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Timestamp: 2019-04-25 13:23:18+00:00

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Susan M. HAYNES, Administratrix (Estate of Barbara S. Freeman) v. YALE-NEW HAVEN HOSPITAL et al.
Before CALLAHAN, C.J., and BORDEN, BERDON, KATZ, PALMER, McDONALD and PETERS, JJ.1 James E. Swaine, New Haven, for appellant (plaintiff). Mark R. Kravitz, with whom were Jeffrey R. Babbin and, on the brief, Penny Q. Seaman, New Haven, and Thomas J. Witt, Hartford, for appellees (defendants). Philip J. O'Connor, Hartford, filed a brief for the Connecticut Defense Lawyers Association as Amicus Curiae.
The dispositive issues in this appeal are whether: (1) underinsured motorist benefits fall within the common law collateral source rule; and (2) the medical malpractice allegations in the complaint are sufficient to state a claim for a violation of the Connecticut Unfair Trade Practices Act (CUTPA), General Statutes § 42-110a et seq. The plaintiff, Susan M. Haynes, as administratrix of the estate of her mother, the decedent Barbara S. Freeman, brought an action against the defendants, Yale-New Haven Hospital (Yale-New Haven) and Charles F. McKhann, a surgeon, alleging medical malpractice and CUTPA violations.2 The trial court granted the defendants' motion for summary judgment and the plaintiff appealed from the judgment rendered thereon.3 The plaintiff claims that the trial court improperly concluded that: (1) on the first count, the plaintiff could not prevail because of the common law bar against double recovery for the same loss; and (2) on the second count, the plaintiff's allegations were legally insufficient to state a CUTPA violation. We affirm the judgment of the trial court.
The record reveals the following facts. The plaintiff's decedent was employed as a rural letter carrier for the United States postal service. On May 14, 1986, while in the course of her duties as a postal worker, the decedent was seriously injured when her vehicle was struck head-on by a vehicle driven by Alan G. Perrier. An ambulance transported the decedent to Yale-New Haven for emergency medical treatment. She was admitted to Yale-New Haven's emergency department at approximately 12:40 p.m. and began receiving emergency medical care for a fractured left leg and a fractured pelvis. At approximately 2:15 p.m., after being in the care of the hospital for approximately one and one-half hours, the emergency room doctors noticed that the decedent was experiencing “ ‘an expanding abdominal girth.’ ” Upon this discovery, the decedent was transported to the operating room for emergency exploratory surgery. At approximately 2:30 p.m., McKhann began the surgery and, upon opening her abdomen, he discovered large amounts of blood as a result of the laceration of her spleen, which he then removed. During the surgery, however, the decedent's circulation failed and she went into cardiac arrest. McKhann was unable to resuscitate her heart and the decedent was pronounced dead at 3:41 p.m.
The plaintiff first brought an action against Perrier, the driver of the vehicle that had struck the decedent's vehicle, for wrongful death and other compensatory damages. The plaintiff received $20,000 from Perrier's insurer, an amount that represented the limit of his automobile liability insurance policy. After exhausting Perrier's policy coverage, the plaintiff then pursued a claim against Covenant Insurance Company (Covenant), the decedent's automobile insurance carrier, which provided uninsured and underinsured motorist coverage (underinsured motorist coverage) 4 in the amount of $900,000. Unable to settle the matter, the parties submitted the plaintiff's underinsured motorist claim to arbitration under the provisions of the decedent's insurance policy. Covenant conceded Perrier's liability, and the parties stipulated that the only issue before the arbitration panel was the amount of damages for the decedent's wrongful death. A panel of three arbitrators determined the damages to be $650,000.5 Covenant paid the plaintiff $630,000, after deducting the $20,000 that the plaintiff had recovered from Perrier's liability carrier.
