Punitive Damages - US Eastern District Court HouseFollowing the Fifth Circuit’s opinion in McBride v. Estis Well Service, 768 F.3d 382, 391 (5th Cir. 2014), we reported that punitive damages had “expired and gone to meet their maker” when it comes to Jones Act seamen. As it turns out, they were only mostly dead. In Corey Hume et al. v. Consolidated Grain & Barge, Inc. et al., No. CA 15-0935, 2016 WL 1089349, at *1 (E.D. La. Mar. 21, 2016), Judge Zainey of the Eastern District ruled that punitive damages are still recoverable by Jones Act seamen against non-employer third parties.

The Plaintiffs, who were employees of defendant Consolidated Grain, were working aboard a vessel owned by defendant Quality Marine Services when a running wire of the vessel struck each of them in the face and head, resulting in brain injuries and facial disfigurement. The Plaintiffs sued Quality Marine for punitive damages under general maritime law. Quality Marine moved to dismiss, arguing that, pursuant to McBride v. Estis Well Service, 768 F.3d 382, 391 (5th Cir. 2014) (en banc), cert. denied, 135 S.Ct. 2310 (2015) (which held that an injured seaman cannot recover punitive damages against his employer), and Scarborough v. Clemco Industries, 391 F.3d 660, 668 (5th Cir. 2004) (which held that a seaman who invokes Jones Act status cannot recover punitive damages against a non-employer third party), Plaintiffs were not able under general maritime law to recover punitive damages from Quality Marine.

The court disagreed. Relying on another recent decision from the Eastern District, Collins v. A.B.C. Marine Towing, L.L.C., 14-1900, 2015 WL 5254710 (E.D. La. Sept. 9, 2015), the court declined to follow the Fifth Circuit’s holding in Scarborough, finding Scarborough had been “effectively overruled” by the Supreme Court in Atlantic Sounding Co. v. Townsend, 557 U.S. 404 (2009). The court held instead that the Jones Act forecloses a seaman’s recovery for non-pecuniary loss in maritime cases only with respect to his employer. With respect to a non-employer tortfeasor such as Quality Marine, to whom the Jones Act does not apply, no statutory regime exists that conflicts with general maritime law remedies, and thus punitive damages may be recoverable. In the end, the court held that the “takeaway from Townsend” was that a seaman may recover punitive damages under general maritime law if the Jones Act is not implicated, and denied Quality Marine’s motion to dismiss the punitive damages claim.

On September 25, 2014, the en banc Fifth Circuit, in McBride v. Estis Well Serv., L.L.C., No. 12-30714 (5th Cir. Sept. 25, 2014), concluded in a brief opinion that the Supreme Court’s decision of Miles v. Apex Marine Corp., 498 U.S. 19 (1990), and its limitation on recovery to pecuniary damages, precluded Jones Act seamen from recovering punitive damages either for Jones Act negligence or general maritime law unseaworthiness. Six judges dissented from the en banc decision, which was supported by nine judges for reversal of the previous panel decision.

This reporter previously commented on the panel decision here, with the observation that punitive damages were not dead yet. The majority en banc opinion has now clarified that punitive damages have “expired and gone to meet their Maker.”

A petition for certiorari to the Supreme Court is an almost certainty. Whether this issue obtains the interest of the requisite four Justices remains to be seen.

NOTE: This post was authored for the firm by Spencer Sinclair, a Tulane Law School student who spent part of his summer working at King, Krebs & Jurgens. — JAD

Stress and the Jones Act
The Eleventh Circuit in Skye v. Maersk Line, Ltd.
held seamen cannot recover for work-related stress under the Jones Act.

Is work-related stress starting to take its toll? If you are a seaman, you better relax—according to the United States Court of Appeals for the Eleventh Circuit, you have no claim under the Jones Act. In Skye v. Maersk Line, Ltd. Corp, No. 12-16433 (11 Cir. May 15, 2014), the appellate court rejected a seaman’s Jones Act claim for damages related to heart problems allegedly attributable to stress at work.

