IN THE COURT OF APPEALS OF IOWA

No. 14-1738

Filed January 13, 2016

PATRICIA ELLEN KNOWLTON, 

Plaintiff-Appellant, 

vs. 

GRINNELL SELECT INSURANCE

COMPANY, 

Defendant-Appellee.

________________________________________________________________

Appeal from the Iowa District Court for Chickasaw County, Richard D. 

Stochl, Judge. 

Patricia Knowlton appeals the jury verdict awarding her damages for an 

underinsured motorist claim. AFFIRMED.

Judith O’Donohoe of Elwood, O’Donohoe, Braun & White, L.L.P., Charles 

City, for appellant.

David L. Riley of McCoy, Riley & Shea, P.L.C., Waterloo, for appellee.

Heard by Vogel, P.J., and Vaitheswaran and Bower, JJ.
2

BOWER, Judge.

Patricia Knowlton appeals the jury verdict awarding her damages for an 

underinsured motorist claim against her insurer Grinnell Select Insurance 

Company (Grinnell). Knowlton claims multiple errors in virtually every facet of 

the trial claiming the court erred by: (1) denying evidence of the terms of the

underinsurance contract; (2) refusing to admit her claim for medical expenses or 

denying a new trial based on its ruling; (3) denying her request to take the 

treating neurosurgeon’s deposition during trial, substitute a local non-treating

orthopedist or postpone trial; (4) directing a verdict or denying a new trial on 

claims for future loss of bodily function and/or future pain and suffering; (5) 

admitting evidence or denying a new trial because of payments made to 

Knowlton, which were excludable under the collateral source rule; (6) denying a 

new trial for the jury’s failure to award any damages for lost income; (7) denying

a new trial based on the cumulative prejudicial effect of its conduct and rulings; 

and(8) reducing the verdict ex parte without a record or hearing. For the reasons 

stated herein, we affirm the judgment of the district court. 

I. BACKGROUND FACTS AND PROCEEDINGS

Knowlton was diagnosed with multiple sclerosis (MS) in 1996. Initially, 

Knowlton struggled with loss of sensation from the waist down, decreased 

balance, leg weakness, and loss of bowel and bladder function. Medical records 

show Knowlton experienced difficulty with short-term memory loss, dizziness, 

and fatigue. She worried her symptoms would affect her job performance—

especially the short-term memory loss. 
3

On June 21, 2011, Knowlton was involved in a car accident when a car in 

which she was a passenger was struck by a car driven by Shaine Slick. 

Knowlton initiated the present lawsuit on June 4, 2013, by filing a petition against 

Grinnell. She claimed the accident was solely the result of Slick’s negligence. 

She claimed Slick was underinsured and did not have sufficient coverage to pay 

the damages she sustained. Knowlton’s underinsurance coverage was 

$300,000. Grinnell admitted Knowlton was insured and if Slick was underinsured 

Knowlton was entitled to benefits under the policy. 

A trial scheduling order was filed on October 29, 2013. The order required 

all depositions to be completed sixty-days before trial, Knowlton to disclose her 

expert witnesses 210 days before trial, and both parties to file a witness and 

exhibit list seven days before trial. If the parties did not adhere to the deadlines 

the court reserved the right to impose sanctions. 

Knowlton filed two designations of expert witnesses. The first, on 

November 7, 2013, designated Dr. Brian Weinshenker as the “treating physician 

for neck,” and Dr. Wayne Newkirk as an economist. The second version, filed 

December 5, 2013, added Thomas Burr, forensic scientist. Knowlton conducted 

a deposition of Weinshenker on June 11, 2014, at the Mayo Clinic in Minnesota. 

A pre-trial conference was scheduled for June 24, 2014. After Knowlton’s 

counsel, Judith O’Donohoe, did not respond as scheduled Grinnell’s counsel

learned O’Donohoe was on vacation. O’Donohoe’s legal assistant also could not 

reach O’Donohoe. The district court conducted the pre-trial conference in 

O’Donohoe’s absence but with her legal assistant on the phone. The court 
4

confirmed both parties were ready to go forward with trial and reminded the 

parties of the scheduling deadlines.