The plaintiff then commenced this action against the defendants. In the medical malpractice count, the plaintiff sought damages against both defendants on the grounds that they allegedly had failed to meet the requisite standard of care in applying emergency room care to the decedent, that the emergency department was inadequately staffed, and that the existing staff was inadequately trained and supported. In the CUTPA count, against Yale-New Haven only, the plaintiff alleged that Yale-New Haven had engaged in unfair and deceptive trade practices because, although the hospital was certified as a major trauma center, it had failed to meet the requisite standards of care for such a center for essentially the same reasons stated in the medical malpractice count. The defendants filed a special defense to the medical malpractice count, alleging that the plaintiff had already received full compensation for the harm suffered by the plaintiff's decedent. Yale-New Haven essentially denied the allegations of the CUTPA count.
The trial court granted the defendants' motion for summary judgment on the medical malpractice count because it concluded that as a result of the plaintiff's having been fully compensated for the death of her decedent, she was precluded from pursuing this claim against the defendants by the common law rule barring a double recovery for the same injury. In addition, the trial court rendered summary judgment on the CUTPA count, based upon the reasoning that a malpractice claim cannot be recast as a CUTPA claim. This appeal followed.
This case forces us to confront the tension between two competing principles. The first is that a tortfeasor should not be rewarded by collateral sources that have benefited an injured party. This principle recognizes the social value in making the tortfeasor pay the injured party even for already “compensated” losses in order to prevent a windfall to the tortfeasor; 2 S. Speiser, C. Krause & A. Gans, American Law of Torts (1985 & Sup.1997) § 8.16, p. 526; and to fulfill the general tort policy of deterring similar tortfeasors from wrongful conduct. W. Prosser & W. Keeton, Torts (5th Ed.1984) § 4, pp. 25-26. The second, competing principle is that a litigant may recover just damages for the same loss only once. The social policy behind this concept is that it is a waste of society's economic resources to do more than compensate an injured party for a loss and, therefore, that the judicial machinery should not be engaged in shifting a loss in order to create such an economic waste. See, e.g., 4 G. Palmer, Law of Restitution (1978 & Sup.1997) § 23.15, p. 437. The question we must decide is which of these two policies should control in the present case.
The plaintiff contends that this conflict is resolved by the contractual basis of underinsured motorist payments. She argues that, because Covenant's liability was based entirely upon its contract with the decedent, all payments made pursuant to the underinsured motorist insurance policy should be viewed as purely contractual in nature. Thus, according to the plaintiff, the collateral source rule should apply.
We are not persuaded that payments made pursuant to an underinsured motorist contract can be so easily classified. In our view, underinsured motorist benefits are sui generis. They are contractual, but they depend on principles of tort liability and damages. Whether in any particular case underinsured motorist benefits should be treated as are other types of insurance must depend on a case-by-case analysis of the underlying purpose and the principles that apply to such benefits.
It is true that Covenant would have had no liability to the plaintiff's decedent but for the existence of the insurance contract, and that, generally speaking, an action by an insured against an underinsured motorist carrier is in form “an action in contract.” Dodd v. Middlesex Mutual Assurance Co., 242 Conn. 375, 384, 698 A.2d 859 (1997). We do not dispute, moreover, that the collateral source rule would apply to various other contractual insurance payments, such as life, disability, or medical insurance. Underinsured motorist insurance, however, is unlike those traditional types of insurance, all of which pay upon proof of the occurrence of the particular loss insured against, irrespective of the legal liability of others for causing that loss. Although in form first party insurance, underinsured motorist insurance operates in part as a surrogate for a third party who lacks sufficient liability insurance. It provides benefits only upon proof that a third party, namely, an underinsured motorist for whose liability it acts as a surrogate, was a tortfeasor who injured the insured. Moreover, the amount of an underinsured motorist payment is determined, within contractual limits, by the measure of tort damages. See Williams v. State Farm Mutual Automobile Ins. Co., 229 Conn. 359, 368, 641 A.2d 783 (1994) (in order to recover under underinsured motorist policy, insured must prove amount of damages and that other motorist was underinsured and legally liable).
