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Collateral Source Cases

Fairfax Injury Lawyer Brien Roche Addresses The Collateral Source Cases

Brien Roche

Tort-Collateral Source Cases

The collateral source rule is a rule of evidence.  It  says that any collateral or side payment made to the plaintiff is not admissible.  In other words a collateral source is a payment from an insurer, a governmental entity, a pension plan or other third party payor.  Therefore these types of payments are collateral.  They are benefits that the plaintiff somehow earned or is otherwise entitled to.  The rule intends to put the full burden of the loss on the at-fault party.  In other words that at-fault party does not get any benefit from any payments that the plaintiff may have received from this collateral or side source of payment.  Accordia of Virginia Insurance Agency v. Genito Glenn, LP, 263 Va 377, 560 S.E.2d 246 (2002).

Under this rule, the defendant cannot present any facts as to any such payments made to the plaintiff.  Likewise any reduction in the plaintiff’s medical bills or write-offs by healthcare providers or insurance carriers cannot be introduced.  Acuar v. Letourneau, 260 Va. 180, 531 S.E.2d 316 (2000).

Also in a wrongful death action, payments made to the decedent’s mother from life insurance are not admissible.  Walthew v. Davis, 201 Va. 557, 111 S.E.2d 784 (1960).

Likewise in a case where the insurer is also the tortfeasor, then payments made by the insurer are not admissible.  For instance in a case against Kaiser for medical malpractice, the fact that Kaiser paid the bills of the plaintiff is not admissible.  Karsten v. Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., 36 F.3d 8 (1994)

Attempts To Breach Collateral Source

Defense lawyers have been seeking to use Obamacare as a further invasion of the collateral source rule.  The claim being made by the defense is that any payments for future health care costs should be capped at what is called the “out-of-pocket limit” under Obamacare.  That limit is $6,350.00 for an individual plan and $12,700.00 for a family plan in 2014.  However there are a number of reasons why the Affordable Care Act (Obamacare) would not apply in these cases:

  • The Act does not require everybody to have insurance
  • The Act does not permit people to buy insurance at any time
  • The out-of-pocket limit does not cover all types of care
  • The maximum out-of-pocket limit does not apply to bills from providers that are not in-network
  • Many of the requirements of the Act do not apply to certain types of plans

Contract-Collateral Source Cases

In addition in 2019 the Virginia high court said the collateral source rule applies in a breach of contract case when the plaintiff has been reimbursed by an insurer for the full amount it seeks in damages. Dominion Resources Inc v Alstom Power Inc 297 Va. 262 (2019). Call, or contact us for a free consult. Also for more info on collateral source matters Wikipedia pages. Also see the post on this site dealing with injury issues.

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Collateral Source Cases

Fairfax Injury Lawyer Brien Roche Addresses The Collateral Source Cases

Brien Roche

Tort-Collateral Source Cases

The collateral source rule is a rule of evidence.  It  says that any collateral or side payment made to the plaintiff is not admissible.  In other words a collateral source is a payment from an insurer, a governmental entity, a pension plan or other third party payor.  Therefore these types of payments are collateral.  They are benefits that the plaintiff somehow earned or is otherwise entitled to.  The rule intends to put the full burden of the loss on the at-fault party.  In other words that at-fault party does not get any benefit from any payments that the plaintiff may have received from this collateral or side source of payment.  Accordia of Virginia Insurance Agency v. Genito Glenn, LP, 263 Va 377, 560 S.E.2d 246 (2002).

Under this rule, the defendant cannot present any facts as to any such payments made to the plaintiff.  Likewise any reduction in the plaintiff’s medical bills or write-offs by healthcare providers or insurance carriers cannot be introduced.  Acuar v. Letourneau, 260 Va. 180, 531 S.E.2d 316 (2000).

Also in a wrongful death action, payments made to the decedent’s mother from life insurance are not admissible.  Walthew v. Davis, 201 Va. 557, 111 S.E.2d 784 (1960).

Likewise in a case where the insurer is also the tortfeasor, then payments made by the insurer are not admissible.  For instance in a case against Kaiser for medical malpractice, the fact that Kaiser paid the bills of the plaintiff is not admissible.  Karsten v. Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., 36 F.3d 8 (1994)

Attempts To Breach Collateral Source

Defense lawyers have been seeking to use Obamacare as a further invasion of the collateral source rule.  The claim being made by the defense is that any payments for future health care costs should be capped at what is called the “out-of-pocket limit” under Obamacare.  That limit is $6,350.00 for an individual plan and $12,700.00 for a family plan in 2014.  However there are a number of reasons why the Affordable Care Act (Obamacare) would not apply in these cases:

  • The Act does not require everybody to have insurance
  • The Act does not permit people to buy insurance at any time
  • The out-of-pocket limit does not cover all types of care
  • The maximum out-of-pocket limit does not apply to bills from providers that are not in-network
  • Many of the requirements of the Act do not apply to certain types of plans

Contract-Collateral Source Cases

In addition in 2019 the Virginia high court said the collateral source rule applies in a breach of contract case when the plaintiff has been reimbursed by an insurer for the full amount it seeks in damages. Dominion Resources Inc v Alstom Power Inc 297 Va. 262 (2019). Call, or contact us for a free consult. Also for more info on collateral source matters Wikipedia pages. Also see the post on this site dealing with injury issues.

Contact Us For A Free Consultation

Contact Us For A Free Consultation