On June 24, 2014, Knowlton advised Grinnell of her intention to call Dr. 

Val Lyons, an orthopedic surgeon, to testify about Knowlton’s neck impairment 

rating. The content of Lyons’s opinion was disclosed for the first time on July 7, 

2014, two days before trial. The court sustained Grinnell’s motion in limine to 

exclude Lyons’s testimony due to its late disclosure. 

On July 2, Knowlton filed her witness and exhibit list, an amended version 

was filed on July 9—the morning of trial. Medical bills were not included as 

exhibits. Later in the morning of July 9, Knowlton filed a third witness and exhibit 

list, in which she included three new proposed medical witnesses and medical 

bills from Mayo Clinic and Mercy Medical Center. 

Also on the morning of trial, Grinnell offered to confess judgment in the 

amount of $100,000, which Knowlton declined. After a five-day trial, the jury 

returned a verdict for Knowlton in the amount of $75,000. Separate damage 

awards were granted to Knowlton’s three children in the amount of $7500 each. 

After several post-trial motions, the district court offset the $75,000 by the 

$50,000 Knowlton had received from Slick’s insurance company and entered 

judgment against Grinnell in the amount of $25,000. 

Knowlton appeals.1 

 

1 Of the eight issues Knowlton has raised on appeal, she has not preserved error on the 

following five issues: (Knowlton’s issues I and III) Knowlton failed to make an offer of 

proof after the district court excluded evidence on the terms of the underinsurance 

contract and the expert medical testimony. “Generally, a ruling sustaining a motion in 

limine is not a ruling on the evidence; the ruling merely adds a procedural step to the 
5

II. STANDARD OF REVIEW

We review the court’s evidentiary rulings for an abuse of discretion. Hall 

v. Jennie Edmundson Mem’l Hosp., 812 N.W.2d 681, 685 (Iowa 2012). A district 

court abuses its discretion when its decision rests on grounds or on reasons 

clearly untenable or to an extent clearly unreasonable. Id. There will be no 

abuse of discretion found unless a party has suffered prejudice. Id. The district 

court is given broad discretion in evidentiary matters, and we will disturb its 

rulings upon a showing of abuse. Id. 

Similarly, we review a claim concerning whether the trial court should have 

given a party’s requested jury instruction for an abuse of discretion. Hagenow v.

Schmidt, 842 N.W.2d 661, 670 (Iowa 2014). 

District courts have considerable discretion to allow amendments at any 

point in the litigation, and we will only reverse the district court’s decision if it has 

abused that discretion. Baker v. City of Iowa City, 867 N.W.2d 44, 51 (Iowa 

2015).

 

offer of evidence. If the evidence is not offered, there is nothing preserved to review on 

appeal.” Twyford v. Weber, 220 N.W.2d 919, 922–23 (Iowa 1974); see also Quad City 

Bank & Trust v. Jim Kircher & Associates, P.C., 804 N.W.2d 83, 91–92 (Iowa 2011). 

(Knowlton’s issue VI) Knowlton did not object to the submission of the damages for lost 

income to the jury, and therefore she has not preserved error on this issue by 

mentioning it for the first time in her motion for new trial. See Iowa R. Civ. P. 1.924; 

Summy v. City of Des Moines, 708 N.W.2d 333, 338 (Iowa 2006) (“To preserve error for 

appellate review, a party must alert the district court to the issue at a time when the 

district court can take corrective action.”). (Knowlton’s issue VII) Knowlton has not 

preserved error on her claim the cumulative effect of the district court’s conduct caused 

an unfair trial. Knowlton did not object at any point during trial when the court engaged 

in the complained of behavior, and since the district court has not ruled on this issue, we 

decline to address it on appeal. See Summy, 708 N.W.2d at 338. Finally, (Knowlton’s 