Thus, underinsured motorist benefits, although contractual in nature, operate in part as a liability insurance surrogate for the underinsured motorist third party tortfeasor. We recognize that an underinsured motorist carrier “is not the alter ego of the tortfeasor and ․ they do not share the same legal [status].” Mazziotti v. Allstate Ins. Co., 240 Conn. 799, 817, 695 A.2d 1010 (1997). Mazziotti, however, dealt with the question of whether an insured's underinsured motorist insurance carrier and a third party tortfeasor should be deemed in privity with each other for purposes of the doctrine of collateral estoppel. Id. at 810-19, 695 A.2d 1010. The fact that the carrier and the tortfeasor do not share a complete legal identity, and thus are not in privity with each other, does not automatically resolve the narrower question of how payments made pursuant to an underinsured motorist policy should be treated.
We do not mean to imply that claims for underinsured motorist payments must be viewed solely as sounding in tort, and not in contract. Neither classification is appropriate for all cases.9 Because underinsured motorist claims are sui generis, we need to go beyond labels in resolving the question posed by this case.10 Put another way, the question is not whether underinsured motorist benefits are a collateral source; the question is whether they should be treated as a collateral source, in the present factual context. We must, therefore, examine the purpose that underinsured motorist coverage is meant to serve, and decide how, as a matter of policy, including consistency with related legal principles, that specific type of insurance should be treated. We conclude that, for the particular purpose of characterizing underinsured motorist payments, the relationship in the present case between the underinsured carrier and the defendant may be viewed as analogous to that of joint tortfeasors,11 and thus that the general tort rule precluding double recovery from joint tortfeasors should apply.
Furthermore, the plaintiff's putative right to recover against the defendants in the present case, for the loss that her decedent's underinsured motorist carrier has already paid, depends solely on the order of litigation in this case. This point can be illustrated by a simple hypothetical. Suppose that after the accident in this case, the tortfeasor motorist's insurance company had refused to pay the last dollar of the motorist's $20,000 coverage. In order to satisfy the exhaustion doctrine; see Ciarelli v. Commercial Union Ins. Cos., 234 Conn. 807, 811, 663 A.2d 377 (1995); the plaintiff would have been required to bring an action against the underinsured motorist. Undoubtedly, at the same time she would have brought an action against these defendants as well, as joint tortfeasors. Under the damages in this case, the plaintiff would have been awarded a total judgment of $650,000. That judgment would have been satisfied by these defendants, or their insurers, paying $630,000 and the underinsured's motorist's liability carrier paying $20,000. In that situation, as the plaintiff acknowledged in oral argument, the plaintiff would not then have been able to make an additional claim for underinsured motorist benefits under her own policy. Thus, under that scenario, the plaintiff would recover a total of $650,000, and no more.
Finally, the equities do not weigh substantially in favor of the plaintiff's position. Precluding the plaintiff from obtaining double recovery does not deprive the decedent of the benefit for which she paid her underinsured motorist premium, namely, a guaranteed recovery of her wrongful death damages, subject to contractual limits, despite the fact that she was hit by an underinsured motorist, and whether there was a joint tortfeasor who could also be held liable. The only thing she is deprived of is the opportunity to recover more than she paid for. Moreover, although we acknowledge the general notion that a defendant, if indeed negligent, should be held accountable, our conclusion does not create an inappropriate windfall for the defendants. It is no more of a windfall to the defendants in this case to bar recovery against them than it was a windfall to the nightclub in Gionfriddo to bar recovery against it. Whenever the principle against double recovery is applied as between various tortfeasors, or tortfeasor surrogates, one of the parties escapes at least some degree of liability. In such cases, however, the policy behind the fundamental principle barring double recovery; see footnote 6; simply is deemed to outweigh the policy behind the collateral source rule. See footnote 7. Such a consequence is, therefore, not a windfall under the law, but rather a necessary consequence of a fundamental policy choice. See RK Constructors, Inc. v. Fusco Corp., 231 Conn. 381, 386, 650 A.2d 153 (1994).
