Partial Section 18.001 Counteraffidavits: Unchallenged Medical-Expense Portions Remain Admissible (and Counteraffidavits May Prove the Reasonable Portion)

I. Introduction

Parties: Tatia Ortiz (plaintiff/petitioner) sued Ramu Nelapatla (defendant/respondent) for injuries arising from a vehicle collision in a Target parking lot in McKinney, Texas.

Core dispute: Ortiz sought to prove past medical expenses using the affidavit procedure in Texas Civil Practice and Remedies Code § 18.001. Nelapatla served counteraffidavits that challenged only parts of two providers’ charges. The trial court treated those partial counteraffidavits as defeating the admissibility/sufficiency of the providers’ affidavits in their entirety and excluded the affidavits (and also excluded the counteraffidavits as hearsay). As a result, the jury awarded only the one provider bill that was wholly unchallenged.

Key issue: What happens under § 18.001 when a counteraffidavit controverts only some of the amounts or matters in an initial medical-expense affidavit? Specifically: (1) do uncontroverted portions remain admissible/competent evidence, and (2) may a claimant offer a counteraffidavit into evidence when it affirmatively supports the reasonableness of some portion of the charges?

II. Summary of the Opinion

The Supreme Court of Texas reversed. It held that a § 18.001 counteraffidavit can controvert “all or part” of the matters in the initial affidavit, and when it does so only partially, the uncontroverted portions of the initial affidavit remain competent, admissible evidence that may be submitted to the factfinder. The Court further held that § 18.001 authorizes admission of counteraffidavits (despite hearsay concerns), and when a counteraffidavit affirmatively attests to the reasonable portion of charges, it may be used to support those uncontroverted matters. The Court remanded for further proceedings rather than rendering an increased damages judgment because § 18.001 evidence is sufficient but not conclusive, leaving the ultimate finding to the factfinder.

III. Analysis

A. Precedents Cited

• In re Chefs' Produce of Hou., Inc., 667 S.W.3d 297 (Tex. 2023)
  The court of appeals relied heavily on the line that “[i]n the face of a compliant counteraffidavit, the claimant may not reach the jury on the reasonableness and necessity of her medical expenses without expert testimony.” The Supreme Court clarified that this proposition applies to controverted claims, not to uncontroverted portions of a partially controverted affidavit. It also distinguished the posture in Chefs' Produce (motion to strike a counteraffidavit partly challenging causation), emphasizing that admissibility can be assessed claim-by-claim (item-by-item), not as an all-or-nothing consequence that wipes out unchallenged matters.
• In re Allstate Indem. Co., 622 S.W.3d 870 (Tex. 2021)
  Allstate supplied the Court’s central framework: § 18.001 is a legislative “streamline” mechanism that lets a party avoid live expert testimony on reasonableness and necessity by using affidavits that would otherwise be hearsay. Here, that framework supported two holdings: (1) when a matter is properly controverted, § 18.001 no longer supplies the hearsay “path” for that matter; but (2) where a matter is not controverted, § 18.001 continues to supply admissibility and evidentiary sufficiency for that portion.
• Whirlpool Corp. v. Camacho, 298 S.W.3d 631 (Tex. 2009) and Helena Chem. Co. v. Wilkins, 47 S.W.3d 486 (Tex. 2001)
  These cases provided the evidentiary standard of review—abuse of discretion for admissibility rulings—anchoring the Court’s conclusion that excluding evidence “without a valid legal basis” is reversible error.
• In re K & L Auto Crushers, LLC, 627 S.W.3d 239 (Tex. 2021) and Dall. Ry. & Terminal Co. v. Gossett, 294 S.W.2d 377 (Tex. 1956)
  These cases reinforced the long-standing Texas rule that past medical expenses must be proven reasonable (and typically necessary), providing context for why § 18.001 matters: it modifies the method of proof (affidavit procedure), not the substantive requirement.
• Haygood v. De Escabedo, 356 S.W.3d 390 (Tex. 2011)
  Cited (via Allstate) for the proposition that § 18.001 exists to avoid requiring expert testimony at trial on reasonableness and necessity when affidavits are properly served and not properly controverted.
• Lewallen v. Hardin, 563 S.W.2d 356 (Tex. App.—Dallas 1978, no writ)
  Used by the court of appeals to emphasize the default rule: affidavits are generally inadmissible hearsay without probative force. The Supreme Court did not dispute that default; instead, it explained that § 18.001 is a statutory exception that applies to both affidavits and counteraffidavits—unless and until a matter is properly controverted (in which case the statutory exception no longer supports admission for that contested matter).
• Williamson v. United States, 512 U.S. 594 (1994)
  Cited to illustrate hearsay’s “hazards” and the importance of cross-examination. The Court used this to explain the design of § 18.001: it mitigates hearsay concerns through a notice-and-controversion mechanism—allowing the opponent to file a counteraffidavit giving reasonable notice of the basis to controvert.
• State v. Cent. Expressway Sign Assocs., 302 S.W.3d 866 (Tex. 2009) and Reliance Steel & Aluminum Co. v. Sevcik, 267 S.W.3d 867 (Tex. 2008)
  These cases supported the harm analysis: when excluded evidence is crucial to a key issue, exclusion is likely harmful. Here, exclusion was decisive because Ortiz was left with “no evidence” of the disputed providers’ charges.