issue VIII) Knowlton claims there was insufficient evidence in the record to support any 

reduction in the $75,000 in damages. The parties discussed this issue with the court 

and Knowlton did not object. Knowlton first objected to this arrangement in a post-trial 

motion, therefore we decline to address it on appeal. See id. 
6

We review the trial court’s decision to direct a verdict for the correction of 

errors of law. Determan v. Johnson, 613 N.W.2d 259, 261 (Iowa 2000). A 

defendant’s motion for directed verdict should be denied if there is substantial 

evidence to support the plaintiff’s claim. Id. “Evidence is substantial when a 

reasonable mind would accept it as adequate to reach a conclusion.” Id.

III. DISCUSSION 

A. Medical Expenses

Knowlton claims the district court erred in refusing to submit her claims for 

medical expenses.

1. Error Preservation

Grinnell contends Knowlton has not preserved error on her claim the court 

erred in refusing to submit her request for past medical expenses. Both parties 

filed their proposed jury instructions on July 8, 2014. Knowlton did not include 

medical expenses in her proposed jury instructions or interrogatories. The 

morning of trial, Knowlton’s counsel decided to include medical expenses. 

The Court: At 8:40 this morning Plaintiff filed its proposed 

jury instructions. Those proposed jury instructions, there’s no 

mention of a loss for medical expenses. In Plaintiff’s petition she 

seeks damages for sustained injuries and other damages including 

lost wages, pain and suffering and loss of enjoyment of life. 

Medical expenses were not pled. 

Ms. O’Donohoe: However, they are in Answers to 

Interrogatories. 

The Court: They’re not pled. Plaintiff did not notify 

Defendant of any intention to claim medical expenses until twenty 

minutes before we were to start trial. Plaintiff advised the Court 

that they were unaware of any subrogation claim for medical 

expenses despite the fact the insurance company with the claim 

advised this Court of multiple communications between counsel’s 
7

office and the company in writing and also communication by 

telephone confirming that subrogation claim. I do find that the 

defendant would be prejudiced by allowing medical bills to be 

submitted at this time and the exhibit list be modified. Therefore, 

Plaintiff’s application to modify its exhibit list and now claim medical 

expenses twenty—that were identified twenty minutes before trial 

started is denied. Ready for openings?

Ms. O’Donohoe: Okay. Your Honor, I do—not right now, but 

I want to make a record and provide Weinshenker’s deposition, my 

Answer’s to interrogatories which clearly showed medical 

expenses. 

The Court: My reason is that you were told by the Court to 

submit your witness and exhibit list seven days before trial and to 

identify each and every exhibit. You didn’t say you were submitting 

any medical bills. This morning you told the Court, you told Mr. 

Riley—you filed a pleading asking for proposed jury instructions 

that in no way ask for medical bills. And now you’re telling the 

Court and Mr. Riley that you want forty-eight thousand dollars or 

thirty-five thousand. I don’t know what amount. You don’t even 

know what amount. How is the jury going to sort out what amount 

of medical bills to give when you don’t even know what they are? 

Ms. O’Donohoe: Well, I know what I think is a valid medical 

expense. 

The Court: Well, we’re five minutes away from openings. I 

think you should know exactly the amount of medical bills claimed. 

Ms. O’Donohoe: Well—

The Court: Well, my ruling stands, but you’re certainly willing 

to make an offer of proof and make an argument.

Although Knowlton’s attorney made an offer of proof counsel did not make 

a formal objection to the court’s refusal to submit the proposed instruction on 

past medical expenses as required by Iowa Rule of Civil Procedure 1.924.2 

 

2 That rule provides in part:

Before jury arguments, the court shall give to each counsel a copy of its 

instructions in their final form, noting this fact of record and granting 

reasonable time for counsel to make objections, which shall be made and 

ruled on before arguments to the jury. Within such time, all objections to 

giving or failing to give any instruction must be made in writing or dictated 

into the record, out of the jury’s presence, specifying the matter objected 

to and on what grounds. No other grounds or objections shall be 

asserted thereafter, or considered on appeal. 

