Opinion
No. CV 09-5026940-S
May 23, 2011
MEMORANDUM OF DECISION MOTION FOR COLLATERAL SOURCE REDUCTION
Following a verdict in favor of the plaintiff awarding economic damages in the total amount of $21,419.35, wherein the plaintiff's comparative negligence was found to be 50%, the defendant has moved for a collateral source reduction pursuant to General Statutes § 52-225b. Through her employer, the plaintiff participates in the New England Healthcare Employees Welfare Fund, an ERISA health and welfare benefit plan (Welfare Fund). The fund paid all her accident-related medical bills. The original lien by the Welfare Fund was $4,352.53. On December 8, 2010, the day after the verdict was returned, through legal counsel, the Welfare Fund notified the plaintiff that it would accept $2,901.69, two-thirds of the total benefits paid out on the plaintiffs behalf, in full settlement of the lien. See Plaintiff's Exhibit 9.
The jury awarded $0 non-economic damages. The verdict was returned on December 7, 2010.
A hearing was held on January 10, 2011 following which the parties filed briefs. Although they addressed the question of the whether an ERISA lien is a collateral source, neither side addressed the specific issue raised herein.
Based on a spread sheet included with Plaintiff's Exhibit 9, the Welfare Fund's calculation of the total amount of medical bills was $20,684.05.
The primary issue for resolution by the court is whether the portion of the lien forgiven by the Welfare Fund should be subject to a collateral source reduction even though there is no question that an ERISA lien is not itself a collateral source.
General Statutes § 52-225b states: "`Collateral sources' means any payments made to the claimant, or on his behalf, by or pursuant to: (1) Any health or sickness insurance, automobile accident insurance that provides health benefits, and any other similar insurance benefits, except life insurance benefits available to the claimant, whether purchased by him or provided by others; or (2) any contract or agreement of any group, organization, partnership or corporation to provide, pay for or reimburse the costs of hospital, medical, dental or other health care services. `Collateral sources' do not include amounts received by a claimant as a settlement."
In Hassett v. New Haven, 49 Conn.Sup. 7, 10, 858 A.2d 922 [ 37 Conn. L. Rptr. 735] (2004), aff'd, 91 Conn.App. 245, 247, 880 A.2d 975 (2005), the court held that voluntary forgiveness of a debt is not a collateral source, if the payment is not made by or pursuant to "[a]ny . . . insurance" or "any contract or agreement within the meaning of § 52-225b." The Appellate Court adopted Hassett v. New Haven, supra, 49 Conn.Sup. 7, "as a proper statement of the issues and the applicable law concerning those issues." Hassett v. New Haven, 91 Conn.App. 245, 247, 880 A.2d 975 (2005). Subsequent to Hassett, trial courts have regularly concluded that contractual writeoffs by health care providers are collateral sources within the definition of that term as set forth in § 52-225b. See Olivero v. Ferrante, Superior Court, judicial District of Waterbury, Docket No. 044001161, (March 22, 2010, Sheedy, J.) [ 49 Conn. L. Rptr. 520]; Bonsanti v. Newman, Superior Court, judicial district of Fairfield at Bridgeport, Docket No. 030401098 (February 3, 2006, Gilardi, J.) ( 40 Conn. L. Rptr. 700) ("[I]nvoluntary forgiveness of a debt, like the adjustments made by medical providers in this case as a condition of their contract with Blue Cross Blue Shield of Massachusetts, is a collateral source payment within the meaning of § 52-225b for the purposes of calculating a reduction in economic damages pursuant to § 52-225a"); and Furlong v. Merriman, Superior Court, judicial district of New Britain, Docket No. 044000416 (May 4, 2006, Shapiro, J.) ("The plaintiff already received the benefit of the Cigna allowance, since it was subtracted from the amount he was billed by Middlesex Hospital. He should not receive that amount again by having it included in the jury's economic damages award").
In the present case, the Welfare Fund's forgiveness of part of its lien against the plaintiff's recovery of economic damages was voluntarily made in favor of its insured. The lien itself is not a collateral source. See Gauntlett v. Webb, Superior Court, judicial district of Fairfield at Bridgeport, Docket No. 980352842 (August 13, 2003, Ballen, J.T.R.) ( 35 Conn. L. Rptr. 419) ("a self-funded welfare benefit plan under ERISA, does not qualify as a collateral source under Connecticut law pursuant to 29 U.S.C. § 1144(b)(2)(B)"). Voluntary forgiveness of a portion of an ERISA lien, like the lien itself, is not a collateral source within the meaning of § 52-225b for the purposes of calculating a reduction in economic damages pursuant to § 52-225a.
Accordingly, the court calculates the economic damage award as follows:
- 722.80 -16,344.02 - 2,176.26 + 361.40
This is the exact amount of medical bills awarded by the jury. The Welfare Fund calculated the total medical bills to be $20,684.05, a difference of $12.52. The discrepancy appears to be in Welfare Fund's calculation of Dr. Calley's bills. As recorded in the Plaintiff's Verdict, the Dr. Calley's bills actually total $812.50, not $800. Compare Plaintiff's Exhibits 8 and 9. For the reasons elsewhere stated in this memorandum, the $12.50 is also a collateral source.
The $16,344.05 is the collateral source reduction which reflects the total amount written off or forgiven in accordance the various medical provider contracts with Connecticut Anthem Blue Cross and Blue Shield, the plaintiff's health insurance carrier. See Defendant's Exhibit E. The Welfare Fund paid a total of $4,352.53 on behalf of the plaintiff, which is not a collateral source.
CONCLUSION
For all the foregoing reasons, in accordance with the foregoing calculations, after reduction for collateral sources, the court hereby orders that the plaintiff is entitled to a total economic damage award of $2,537.67.