We next address the issue of whether the plaintiff's CUTPA count against Yale-New Haven sufficiently stated a claim pursuant to § 42-110a et seq.16 The trial court rendered summary judgment on this count because it concluded that the second count of the plaintiff's complaint was merely a negligence claim recast as a CUTPA claim and that it was therefore legally insufficient.17 The plaintiff argues that her allegations of negligence can support a CUTPA claim because Yale-New Haven held itself out to be a major trauma center even though it allegedly did not meet those standards. We disagree.
We previously have concluded “that the provision of medical services falls within CUTPA's definition of trade or commerce as ‘the distribution of any services․' General Statutes § 42-110a (4).” Fink v. Golenbock, 238 Conn. 183, 213, 680 A.2d 1243 (1996). Fink, however, was based upon the entrepreneurial or business aspects of providing medical services. Id. at 185-88, 680 A.2d 1243. In Fink, the dispute that gave rise to a violation of CUTPA involved a situation in which “the defendant took certain actions designed to usurp the business and clientele of one [professional] corporation in favor of another ․ [that] placed him in direct competition with the interests of the [professional] corporation.” (Citations omitted; internal quotation marks omitted.) Id. at 212-13, 680 A.2d 1243.
The trial court in the present case, relying on A-G Foods, Inc. v. Pepperidge Farm, Inc., 216 Conn. 200, 217, 579 A.2d 69 (1990), held that negligence could not be a basis for a CUTPA claim. The trial court then determined that the allegations were based solely on negligence and rendered summary judgment. We agree with the trial court that the plaintiff's CUTPA count does not allege a sufficient cause of action, but for different reasons.
In A-G Foods, Inc., we held that “the first prong [of the ‘cigarette rule’], standing alone, is insufficient to support a CUTPA violation, at least when the underlying claim is grounded solely in negligence.” Id.18 We agreed with the defendant in A-G Foods, Inc., that “its negligence was not an unfair or deceptive trade practice within the meaning of General Statutes § 42-110b (a).” Id. at 215, 579 A.2d 69. We also stated that “[c]learly [the defendant's] negligence did not constitute an ‘immoral, unethical, oppressive or unscrupulous' practice.” Id. at 216-17, 579 A.2d 69. Subsequently, this court stated that A-G Foods, Inc., stands for the proposition “that there is no CUTPA violation when the sole basis of the claim is the defendant's negligence and the jury determines that the plaintiff was contributorily negligent.” Williams Ford, Inc. v. Hartford Courant Co., 232 Conn. 559, 591, 657 A.2d 212 (1995). In Williams Ford, Inc., however, we made clear that we did not decide “whether negligence of the defendant alone, unaccompanied by contributory negligence of the plaintiff, [could] establish a CUTPA violation” because the plaintiffs in Williams Ford, Inc. were found to have been contributorily negligent.19 Id. at 591 n. 25, 657 A.2d 212. Indeed, we specifically left that issue open for another day. Id. Likewise, in the present case we do not decide whether negligence alone is sufficient to support a CUTPA violation.
We conclude that professional negligence-that is, malpractice-does not fall under CUTPA. Although physicians and other health care providers are subject to CUTPA, only the entrepreneurial or commercial aspects of the profession are covered, just as only the entrepreneurial aspects of the practice of law are covered by CUTPA. “Although an attorney is not exempt from CUTPA; Heslin v. Connecticut Law Clinic of Trantolo & Trantolo, 190 Conn. 510, 461 A.2d 938 (1983); we made it clear in Heslin that we were not deciding ‘whether every provision of CUTPA permits regulation of every aspect of the practice of law․’ Id. at 520 [461 A.2d 938]. We have held that it is important not to ‘interfere with the attorney's primary duty of robust representation of the interests of his or her client.’ Mozzochi v. Beck, [204 Conn. 490, 497, 529 A.2d 171 (1987) ]. This public policy consideration requires us to hold that CUTPA covers only the entrepreneurial or commercial aspects of the profession of law. The noncommercial aspects of lawyering-that is, the representation of the client in a legal capacity-should be excluded for public policy reasons. See Krawczyk v. Stingle, 208 Conn. 239, 246, 543 A.2d 733 (1988).” Jackson v. R.G. Whipple, Inc., 225 Conn. 705, 730-31, 627 A.2d 374 (1993) (Berdon, J., concurring).