Iowa R. Civ. P. 1.924.
8

However, our supreme court, in Ostrem v. State Farm Mutual Automotive 

Insurance Company, held a jury instruction was properly raised and preserved if 

the party advised the court what she wanted and why, the court ruled on the 

matter before arguments, and a record was made on the instruction. 666 N.W.2d 

544, 548 (Iowa 2003). Based on the pre-trial exchange between the court and 

Knowlton’s counsel, and Knowlton’s offer of proof, Knowlton adequately raised 

the issue concerning the district court’s refusal to submit an instruction on past 

medical expenses. 

2. Merits

In support of Knowlton’s claim, she raises several arguments on why the 

court erred. Ultimately, we must decide if the court erred in excluding Knowlton’s 

claim for past medical expenses. 

As noted above, the first time Knowlton expressed a desire to claim past 

medical expenses was a few minutes before trial. The court found Grinnell would 

be prejudiced by their submission. The court relied on the untimely nature of 

Knowlton’s claim as she did not include medical expenses in any of her 

pleadings. The language used by the district court tracks with the law concerning 

amendments to pleadings:

Iowa Rule of Civil Procedure [1.402(4)] governs the 

amendment of pleadings. This rule instructs district courts to freely 

grant leave to amend when required by the interests of justice.

Iowa R. Civ. P. [1.402(4)]; Davis [v. Ottumwa Young Men’s 

Christian Ass’n], 438 N.W.2d [10,] 14 [(Iowa 1989)]. Generally, a 

party may amend a pleading at any time before a decision is 

rendered, even after the close of the presentation of the evidence. 

Ackerman v. Lauver, 242 N.W.2d 342, 345 (Iowa 1976). As long as 

the amendment does not substantially change the issues or 
9

defense of the case, the court should permit the amendment. 

Glenn v. Carlstrom, 556 N.W.2d 800, 804 (Iowa 1996); Davis, 438 

N.W.2d at 14; . . . . Even an amendment that substantially changes 

the issues may still be allowed if the opposing party is not 

prejudiced or unfairly surprised. See McElroy [v. State], 637 

N.W.2d [488,] 495 [(Iowa 2001)]; Chao v. City of Waterloo, 346 

N.W.2d 822, 825–26 (Iowa 1984).

Rife v. D.T. Corner, Inc., 641 N.W.2d 761, 767 (Iowa 2002). “The relevant 

‘issues’ are established either by the initial pleadings . . . or by those matters on 

which the parties have ‘consented’ to litigate, either expressly or impliedly.” 

Allison-Kesley Ag Ctr., Inc. v. Hildebrand, 485 N.W.2d 841, 846 (Iowa 1992)

(citations omitted).

Here, the initial pleadings did not include a request for medical expenses. 

The first time Knowlton made a claim for past medical expenses was the morning 

of trial. While the medical records at issue were included in discovery, Grinnell’s 

counsel did not have an opportunity to analyze the records and discern the 

amount directly related to the injury. Grinnell’s counsel stated he relied on the 

witness and exhibit list and determined medical expenses were not at issue. The 

district court found Grinnell was prejudiced by Knowlton’s eleventh-hour 

amendment to her pleadings and disallowed her claim for medical expenses. We 

find the district court did not abuse its discretion. 

B. Directed Verdict on Future Loss of Function of the Body 

and/or Future Pain and Suffering

Knowlton claims the district court erred in granting Grinnell’s motion for 

directed verdict on future loss of function of the body and future pain and 

suffering. 
10

At the close of Knowlton’s case, Grinnell moved for a directed verdict. In 

its motion, Grinnell argued Knowlton had presented insufficient evidence to 

support these claims because they included medical questions and no expert 

testimony had been presented to show the injuries were permanent or may 

cause future problems for Knowlton. In granting Grinnell’s motion the court 

reasoned:

Last evening I thoroughly reviewed plaintiff’s medical records 

with an eye on trying to find some support in these records that 

would justify the submission of future damages, looking at them in 

the light most favorable to the plaintiff. The last record I could find 

addresses her—that addresses her true orthopedic issues is April 

of 2012, more than two years ago. The only other evidence is her 

subjective statements and the opinions of her family members. 