The chief mate on board the SEALAND PRIDE alleged that he worked tirelessly to perform his arduous duties, regularly working over 90 hours a week for up to 84 days at time. After eight long years on the job, he began to experience headaches, a sore back, and a burning sensation in his chest. His cardiologist diagnosed him with left ventricular hypertrophy, a thickening of the heart wall of the left ventricle. The doctor attributed the condition to continued physical job-related stress with long hours and lack of sleep. A few years later, the chief mate filed a Jones Act claim against his employer alleging that unreasonable working conditions were the cause of the physical damage to his heart. The jury agreed—it awarded the chief mate almost $600,000 after taking into account his own comparative fault.

On appeal, the Eleventh Circuit was not so sympathetic. Pointedly, the court held that “[t]he Jones Act does not allow a seaman to recover for injuries caused by work-related stress because work-related stress is not a ‘physical peril.’” Relying on the Supreme Court case, Consolidated Rail Corp. v. Gottshall, 512 U.S. 532 (1994), the court reasoned that for an employer to be liable under the Jones Act, the employee’s injuries must be caused by negligent conduct that threatens imminent physical impact. Indeed, the “central focus” on assigning liability to an employer under the Jones Act is on “physical perils.” A strenuous work schedule and an irregular sleep schedule, the court concluded, are not such perils.

The court, however, was far from unanimous. Of the three judge panel, each offered their own two cents. Judge Fay regretfully concurred with the majority opinion only because he thought the court was bound by the Supreme Court precedent established in Gottshall. Showing signs of sympathy toward the plaintiff, the concurring judge urged the Supreme Court to revisit its decision in Gottshall to find a suitable remedy for workers who have been subjected to “outrageous hours.” In contrast, a dissenting judge denied that Gottshall was dispositive to the outcome of the case. He loosely declared that this case dealt with physical injury, whereas Gottshall dealt with injury from emotional distress.

The Skye decision raises an important issue: should stress-related conditions merit recovery under the Jones Act; or would allowing stress-related claims open the floodgates for trivial suits and fraud? Keep an eye on this one—the Supreme Court may hear the concurring judge’s pleas.

In Chenevert v. Travelers Indemnity Co., No. 13-60119 (5th Cir. March 7, 2014), the Fifth Circuit formally recognized the right of an insurer providing and making voluntary payments to an injured employee under the Longshore and Harbor Workers’ Compensation Act (LHWCA) to recover its payments from a recovery of Jones Act damages obtained by the employee for the same injury.

Mr. Chenevert was injured while an employee of GC Constructors (GC) in May of 2007. At the time of his injury, Travelers Indemnity Co. (Travelers) provided coverage to GC for Chenevert’s injury under the LHWCA. The Travelers policy excluded coverage for bodily injuries to a master or a member of crew of any vessel. Between May 2007 and May 2010, Travelers paid benefits under the LHWCA in excess of $275,000. In May of 2010, Chenevert sued GC in federal court alleging Jones Act Status. Based upon Chenevert’s claim to be a seaman, Travelers stopped making payments under the LHWCA. Travelers then put Chenevert and GC on notice that it would seek reimbursement of the amounts paid under the LHWCA from any recovery Chenevert received in his Jones Act suit. The matter was eventually settled with an amount equal to that paid by Travelers in benefits under the LHWCA placed into the registry of the Court pending a determination of whether it had a legal right to recover said amounts.

Basing his decision on the legal tenet that no right of subrogation can arise in favor of an insurer against its own insured, the Magistrate to whom this issue was assigned denied Travelers right to recoup its payments. On appeal to the Fifth Circuit, the Court felt that this rule would not apply in this factual setting as Travelers did not insure GC against Jones Act liability.

The panel cited its previous holdings in Peters v. North River Ins. Co., 764 F.2d 306 (5th Cir. 1985) (recognizing the employer/insurer’s compensation lien in a third party suit), Taylor v. Bunge Corp., 845 F.2d 1323 (5th Cir. 1988) ( recognizing insurer’s right to recovery in 905(b) claim against the employer as a vessel owner) and Massey v. William-McWilliams, Inc.. 414 F.2d 675 (5th Cir. 1969), which recognized a ship owner-employer’s right to a credit for amounts paid under the LHWCA that bear reasonable relation to the items of loss compensated under a Jones Act claim. The Court felt the right to assert a lien by Travlers as a logical extension of this line of cases and it saw no difference between the insurer in the Massey case and Travelers in the instant case asserting a lien against a 905(b) recovery as opposed to a lien against a Jones Act recovery.