Other jurisdictions have reached a similar result with respect to the medical profession. The Washington Court of Appeals has held that although the entrepreneurial or commercial aspects of the practice of medicine are covered as “trade or commerce” under that state's consumer protection act, violations predicated on negligence or malpractice, whether legal or medical, are not covered because those claims address only competence. See Quimby v. Fine, 45 Wash.App. 175, 180, 724 P.2d 403 (1986) (holding that claims that relate to “actual competence of the medical practitioner” are not recognized under state's consumer protection act, but claims implicating entrepreneurial aspects of practice of medicine may be sufficient), rev. denied, 107 Wash.2d 1032 (1987); see also Ikuno v. Yip, 912 F.2d 306, 312 (9th Cir.1990) (applying Washington law, Court of Appeals concluded that “Washington has recognized that both the practice of law and medicine may give rise to [consumer protection act] claims․ These may arise, however, only when the actions at issue are chiefly concerned with ‘entrepreneurial’ aspects of practice, such as the solicitation of business and billing practices, as opposed to claims directed at the ‘competence of and strategy’ employed by the ․ [defendant].” [Citations omitted.] ); Eriks v. Denver, 118 Wash.2d 451, 465, 824 P.2d 1207 (1992) (adopting “entrepreneurial” test from Quimby and applying it in legal malpractice setting); Jaramillo v. Morris, 50 Wash.App. 822, 827, 750 P.2d 1301 (relying on Quimby and holding that negligence claims against hospital were not cognizable under state's consumer protection act because “[t]he entrepreneurial aspects of the hospital's business, such as billing, were not implicated”), rev. denied, 110 Wash.2d 1040 (1988); Burnet v. Spokane Ambulance, 54 Wash.App. 162, 166-67, 772 P.2d 1027 (relying on Quimby and Jaramillo in holding that negligence claims asserted against hospital did not include entrepreneurial aspect of hospital's operations, so that claims fell outside reach of state's consumer protection act), rev. denied, 113 Wash.2d 1005, 777 P.2d 1050 (1989).
Just recently, the Michigan Court of Appeals addressed this same issue in Nelson v. Ho, 222 Mich.App. 74, 564 N.W.2d 482 (1997). In Nelson, the court held that “it would be improper to view the practice of medicine as interchangeable with other commercial endeavors, and apply to it concepts that originated in other areas․ 20 Therefore, a blanket inclusion in the [state consumer protection act] for physicians would also be improper. Consequently, we ․ hold that only allegations of unfair, unconscionable, or deceptive methods, acts or practices in the conduct of the entrepreneurial, commercial, or business aspect of a physician's practice may be brought under the [consumer protection act]. Allegations that concern misconduct in the actual performance of medical services or the actual practice of medicine would be improper. We do not consider the [l]egislature's use of ‘trade or commerce’ in defining the application of the act to exhibit an intent to include the actual performance of medical services or the actual practice of medicine. If we were to interpret the act as such, the legislative enactments and well-developed body of law concerning medical malpractice could become obsolete․ Only when physicians are engaging in the entrepreneurial, commercial, or business aspect of the practice of medicine are they engaged in ‘trade or commerce’ within the purview of the [consumer protection act].” (Citation omitted.) Id. at 486; see also Gadson v. Newman, 807 F.Supp. 1412, 1416 (C.D.Ill.1992) (applying Illinois law, District Court determined that in order to bring claim against health care provider under consumer fraud act, “[t]he distinction between the business aspects [of] medicine and the ‘actual practice of medicine’ or the non-business aspects of medicine is crucial”).