Ironically, there is evidence in this record plaintiff suffered a neck 

fracture in an auto accident while a teenager. She claims no 

permanency from that injury, but demonstratively presents at trial 

with severe limitations before this jury without any medical 

testimony as to why that is. . . . We also don’t know from medical 

support why she was having neck pain—on a scale of one to ten, a 

three—several years before this accident that she described as 

constant. All of these things needed to be addressed by medical 

expert testimony which is absent in the record. 

. . . . It is clear to this Court that if I would have allowed Dr. 

Lyons to testify, many of these issues would have been addressed 

and perhaps, rectified. However, that issue has been previously 

addressed by this Court. It is important to note that no motion to 

continue was ever filed. 

Knowlton claims expert medical testimony is not required to establish a 

permanent injury if its permanency can be inferred from its nature and sufficient 

evidence was presented to justify submitting the future damage claim to the jury.

There can be no recovery for future pain and suffering unless reasonably 

certain it resulted from the injury. Mercer v. Ridnour, 218 N.W.2d 625, 627 (Iowa 

1974). Expert testimony is often necessary to establish future pain and suffering. 
11

DeBurkarte v. Louvar, 393 N.W.2d 131, 140 (Iowa 1986). However, “when pain 

is suffered right up to the time of trial and there is evidence plaintiff has not fully 

recovered, future pain and suffering may be submitted to the jury without medical 

testimony.” Id. (quoting Mabrier v. A.M. Servicing Corp., 161 N.W.2d 180, 183 

(Iowa 1968)). “The mere statement by the plaintiff that she still suffers pain is not 

sufficient per se to warrant a finding that there will be any future pain or physical 

suffering because of her injuries.” Daniels v. Bloomquist, 138 N.W.2d 868, 873 

(Iowa 1965). Where “the symptoms from which personal injury may be inferred 

are subjective only,” and plaintiff presents no medical testimony to establish 

future pain and suffering or permanent injury are “reasonably certain,” the trial 

court need not instruct the jury on that element of damage. See id.

Our court has addressed this issue in recent years. In Brundage v. 

McElderry, we affirmed the district court’s decision not to instruct the jury on 

future pain and suffering and future loss of function. No. 00-0811, 2001 WL 

725688, at *3 (Iowa Ct. App. June 29, 2001). The claimant seeking future 

damages presented evidence consisting of his own testimony on pain in his daily 

life and his mother’s testimony concerning her observations of him experiencing 

pain. Id. The treating physician reported the claimant’s injury was fully healed, 

risk of future injury was minimal, and individuals with similar injuries do not 

experience long-term pain. Id. 

In Horn v. Chicoine, our court affirmed the district court’s decision to 

submit a claim for future pain and suffering to the jury. No. 08-0902, 2009 WL 

2169148, at *6 (Iowa Ct. App. July 22, 2009). The evidence supporting the 
12

submission of the claim to the jury included claimant’s testimony he had

numbness and soreness and can no longer do some household tasks. 

Additionally, at the time of trial claimant was receiving treatment from an 

orthopedist who testified the claimant had incurred nine percent impairment to his 

whole body and had not yet fully recovered from the injury. Id. At the time of trial 

an orthopedic spine specialist had limited the claimant to lifting ten pounds or 

less. Id.

Here, as the district court noted, viewing the evidence presented by 

Knowlton in the light most favorable to her, there is insufficient evidence to 

present her future damage claim to the jury. The last orthopedic medical record 

is from 2012—two years before the accident. Further complicating the issue was 

the fact Knowlton had suffered a previous neck injury (fracturing her seventh 

vertebrae as a teenager), and was currently suffering from multiple sclerosis. 

