defendant's counsel objected and moved for a mistrial. The trial court denied the motion for mistrial but warned counsel that it would not allow any further questions regarding the children or a judgment's effect on the Estate. After a brief recess, the parties stipulated to an instruction to be read by the trial court to the jury addressing the remarks:

The parties have entered this stipulation. The [Defendant's] last question and answer is stricken from the record. [Plaintiff's] last question is stricken from the record. The parties stipulate that the only issues to be decided are liability of the parties, and what, if any damages, the [Plaintiff] sustained. In making such determinations, who would pay such damages, or if they would be paid, is not to be taken into consideration in arriving at your verdict. That's been signed by the attorneys.

Standard of Review

A mistrial is a drastic remedy that should be granted only in exceptional circumstances. We afford the trial court great discretion in deciding whether a mistrial should be granted, and we will reverse its denial of a motion for mistrial only if the denial was a manifest abuse of discretion. A manifest abuse of discretion occurs only when the error is so grievous that prejudice cannot be removed through less drastic means. We recognize that the trial court is better positioned to assess the prejudicial effect that improper evidence has on the jury.

Payne v. Fiesta Corp., 543 S.W.3d 109, 123 (Mo. App. E.D. 2018) (internal citations and quotations omitted). “A limiting instruction may be sufficient to avoid prejudice, and the trial court is in the best position to determine the impact on the jury.” Campise v. Borcherding, 224 S.W.3d 91, 95 (Mo. App. E.D. 2007) (quoting State v. Myers, 997 S.W.2d 26, 35 (Mo. App. S.D. 1999)).

Analysis

In general, it is improper for counsel to inject the issue of the existence of insurance into an action for damages. Payne, 543 S.W.3d at 124. However, “[n]ot every reference to insurance constitutes reversible error or requires the discharge of a jury.” Woodgate v. St. James Winery, Inc., 656 S.W.3d 24, 28 (Mo. App. S.D. 2022) (quoting Taylor v. Republic Auto. Parts, Inc., 950 S.W.2d 318, 321 (Mo. App. W.D. 1997)); see also Means v. Sears, Roebuck & Co., 550 S.W.2d 780, 788 (Mo. banc 1977). The party alleging that the reference to insurance constitutes reversible error must demonstrate it was prejudiced by the reference. Payne, 543 S.W.3d at 124.

There was no manifest abuse of discretion in this case. The question asked by Plaintiff's counsel was in response to Defense counsel's redirect-examination. The question was not answered by the witness. Most importantly, the trial court gave a proper limiting instruction approved by the parties. The trial court was in the best position to determine the remarks’ impact on the jury. Because the trial court concluded that a limiting instruction and prohibition of further remarks were the most appropriate remedies, we conclude that the trial court was acting within its discretion to avoid a mistrial.

Moreover, the curative limiting instruction was stipulated and presented to the trial court by the parties. “A party cannot complain on appeal about an alleged error in which that party joined or acquiesced at trial.” Rinehart, 669 S.W.3d at 686 (internal citation omitted). Defendant may not complain about the limiting instruction in which they joined in crafting. See id.; see also Wilson v. P.B. Patel, M.D., P.C., 517 S.W.3d 520, 525 (Mo. banc 2017). Point 2 is denied.

Point 3: Opinion of Treating Physician

Defendant's third point alleges that the trial court erred in permitting Dr. Willis, a non-retained treating physician, to offer causation opinions based on medical records not reviewed prior to treatment. Defendant argues that Dr. Willis's testimony exceeded the permissible scope of non-retained expert testimony. We disagree.

Factual and Procedural Background

In discovery, Dr. Willis was disclosed as a non-retained, treating physician who performed surgery on Plaintiff on November 27, 2023. Plaintiff's counsel further disclosed that Dr. Willis would testify to his treatment of Plaintiff, as well as the causation of Plaintiff's injuries in relation to the motor vehicle accident. Plaintiff's counsel disclosed that Dr. Willis would testify and offer opinions based on “the medical records of Plaintiff, imaging, records produced in this case and his review of any other pertinent records in this case concerning Plaintiff[.]”

During a video deposition on August 1, 2025, Plaintiff's counsel provided to Dr. Willis, who practices in Arizona, copies of Plaintiff's post-accident medical records from Missouri. On cross-examination, Defendant's counsel questioned Dr. Willis about the Missouri medical records, referring to the imaging records created on the day of the accident. Dr. Willis confirmed to Defendant's counsel that he “most likely” was not given Plaintiff's Missouri medical records when he first started treatment. At the conclusion of the deposition, Dr. Willis confirmed that the motor vehicle accident “directly caused or contributed to cause [Plaintiff's] neck problems and symptoms ․ and the surgery[.]”

On August 6, 2025, Defendant's counsel filed a motion in limine to exclude Dr. Willis's opinions and testimony. Defendant argued that, because Dr. Willis was provided with medical records for analysis, he exceeded the scope of his testimony as a “non-retained” expert witness. Defendant further argued that, because Dr. Willis was not listed as a “retained” expert witness, Defendant was subjected to unfair surprise and prejudice. Plaintiff's counsel countered that both Dr. Willis and his opinion on causation were disclosed ten months prior to the deposition and that his opinion was not changed as a result of the medical records discussed during the deposition. The trial court stated that Dr. Willis's opinions and testimony would probably be admitted unless “there's something specifically” that indicated otherwise. The three-day trial was held on August 27-29, 2025. During the trial, portions of the video deposition of Dr. Willis were played for the jury over Defendant's objection.