We find these decisions persuasive, and conclude that their reasoning is equally applicable to CUTPA claims. We appreciate, however, that “[i]t would be a dangerous form of elitism, indeed, to dole out exemptions to our [consumer protection] laws merely on the basis of the educational level needed to practice a given profession, or for that matter, the impact which the profession has on society's health and welfare.” United States v. National Society of Professional Engineers, 389 F.Supp. 1193, 1198 (D.D.C.1974). A blanket exemption for the medical profession would therefore be improper. Nelson v. Ho, supra, 564 N.W.2d at 486. We thus conclude that the touchstone for a legally sufficient CUTPA claim against a health care provider is an allegation that an entrepreneurial or business aspect of the provision of services is implicated, aside from medical competence or aside from medical malpractice based on the adequacy of staffing, training, equipment or support personnel. Medical malpractice claims recast as CUTPA claims cannot form the basis for a CUTPA violation. To hold otherwise would transform every claim for medical malpractice into a CUTPA claim. Accordingly, within this framework, we must review the plaintiff's allegations of CUTPA violations and look to the underlying nature of the claim to determine whether it is really a medical malpractice claim recast as a CUTPA claim.
The plaintiff alleged that Yale-New Haven was certified as a major trauma center and held itself out as such, but failed to staff the emergency department adequately, and that it failed to train and support adequately its existing staff to meet the applicable standards for a major trauma center. The plaintiff further alleged that Yale-New Haven also failed, with respect to emergency room procedures, to meet the standards for a major trauma center.21 It is undisputed that Yale-New Haven was certified as a major trauma center. Therefore, it was not a misrepresentation when it held itself out as certified. By holding itself out as a major trauma center, however, it was representing to the public that it would meet the applicable standards of competency for a major trauma center. We conclude that this representation is simply what all physicians and health care providers represent to the public-that they are licensed and impliedly that they will meet the applicable standards of care. If they fail to meet the standard of care and harm results, the remedy is not one based upon CUTPA, but upon malpractice. The trial court properly rendered summary judgment on the CUTPA count because no unfair or deceptive practices were alleged.
We have recognized two fundamental rules with respect to recovery of damages in tort cases. The first is the single recovery rule-that is, a tort victim can obtain but one full recovery from joint tortfeasors for the damages he or she has sustained. The second is the collateral source rule-that is, the tortfeasor is not entitled to take advantage of the benefits received by the tort victim as a result of his or her injuries when the benefits come from a source independent of the tortfeasor. Part I of the majority's decision disregards this latter rule by shielding the defendants Yale-New Haven Hospital and Charles F. McKhann, a surgeon at the hospital, from liability and the payment of damages for their alleged negligence in allowing the plaintiff's decedent, Barbara S. Freeman, to bleed to death after an automobile accident. The majority insulates the defendants from liability because Freeman had obtained and paid for a policy of insurance that provided for underinsured motorist protection 2 in the amount of $900,000, of which her estate received $630,000 for her wrongful death.3 The basis for the majority's unusual decision is that the $630,000 was not a true collateral source. In the words of the majority, “underinsured motorist benefits ․ operate in part as a liability insurance surrogate for the underinsured motorist third party tortfeasor.” Because the majority improperly concludes that payment by the decedent's underinsured motorist carrier was made on behalf of the underinsured motorist tortfeasor in a “surrogate” capacity, thereby treating the underinsured motorist carrier as a joint tortfeasor, it then concludes that the defendants can take advantage of the insurance payment because of the single recovery rule. This blurring of the collateral source and single recovery rules, by labeling the payment received from a tort victim's own insurance carrier as a payment on behalf of the underinsured motorist tortfeasor, is not only contrary to our long-standing precedent, but also flies in the face of two recent decisions of this court; see Mazziotti v. Allstate Ins. Co., 240 Conn. 799, 817, 695 A.2d 1010 (1997), and Dodd v. Middlesex Mutual Assurance Co., 242 Conn. 375, 698 A.2d 859 (1997); both of which I will discuss later in this opinion.