The only evidence in support of her claim, as noted by the district court, was the 

subjective evidence presented by Knowlton and the observations of her family. 

The district court summed up the evidence as follows:

She walks with a walker and she had to use a high-back 

chair during trial. But as I waited throughout this trial, not knowing

what was coming, I was waiting to hear testimony as to why. What 

was—what is her condition in her neck which is causing this? 

Fractures heal; and when they don’t, we generally hear testimony 

from a doctor that these are the complicating factors that are 

causing lack of motion, the loss of range of motion at this time, 

these are the issues that are causing the pain, arthritic changes 

have taken place. Nothing. And with nothing, it leaves me only 

speculating. And I cannot imagine what the jury is thinking when 

they watch her in her high-back chair, thinking, what’s causing 

these problems in her neck? You can’t just say she broke her neck 

two years ago. That’s it. That’s what we have. That’s all we have.
13

We find the district court did not err in granting Grinnell’s motion for 

directed verdict on future loss of function of the body and future pain and 

suffering. 

C. Evidence of Payments Made to Knowlton

Knowlton claims the district court erred in admitting evidence of disability 

payments Knowlton received for multiple sclerosis, which prejudiced her claims 

for lost income. 

1. Error Preservation 

Grinnell claims Knowlton has not preserved error on this issue. Knowlton 

sought to exclude the evidence of payments made by her private insurance 

policies in her motion in limine. The court ruled on this issue prior to trial and

stated:

The Court: Finally, plaintiff moves to limit any testimony that 

she received disability benefits following this accident. Plaintiff was 

diagnosed with multiple sclerosis prior to the accident that is the 

basis of this action. And my understanding is there’s some 

evidentiary dispute of whether disability payments she began 

receiving were for the purposes of her multiple sclerosis or for the 

purpose—or caused by this accident. Is that a fair statement?

Ms. O’Donohoe: I believe it is, your honor. 

The Court: And because that’s an evidentiary issue and a 

factual issue that, I think, has to be determined by this jury, 

although disability payments, which are clearly collateral source 

payments, are normally not admissible, the question here is 

whether she has lost wages caused by this accident or whether the 

disability payments would have been made despite this accident. 

And because of that, defendant has to have a right to discuss that 

those payments exist. My position on that is reinforced by the 

plaintiff’s own expert who did originally reduce those future 

damages—or those past lost damages by those insurance 

payments in his initial report, which leads me to believe even 
14

plaintiff is struggling with how much is caused by that and how 

much is not. So the jury must be allowed to consider it. 

Subsequently, the district court denied Knowlton’s motion in limine.

“Generally, a ruling sustaining a motion in limine is not a ruling on the 

evidence; the ruling merely adds a procedural step to the offer of evidence.

Twyford, 220 N.W.2d at 922–23; see also Quad City Bank, 804 N.W.2d at 91–92. 

To preserve error after a motion in limine has been denied, it is necessary to 

make a proper objection at the time the evidence is offered. Twyford, 220

N.W.2d at 924.

Knowlton’s counsel objected when the disability payments made to 

Knowlton were mentioned. 

Mr. Riley: Then when your disability came through, could 

you tell the jury what benefits you started receiving?

Ms. O’Donohoe: I’m going to object as a violation of the 

collateral source rule. 

The Court: Based on the ruling in the motion in limine, the 

objection is overruled. You may answer. 

We find Knowlton’s objection sufficient for our error preservation rules and 

address the merits. 

2. Merits

Knowlton claims the evidence concerning disability benefits made to 

Knowlton were excludable under the collateral source rule, and admission of 

evidence of the benefits prejudiced her claim for lost income. 