Standard of Review

Courts review the decision of the trial court to admit or exclude expert testimony for abuse of discretion. Linton by and through Linton v. Carter, 634 S.W.3d 623, 626-27 (Mo. banc 2021) “A circuit court abuses its discretion when its ruling is clearly against the logic of the circumstances then before the court and is so unreasonable and arbitrary that it shocks the sense of justice and indicates a lack of careful, deliberate consideration.” Id. at 627 (internal quotations and citation omitted); see also Woodgate, 656 S.W.3d at 27.

Analysis

Defendant directs this Court to Ralls v. Soo Line Railroad, 710 S.W.3d 606 (Mo. App. W.D. 2025). In Ralls, the defendant called the treating physician of the plaintiff's deceased husband as merely a treating physician, not an expert. The physician was “not disclosed as an expert at all” by the defendant. Id. at 612. The physician offered a definitive causation opinion at trial after stating that he could not reach a definitive causation opinion during his deposition. Because the physician was not disclosed as an expert, the Court was left with the issues of whether the plaintiff was prejudiced and unfairly surprised by the testimony of the physician. The Court found both unfair surprise and prejudice. Id. at 619. The Court reasoned that even though “the Treating Physician was identified by [the plaintiff] as a treating physician[,] ․ his deposition testimony ․ fell outside the scope of permissible testimony by a treating physician.” Id. Because the treating physician was not properly disclosed to give notice of a causation opinion, and he offered a different opinion at trial from the deposition, this amounted to unfair surprise.

The case at hand substantively differs from Ralls. Here, Plaintiff disclosed that Dr. Willis would testify to his treatment of Plaintiff, as well as the causation of Plaintiff's injuries in relation to the motor vehicle accident. In reaching his causation opinion, it was disclosed that Dr. Willis would rely upon his treatment of Plaintiff, Plaintiff's medical records, as well as Dr. Willis's knowledge, education, training, and experience. Unlike in Ralls, Dr. Willis's opinions remained consistent throughout discovery and the deposition played at trial. Finally, Defendant cross-examined Dr. Willis at the deposition.

The instant case is more akin to Kehr v. Knapp, 136 S.W.3d 118 (Mo. App. E.D. 2004). In Kehr, a treating physician was disclosed as an expert witness by the defendant. The defendant also disclosed that the treating physician would offer causation testimony. The plaintiffs opted not to depose the treating physician. At trial, the treating physician gave testimony in compliance with the scope offered in the original disclosure, including a causation opinion. The plaintiffs appealed, alleging surprise. This Court held that any surprise by the testimony was not the result of an abuse of discretion by the trial court to allow the testimony. Id. at 125. At the basis of its reasoning, this Court stated that “[the defendant] disclosed [the treating physician's] identity and the scope of his testimony[.]” Id. The scope of the testimony as disclosed included causation testimony. The physician's trial testimony complied with the disclosure, and the case was affirmed on appeal. Id.

Here, ten months prior to the deposition, Plaintiff properly disclosed Dr. Willis as a treating physician who would offer causation testimony. Dr. Willis's deposition testimony complied with that disclosure. Defendant cross-examined Dr. Willis as to his conclusions. There was no surprise. Point 3 is denied.

Conclusion

The judgment of the trial court is affirmed.

FOOTNOTES

1.   Plaintiff's spouse, Misty Cabrales, also filed a loss of consortium claim. The jury found she was not damaged. As that issue is not before this Court, we refer only to Jose Cabrales as Plaintiff herein to avoid confusion.

2.   Unless otherwise indicated, all statutory references are to RSMo Cum. Supp. (2017).

3.   Defendant relies upon the current 2017 version of § 490.715, while Schieffer applies the 2005 version of the same statute. The changes to § 490.715 in the 2017 update do not reflect any substantive alterations for the purpose of our analysis. The provisions of § 490.715 in effect in Schieffer were as follows:1. No evidence of collateral sources shall be admissible other than such evidence provided for in this section.2. If prior to trial a defendant or his or her insurer or authorized representative, or any combination of them, pays all or any part of a plaintiff's special damages, the defendant may introduce evidence that some other person other than the plaintiff has paid those amounts. The evidence shall not identify any person having made such payments.3. If a defendant introduces evidence described in subsection 2 of this section, such introduction shall constitute a waiver of any right to a credit against a judgment pursuant to section 490.710.4. This section does not require the exclusion of evidence admissible for another proper purpose.5. (1) Parties may introduce evidence of the value of the medical treatment rendered to a party that was reasonable, necessary, and a proximate result of the negligence of any party.(2) In determining the value of the medical treatment rendered, there shall be a rebuttable presumption that the dollar amount necessary to satisfy the financial obligation to the health care provider represents the value of the medical treatment rendered. Upon motion of any party, the court may determine, outside the hearing of the jury, the value of the medical treatment rendered based upon additional evidence, including but not limited to:(a) The medical bills incurred by a party;(b) The amount actually paid for medical treatment rendered to a party;(c) The amount or estimate of the amount of medical bills not paid which such party is obligated to pay to any entity in the event of a recovery. Notwithstanding the foregoing, no evidence of collateral sources shall be made known to the jury in presenting the evidence of the value of the medical treatment rendered.§ 490.715 RSMo Cum. Supp. (2005).

BRYAN E. NICKELL, J. – OPINION AUTHOR

JEFFREY W. BATES, J. – CONCURS JACK A. L. GOODMAN, J. – CONCURS