Fifth Circuit Affirms Jury Finding for Land-Based Worker to be Covered by Jones Act but Reverses Award of Emotional Damages in Naquin v. Elevating Boats LLC, No. 12-31258 (5th Cir., 3/10/14)

Plaintiff, Larry Naquin, Sr., a vessel repair supervisor employed by Elevating Boats, LLC, was injured on November 17, 2009, when a shipyard crane he was operating suddenly failed, causing the boom and crane housing to separate from the crane pedestal. In addition to Mr Naquin’s injury, a relative of his was killed when the crane boom landed on a structure in which the relative was working.

Although Mr. Naquin was not assigned to any particular vessel but oversaw the repair of a number of vessels manufactured and/or owned by his employer, he was found, by a jury, to be a Jones Act seaman and was awarded significant damages, including $1,000,000 for past and future physical pain and suffering, $1,000,000 for past and future metal pain and suffering, and $400,000 for future lost wages.

The employer appealed the jury’s finding to the Fifth Circuit, asserting that Mr. Naquin had failed to establish that he was a Jones Act seaman, that the evidence was insufficient to establish the employer’s negligence, and that the District Court erred by admitting evidence of Mr. Naquin’s relative’s death in regard to his claim for damages.

A split Fifth Circuit decision on the issue of status authored by Judge W. Eugene Davis affirmed the jury’s determination. The majority indicated that in accord with established precedent, Mr. Naquin could be considered to be assigned to and in the service of an identifiable fleet of vessels owned by his employer to which he spent approximately 70% of his time in the maintenance thereof. In dissent Judge Jones questioned how a land-based employee whose work was primarily on vessels docked for repair or maintenance could be exposed to the perils of the sea and be said to be in the service of a vessel in navigation. She suggested that under the majority’s rationale any land-based worker, even one hired to fuel the boats at the employer’s dock, could qualify as a seaman.

The employer also complained that the jury finding of negligence was one that was solely built upon circumstantial evidence and that there was no direct evidence indicating that the employer caused or could have foreseen the accident. The panel pointed out that the crane in question was manufactured, maintained and owned by the employer, and although Mr. Naquin could not prove precisely why a weld had failed, it was undisputable that the employer was the party who was responsible for the design of the crane and the integrity of the weld.

The panel however reversed the jury finding on damages on the basis that emotional damages are not recoverable under the Jones Act unless the plaintiff is considered to be within the “zone of danger.” While Mr. Naquin was within the “zone of danger” insofar as his own injuries were concerned, the Court questioned whether he could assert a claim for emotional harm arising from the injury to and death of his relative. In determining that this was not a recoverable element of damages under the Jones Act, the Court felt that the presentation of evidence with regard to the death of the relative so pervaded the other elements of damages that it reversed the complete damage award, remanding the matter for a trial on the sole issue of damages.

 

In the wake of the revisited tests of vessel status by the Supreme Court in Stewart vs. Dutra Construction Company, 543 U.S. 481 (2005) and Lozman v. City of Riviera Beach, Fla., 133 S.Ct. 735 (2013), it remains to be seen whether floating oil and gas production structures, such as SPARS and tension leg platforms (“TLP”), retained their non-vessel status. In Mooney v. W&T Offshore, Inc., No. 2:12-cv-969 (E.D. La. Mar. 3, 2013), District Judge Lance M. Africk recently concluded that the MATTERHORN SEASTAR, a TLP secured to the Outer Continental Shelf off the coast of Louisiana, was not a vessel as a matter of law. The plaintiff had filed suit against W&T Offshore, Inc., the owner and operator of the MATTERHORN SEASTAR, under the Jones Act, the Longshore and Harbor Workers’ Compensation Act (“LHWCA”), and general maritime law for alleged personal injuries he claimed to have received while working on the MATTERHORN SEASTAR. The plaintiff’s potential recovery against W&T under the foregoing statutes and general maritime law depended on whether the MATTERHORN SEASTAR is a vessel. 