This issue was summarized by the district court in the following fashion:

The Court: In this case plaintiff is claiming that she was 

disabled in December of 2011 as a result of this motor vehicle 

accident. Defendant contends that the medical evidence proves 
15

that she was disabled in December of 2011 not because of the 

injuries she sustained in this accident but because of her symptoms 

related to multiple sclerosis. If she was disabled in December of 

2011 because of the multiple sclerosis, her disability was not 

caused by this accident and we’re not in an offset situation. The 

statute, in fact, would not apply in that situation. If, however, she 

was disabled primarily as a result of her disability—I mean, as a 

result of her injuries in this accident, any lost wages she was 

proven would not be offset, pursuant to that statutory provision, by 

her disability payments. So the issue really is whether or not she 

was disabled in December as a result of her multiple sclerosis. I 

drafted instruction 17[3]based on the request made by the plaintiff 

and I do think it accurately sets forth the law. 

Ms. O’Donohoe: I guess I don’t have any objection to it as 

stated. 

The Court: I just think it was important for me to identify it. 

It’s somewhat misleading—and I may hear this from Mr. Riley—in 

that I am saying if you find that she was eligible for and received 

disability payments based primarily on her symptoms related to MS, 

despite the injuries, you shall reduce any claim, when, in fact, I 

can’t go so far as to say in this instruction that if you find it was MS 

alone, because the testimony is it may have accelerated it. So for 

 

3

Instruction 17 states: 

You have heard evidence that Patricia Knowlton received 

disability payments after leaving her employment in December of 2011. If 

you find that she has proven by a preponderance of the evidence that the 

primary cause of her separation from employment in December of 2011 

was the injuries she sustained in the accident of June 21, 2011, you may 

not reduce any damages for loss of past income by the disability 

payments she received. If however, you find that she was eligible for and 

received disability payments based primarily on her symptoms related to 

her diagnosis of Multiple Sclerosis despite the injuries she received in the 

accident of June 11, 2011, you shall reduce any claim for past lost wages 

by the amount of the disability payments she received subject to the 

qualifications below. 

If you decide her claim for lost wages should be reduced by the 

disability payments she received, you shall consider the nature and type 

of the payments made in reference to the purpose for those payments 

and their usage by Patricia Knowlton as they relate to the replacement of 

her lost income. If you find payments were made to reimburse her for 

expenses she incurred for her daily care and rehabilitation and to 

reimburse her for assistance she received to support her in her activities 

of daily living, you shall not consider show payments in offsetting her 

claim for lost wages. 
16

that purpose, I’m going to say that if you find that it’s primarily, so 

they can still want to give some lost wages. Mr. Riley’s free to 

argue that if this was all MS, and if they find all MS, she’s not going 

to get lost wages. We know that. So any further requested 

instructions, Ms. O’Donohoe, or changes?

Ms. O’Donohoe: No, your honor. 

The collateral source rule is a common law rule of evidence that bars 

evidence of compensation received by an injured party from a collateral source. 

Pexa, 686 N.W.2d at 156; Schonberger v. Roberts, 456 N.W.2d 201, 202 (Iowa 

1990). Under the rule a tortfeasor’s obligation to make restitution for an injury he 

or she caused is not reduced by any compensation received by the injured party 

from a collateral source. Id. The rule prevents the jury from reducing the 

tortfeasor’s obligation to make full restitution for the injuries caused by the 

tortfeasor’s negligence. Id.

Here, the jury was asked to use the evidence of disability payments made 

to Knowlton only if it determined they were paid primarily for her symptoms 

relating to her MS diagnosis. The jury was then permitted to use those payments 

to reduce the damages for lost income, subject to other qualifications. If the jury 

determined the payments were made because of injuries Knowlton received from 

the accident then it was not allowed to use them to reduce damages as that 

would have violated the collateral source rule. Knowlton has not shown the 

introduction of the disability payments was prejudicial. Therefore, the district 

court did not abuse its discretion. 

IV. CONCLUSION

We find the district court did not abuse its discretion in refusing to submit 

Knowlton’s claim for medical expenses, directing a verdict on her claims for 
17

future loss of bodily function and/or future pain and suffering, and submitting 

evidence of disability payments paid to Knowlton. Knowlton has failed to 

preserve error on her other claims. We affirm the judgment of the district court. 

AFFIRMED.