B. Legal Reasoning

1. Section 18.001 operates at the level of “claims” within a bill, not necessarily the entire bill.
   The text allows a counteraffidavit to testify “in contravention of all or part of any of the matters contained in the initial affidavit.” From that, the Court derived a claim-by-claim approach: a counteraffidavit defeats § 18.001 sufficiency only as to the controverted matters.
2. Partial controversion does not justify total exclusion.
   If only some services/charges are controverted, the remainder remains within § 18.001(b)’s “sufficient evidence” rule. The correct evidentiary response is not blanket exclusion, but redaction of the controverted portions so the jury sees only admissible (uncontroverted) § 18.001 material.
3. Controversion withdraws the statutory hearsay exception only for what is contested.
   The Court reconciled the hearsay baseline (Tex. R. Evid. 802) with § 18.001 by treating controversion as turning off the statute’s shortcut for the challenged matters. Those challenged passages revert to ordinary evidentiary rules—typically requiring live expert testimony.
4. Counteraffidavits can be admissible evidence—sometimes even for the claimant.
   Section 18.001 repeatedly references a “party” offering a counteraffidavit, not just a defendant. Therefore, if a counteraffidavit affirmatively states that a portion of the charge is reasonable (as in Guitreau’s allocation of reasonable amounts within each charge), it may be offered to prove that reasonable portion. The trial court’s categorical “hearsay” exclusion was inconsistent with the statute’s express contemplation of offering counteraffidavits into evidence.
5. Application to the two disputed providers.
   • Synergy (Le Cara): some services were challenged as medically unnecessary; unchallenged items remained admissible via the initial affidavit, and the counteraffidavit could support the amount it affirmatively deemed “reasonable and necessary” ($2,950).
   • LifeSciences (Guitreau): necessity of services was not disputed, but each charge was partially disputed as exceeding usual/customary amounts; the initial affidavit could support necessity, while Guitreau’s counteraffidavit could support the reasonable portions ($9,774.54) without requiring Ortiz to call live expert testimony—so long as only the admissible portions were presented.
6. Remedy and limits.
   The Court refused to render an additur-like judgment for the uncontroverted totals because § 18.001 evidence is “sufficient, but not conclusive.” The factfinder remains free to accept or reject it. The Court also emphasized a ceiling: absent expert testimony, a jury award cannot exceed the uncontroverted amount; if it does, remittitur is appropriate.

C. Impact

• Trial-court procedure will shift from “all-or-nothing” to “surgical.”
  Trial courts confronted with partial counteraffidavits should expect targeted redactions and item-by-item admissibility determinations, rather than wholesale exclusion of a provider’s affidavit/bill.
• Defense counteraffidavits may become double-edged.
  If a defense expert counteraffidavit concedes (or calculates) a reasonable portion, plaintiffs may use those concessions as admissible § 18.001 evidence—reducing the need to retain an additional expert for the conceded portions.
• More precise drafting incentives.
  Counteraffidavits that “over-concede” reasonableness may effectively establish a plaintiff’s floor of recoverable expenses (subject to the factfinder’s acceptance). Conversely, plaintiffs will be incentivized to prepare redacted exhibits and to segregate contested from uncontested items to preserve admissibility.
• Clarifies the scope of “expert testimony required” language.
  After this decision, the “expert testimony is required” principle from In re Chefs' Produce of Hou., Inc. is best understood as applying to the controverted medical-expense matters, not as a rule that nullifies an entire affidavit whenever any part is challenged.

IV. Complex Concepts Simplified

Section 18.001 affidavit

A pretrial sworn statement (with an itemized bill) that can serve as evidence that medical charges were reasonable and services necessary—avoiding calling a live expert—unless properly controverted.

Counteraffidavit

A sworn statement served by the opposing party that challenges (“controverts”) all or part of the initial affidavit’s claims, and must give reasonable notice of the basis for the challenge.

Hearsay and statutory exceptions

Affidavits are ordinarily inadmissible hearsay (Tex. R. Evid. 802). Section 18.001 creates a statute-based admissibility pathway—but only for matters not properly controverted (or, as this case clarifies, only for the uncontroverted parts).

“Sufficient but not conclusive”

Evidence that is legally enough to support a finding, but the jury is not required to accept it; the factfinder weighs it.

Redaction

Editing an exhibit so the jury sees only the admissible portions (here, removing controverted line items or statements about controverted amounts).

Remittitur

A procedure reducing an excessive damages award to the maximum supported by legally sufficient evidence.

V. Conclusion

Ortiz v. Nelapatla establishes a practical, text-driven rule for Texas civil trials under Texas Civil Practice and Remedies Code § 18.001: partial controversion does not erase uncontroverted proof. Unchallenged portions of a medical-expense affidavit remain admissible and competent evidence, and counteraffidavits—expressly contemplated by the statute—may also be admissible, including when offered by the claimant to prove the portion the counteraffiant concedes is reasonable. The decision strengthens § 18.001’s streamlining function while preserving the adversarial safeguard that controverted matters must be proven by ordinary evidence (typically live expert testimony) rather than affidavit alone.