The MATTERHORN SEASTAR is a floating oil and gas production structure that has been secured to the seabed since 2003 by six mooring tendons, seven casing production risers, and two export pipelines, and it will remain in that moored location until at least 2020. Its buoyant hull had been towed to the moored location, where it was secured to the seabed by the mooring tendons, which tendons in turn were affixed to suction pilings driven hundreds of feet below the seafloor. Subsequently, the oil and gas production and processing equipment that comprised the top-sides of the TLP was installed on top of the hull. Thereafter, the production risers and pipelines were connected to the top-sides equipment. It would take W&T several months of preparation and activities, including the removal of the topsides from the hull, before the hull could be ready for towage away from the moored location. Lastly, the MATTERHORN SEASTAR has no system of self-propulsion, no raked bow, and is not intended to be towed or moved except as part of the initial positioning and ultimate removal of the hull from its moored location. 

Under the Rules of Construction Act, 1 U.S.C. § 3, as expanded by the Stewart and Lozman decisions, the current tests for whether a structure qualifies as a vessel is whether the structure is practically capable of being used as a means of transportation on the water, including whether a reasonable observer would consider the structure to be designed to a practical degree for carrying people or things over water. Based on the undisputed evidence, Judge Africk concluded that no reasonable observer would consider the MATTERHORN SEASTAR to be designed to a practical degree for carrying people or things over water. Moreover, it was only theoretically possible, and thus not practically possible, for the TLP to participate in maritime transportation. As a result, the MATTERHORN SEASTAR was not a vessel, and the plaintiff’s claims against W&T under the Jones Act, the LHWCA, and general maritime law were dismissed with prejudice. King, Krebs & Jurgens, including the author, represented W&T in its successful motion for partial summary judgment.

This is not a vessel.

Jones Act status remains unavailable on SPAR Platforms, a type of deepwater floating oil drilling and production facility used in the offshore petroleum industry. While, as noted in the recent blog by Joseph Devall, Jr., the Supreme Court of the United States (SCOTUS) contemplates a further “clarification” of the term “vessel,” the Fifth Circuit has reiterated that, even in light of the previous decision of SCOTUS in Stewart vs. Dutra Construction Company, 543 U.S. 481, 125 S.Ct. 1118, 160 L.Ed.2d 932 (2005), addressing the definition of “vessel,” SPAR platforms that are practically immovable continue to not be vessels for Jones Act purposes.

The Fifth Circuit in Fields vs. Pool, 182 F.3d 353 (5thCir. 1999), in a case that was then one of first impression, evaluated the characteristics of SPAR platforms and determined they were not vessels due to the fact that they:

  1. were designed to be in place for the foreseeable future;
  2. were secured to the sea floor by elaborate systems insuring that movement would be difficult and a costly undertaking; and,
  3. had a tightly constrained area of movement on the sea surface limited by its anchor pattern to incidental movement.

Subsequent to the Fifth Circuit decision in Fields, SCOTUS in Stewart defined the term “vessel” for the maritime industry indicating that a vessel was “any watercraft practically capable of maritime transportation, regardless of its primary purpose or state of transit at a particular moment.” The court, however, went on to state that “a watercraft is not ‘capable of being used for maritime transfer’ in any meaningful sense if it has been permanently moored or otherwise rendered practically incapable of transportation or movement.”

A number of Federal district courts in Louisiana and Texas, subsequent to the Stewart decision, have been called upon to determine whether SPAR platforms should be considered vessels under the defining opinion in Stewart. All of the district courts that met this issue, but for one, felt that the Stuart decision did not overrule the earlier Fifth Circuit’s opinion in Fields.

Most recently, in Mendez vs. Anadarko, 466 Fed.Appx. 316 (5th Cir. 2012) (unpublished),  the Fifth Circuit again specifically addressed the status of SPAR platforms, but this time in light of the Supreme Court decision in Stewart and has reiterated its previous holding, finding that SPAR platforms do not qualify as vessels for Jones Act purposes. Applying this decision, Magistrate Hill, in the U.S. District Court for the Western District of Louisiana, Lafayette Division has recently, in Hefren vs. Murphy Exploration and Production Company, found that the Front Runner, a SPAR platform, was not a vessel for Jones Act purposes.

One of the recurring issues in handling maritime wrongful death and personal injury claims is determining what information is sufficient to start the vessel owner’s six-month deadline to file a complaint seeking exoneration or limitation of liability under the Shipowners’ Limitation of Liability Act, 46 U.S.C. § 30501 et seq. from that claim.  It is clear that a written demand for payment/settlement before suit is filed which exceeds the value of the vessel will start the running of the six-month period.  Additionally, when the petition alleges recovery of damages in excess of the value of the vessel, the vessel owner’s receipt of that petition will start the clock.  However, it is less certain when the written notice of the claim is via service of a state court petition in which the plaintiff has not alleged a specific damages amount, as is generally the case in Louisiana and Texas state courts, but thereafter makes an initial settlement demand that exceeds the vessel’s value.

