Case Title: Radvany v. Davis

Citation: 

Docket Number: 002499

State: virginia

Court: Virginia Supreme Court

Date: 2001-09-14T00:00:00Z

Document:
Present:  All the Justices 
 
DONALD W. RADVANY 
 
v.  Record No. 002499     OPINION BY JUSTICE ELIZABETH B. LACY 
 
 
 
September 14, 2001 
JEAN T. DAVIS 
 
FROM THE CIRCUIT COURT OF CHESTERFIELD COUNTY 
Michael C. Allen, Judge 
 
 
 Donald W. Radvany seeks reversal of a trial court 
judgment entered on a jury verdict awarding Jean T. Davis 
$65,000 in damages for injuries she suffered as a result of 
Radvany's negligence.  For the following reasons, we conclude 
that the trial court did not err in refusing to allow the 
introduction into evidence of the payment accepted by health 
care providers for the medical services rendered to Davis and 
did not err in instructing the jury on the aggravation of a 
preexisting condition. 
I.  Medical Bills 
Davis' medical bills showed that the health care 
providers billed her $19,219.64 for the medical services 
rendered to her.  The bills also showed the amount accepted by 
the health care providers as payment in full, $7,819.99.  The 
trial court held that, "under the Supreme Court decision of 
Acuar v. Letournea[u] [260 Va. 180, 531 S.E.2d 316 (2000)] and 
other authorities," Radvany could not introduce into evidence 
the amounts paid by Davis' medical insurance carrier and 
 
 
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accepted by the health care providers as payment in full for 
the medical services rendered to Davis. 
Radvany asserts that this ruling is erroneous because 
Acuar only addressed whether amounts "written off" by health 
care providers could be claimed as damages and did not rule on 
whether the amounts accepted by health care providers as 
payment in full for medical care rendered were evidence of the 
reasonable value of the services.  We disagree. 
In Acuar, applying the collateral source rule, we held 
that a tortfeasor may not deduct from the full compensation 
owed an injured party any part of the benefits the injured 
party received from his contractual arrangement with his 
health insurance carrier.  Those benefits included not only 
the amounts written off by the health care provider but also 
the actual payments made by the health insurance carrier. 
Those amounts written off are as much of a benefit 
for which Letourneau paid consideration as are the 
actual cash payments made by his health insurance 
carrier to the health care providers. 
 
260 Va. at 192, 531 S.E.2d at 322.  Payments made to a medical 
provider by an insurance carrier on behalf of an insured and 
amounts accepted by medical providers are one and the same.  
Regardless of the label used, they are payments made by a 
collateral source and, thus, are not admissible in evidence 
for that reason. 
 
 
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Furthermore, such amounts are not evidence of whether the 
medical bills are "reasonable, i.e., not excessive in amount, 
considering the prevailing cost of such services."  McMunn v. 
Tatum, 237 Va. 558, 568, 379 S.E.2d 908, 913 (1989).  The 
amounts accepted by Davis' health care providers represent 
amounts agreed upon pursuant to contractual negotiations 
undertaken in conjunction with Davis' health insurance policy.  
Such negotiated amounts, presumably inuring to the benefit of 
the medical providers, the insurance carrier, and Davis, do 
not reflect the "prevailing cost" of those services to other 
patients. 
 
Accordingly, the trial court did not err in ruling that 
Radvany could not introduce into evidence the amounts accepted 
by the medical service providers as payment in full for the 
medical services rendered Davis. 
II.  Aggravation of a Preexisting Condition 
Radvany also claims that there was no evidence to support 
a jury instruction on the aggravation of a preexisting 
condition and that the trial court erred in giving that 
instruction.  Again, we disagree with Radvany. 
Davis testified that she experienced pain in her right 
shoulder approximately three months after the accident and 
that she did not recall having any pain or problems with her 
shoulder prior to that time.  Her treating physician, Dr. Mark 
E. deBlois, testified that Davis' rotator cuff was injured, 
 
 
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that the accident caused the tear in Davis' rotator cuff, and 
that the injury required surgery.  Dr. deBlois also testified 
that Davis had a bone spur on her shoulder joint, which he 
described as a calcium growth associated with degenerative 
changes in the shoulder joint. 
Radvany's expert witness, Dr. John Meyers, disagreed, 
asserting that the injury was the result of degenerative 
changes that would have occurred regardless of the accident.  
Meyers also testified that 75% of people Davis' age have 
rotator cuff tears and that many of such conditions are 
asymptomatic.  In response to a question by Davis' counsel, 
Meyers stated that the tear in Davis' rotator cuff "may have" 
developed prior to the accident. 
 
Both experts testified that Davis had a condition which 
could have pre-dated the accident, a degenerative shoulder 
joint and a rotator cuff tear.  Dr. Meyers' testimony 
supported the inference that the torn rotator cuff could have 
been asymptomatic prior to the accident.  Davis testified she 
had no shoulder pain until after the accident.  This evidence 
was "more than a scintilla" and thus was sufficient to support 
a jury instruction on the aggravation of a preexisting 
condition.  Rosen v. Greifenberger, 257 Va. 373, 380, 513 
S.E.2d 861, 865 (1999). 
 
For these reasons, we will affirm the judgment of the 
trial court. 
 
 
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Affirmed.