The U.S. Fifth Circuit, in In re Eckstein Marine Service L.L.C., No. 10 – 20600 (Feb. 22, 2012), recently examined this issue.  Jackson, a Jones Act seaman employed by Eckstein, filed suit in Texas state court.  Eight months after it was served with Jackson’s state court suit, Eckstein filed a limitation proceeding in Texas federal court.  The Fifth Circuit affirmed the federal court’s judgment dismissing Eckstein’s limitation proceeding for lack of subject matter jurisdiction, concluding that the limitation proceeding had been filed too late.  Although Jackson’s state court petition was silent on the quantum of damages, the Fifth Circuit concluded that pleading revealed a reasonable possibility that Jackson’s claim would exceed the value of Eckstein’s vessel, and therefore the clock started running for Eckstein to file a limitation suit upon its receipt of service of the state court petition.

Jackson’s state court petition had alleged that on February 28, 2009, Jackson had sustained serious and debilitating injuries on Eckstein’s M/V ST. ANDREW when his left leg became entangled in a line and was thereafter pulled into a mooring bit, causing him to suffer serious and debilitating injuries of a permanent nature.  The petition also alleged the standard laundry list of damages categories:  past loss of earnings, future loss of earnings capacity, past and future disability, past and future disfigurement, past and future medical and hospital expenses, past and future pain and mental anguish and maintenance and cure.  Moreover, as part of Eckstein’s cure obligation, it monitored Jackson’s medical treatment, which revealed multiple surgeries during Jackson’s initial two-week hospitalization to insert hardware to treat his bone fractures, as well as to perform debridement and skin graft procedures.  Based on the foregoing information, the Fifth Circuit concluded that the service of Jackson’s petition on April 28, 2009 started the six-month period for Eckstein to file its limitation complaint.

Eckstein, who filed the limitation complaint on January 18, 2010, argued that the six-month period should have started on December 2, 2009, when Jackson made his initial settlement demand for $3 million.  Under that theory, Eckstein’s limitation complaint clearly would have been timely.

The Fifth Circuit affirmed the federal district court, concluding that service of the Texas state court complaint on April 28, 2009, coupled with Eckstein’s knowledge of Jackson’s initial two – week medical treatment, raised a “reasonable possibility” that Jackson’s damages would exceed the value of the M/V ST. ANDREW.  As the Fifth Circuit explained:

Once a reasonable possibility has been raised, it becomes the vessel owner’s responsibility to initiate a prompt investigation and determine whether to file a limitation action.  The Limitation Act provides generous statutory protections to the vessel owners who reap all of its benefits.  When there is uncertainty as to whether a claim will exceed the vessel’s value, the reasonable possibility standard places the risk and the burdens associated with that risk on the owner.  In other words, if doubt exists as to the total amount of the claims or as to whether they will exceed the value of the ship the owner will not be excused from satisfying the statutory time bar since he may institute a limitation proceeding even when the total amount claimed is uncertain.

Id. at p. 9.  Accordingly, the Fifth Circuit concluded Eckstein’s limitation complaint should have been filed by October 28, 2009 and not on January 18, 2010.

Vessel owners – as the title suggests, when in doubt, file the limitation complaint.

The United States Supreme Court, in Pacific Operators Offshore, LLP v. Valladolid, concluded that the widow of an employee who suffered fatal injuries on shore may still recover LHWCA benefits pursuant to OCSLA if her husband’s death had a “substantial nexus” to his employer’s oil and gas operations on the OCS.  This is an unexpected decision based upon loose Congressional language in 43 U.S.C. § 1333(b), which adopts the LHWCA as the workers’ compensation scheme for the “disability or death of an employee resulting from any injury occurring as the result of operations conducted on the outer Continental Shelf” for the purpose of extracting its natural resources.

The Court disagreed with the Third Circuit’s test which was based on a “but for” standard.  The Court also rejected the Solicitor General’s proposal to adopt a Chandris-esque test that the employee have a substantial relation in duration and nature to OCS operations in order to qualify for LHWCA benefits under OCSLA.

Moreover, the Court discarded the en banc Fifth Circuit’s test for coverage that had focused solely on whether the incident occurred on an OCS situs.  The Court consigned to dicta inferences or statements to the contrary in its earlier decisions of Herb’s Welding, Inc. v. Gray and Offshore Logistics, Inc. v. Tallentire that had been interpreted to focus on the situs of the underlying accident as determining whether the employee was entitled to LWHCA benefits pursuant to OCSLA.

Rather, the Court agreed with the Ninth Circuit’s “substantial nexus” test in determining LHWCA coverage for OCSLA purposes.  Although the accident giving rise to this claim occurred on shore, 98% of Valladolid’s work activities were based on platforms and other oil and gas production structures affixed to the OCS.  Accordingly, Valladolid’s widow could recover LHWCA death benefits, pursuant to OCSLA.

Unlike the 30% test set forth in by the Court in Chandris, Inc. v. Latsis, the Supreme Court in Vallalodid left it to the lower courts to develop the boundaries of the “substantial nexus” criteria.  As Justice Scalia pointed out in his concurrence that agreed a “causation-like” standard was appropriate, but disagreed with the “substantial nexus” standard adopted by the Court – “What a tangled web we weave.”

A recurring issue in personal injury litigation is the amount of medical expenses a plaintiff is entitled to recover from the defendant.  The health care providers charge or bill the plaintiff for the treatment provided, but typically accept as payment in full significantly less from health insurers or the government.  The health insurers or government typically are protected via liens against the plaintiff’s recovery up to the amount they paid on behalf of the plaintiff.  Moreover, except for a potential deductible or co-payment, the plaintiff is not “out of pocket” any significant sum.  Yet, defendants often confront what is the proper recovery for the plaintiff’s medical expenses:  (1) the amount billed by the health care provider or (2) the amount accepted by the health care provider from third parties plus any deductible or co-pay by the plaintiff.  It does not strain the imagination to realize that awards based on the invoiced amount will result in a windfall to the plaintiff based on the spread between the amount billed and the amount accepted by the health care provider.

In Manderson v. Chet Morrison Contractors Inc., No. 10 – 31063 (5th Cir. Jan. 3, 2012), the U.S. Fifth Circuit reiterated that an injured seaman may recover cure (medical care) only for those medical expenses actually incurred.  In determining the seaman’s recovery for unpaid cure, the recoverable quantum is the amount “needed to satisfy the seaman’s medical charges.  This applies whether the charges are incurred by a seaman’s insurer on his behalf and then paid at a written-down rate, or incurred and then paid by the seaman himself, including at a non-discounted rate.”

The Fifth Circuit observed that the collateral source rule appeared incompatible with the obligation of Chet Morrison Contractors (“CMC”), the vessel owner, to provide cure to Manderson, an engineer, who was allegedly injured or became ill on CMC’s vessel.  Note:  In the same opinion, the Fifth Circuit had affirmed the district court’s denial of Manderson’s claims against CMC for negligence under the Jones Act or for unseaworthiness of the vessel under the general maritime law.

Generally speaking, the vessel owner’s obligations to pay maintenance (food and lodging during recuperation) and cure were implied in the contract of employment with the seaman, and did not depend on any determination of fault on the part of the vessel owner.  In contrast, the collateral source rule barred a tort defendant from reducing the quantum of damages owed to a personal injury / wrongful death plaintiff by the amount of recovery the plaintiff received from sources collateral to, or independent of, the defendant.  Under the general maritime law the collateral source rule has not been strictly applied to a seaman’s claims for maintenance and cure, which are owed irrespective of the vessel owner’s fault.  However, the Fifth Circuit previously recognized that “[W]here a seaman has alone purchased medical insurance, the ship owner is not entitled to a set-off from the maintenance and cure obligation moneys the seaman receives from his insurer.”

The Fifth Circuit recognized that a different result would have occurred had Manderson been pursuing a tort claim against CMC for which CMC would have been liable for compensatory damages.  Nevertheless, because CMC was liable to Manderson only for maintenance and cure, the bar of the collateral source rule was inapplicable.  As a result, Manderson’s recovery from CMC for breach of its cure obligation was reduced to the amount Manderson’s insurers actually paid his health care providers.  He was not entitled to recover the full amount billed by his health care providers.