“Simply stated, the collateral source rule will not allow a tortfeasor to reduce his damage liability resulting from harm caused to another by benefits the injured person received from sources other than the tortfeasor himself or one acting on the tortfeasor's behalf. In essence, the collateral source rule is both a rule of damages and a rule of evidence. Its operation prevents a tort defendant from introducing evidence to prove that the plaintiff incurred no medical expenses because the plaintiff's insurer paid them, or no wage loss because a kind employer continued wages during the disability.
“The end result of the operation of the collateral source rule is that in some cases the tort plaintiff may recover twice or more for some elements of damages-one from the tortfeasor who caused the harm and again from any source of benefits collateral to the tortfeasor. Such multiple recovery, however, is the by-product of the rule and not a principle of the rule itself nor a policy at the foundation of the rule.” J. Kircher, “Insurer Subrogation in Wisconsin: The Good Hands (Or A Neighbor) in Another's Shoes,” 71 Marq.L.Rev. 33, 51-52 (1987).
The collateral source rule was embraced by the United States Supreme Court in 1854; see Propeller Monticello v. Mollison, 58 U.S. (17 How.) 152, 15 L.Ed. 68 (1854); 7 and has been faithfully applied in this state since 1891. Regan v. New York & New England R. Co., supra, 60 Conn. 124, 22 A. 503. Nevertheless, I recognize that we also have the rule that as between joint tortfeasors, a plaintiff can only recover his or her full damages once. In Gionfriddo v. Gartenhaus Cafe, 211 Conn. 67, 71, 557 A.2d 540 (1989), we explained the single recovery principle to be a “simple and time-honored maxim that [a] plaintiff may be compensated only once for his just damages for the same injury.” (Internal quotation marks omitted.) We further elaborated that this rule applies with respect to recovery from joint tortfeasors: “Plaintiffs are not foreclosed from suing multiple defendants, either jointly or separately, for injuries for which each is liable, nor are they foreclosed from obtaining multiple judgments against joint tortfeasors․ This rule is based on the sound policy that seeks to ensure that parties will recover for their damages․ The possible rendition of multiple judgments does not, however, defeat the proposition that a litigant may recover just damages only once․ Double recovery is foreclosed by the rule that only one satisfaction may be obtained for a loss that is the subject of two or more judgments.” (Citations omitted; emphasis added; internal quotation marks omitted.) Id. at 71-72, 557 A.2d 540; see also 2 Restatement (Second), Judgments § 50 (1982). That rule, as will be discussed later, is inapposite to the facts of this case.
In my view, underinsured motorist benefits fall squarely within the purview of the collateral source rule. The majority, however, holds that the payment by the decedent's underinsured motorist carrier, Covenant Insurance Company (Covenant), of the underinsured motorist benefits to the plaintiff was made on behalf of the underinsured motorist tortfeasor and, therefore, subject to the single recovery rule. The majority's reasoning stands underinsured motorist law on its head by transforming the decedent's insurance, for which she paid the premiums for coverage substantially in excess of that required by law, into the underinsured motorist tortfeasor's insurance. Before addressing the majority's reasoning, I first analyze why underinsured motorist benefits fit within the definition of a collateral source.
Comment (b) to § 920A further underscores the clearly defined nature of collateral source payments. Specifically, “[i]f the plaintiff was himself responsible for the benefit, as by maintaining his own insurance or by making advantageous employment arrangements, the law allows him to keep it for himself. If the benefit was a gift to the plaintiff from a third party or established for him by law, he should not be deprived of the advantage that it confers. The law does not differentiate between the nature of the benefits, so long as they did not come from the defendant or a person acting for him. One way of stating this conclusion is to say that it is the tortfeasor's responsibility to compensate for all harm that he causes, not confined to the net loss that the injured party receives․” (Emphasis added.) Id., § 920A, comment (b).
Likewise, the Restatement (Second) of Judgments sets forth the clearly defined areas that those two concepts occupy: “One [concept] is that the injured party is entitled to be recompensed only once by persons chargeable with injuring him; the other is that the liability of a wrongdoer should not be diminished by the fact that provision against the loss had been made on behalf of the injured person. Which one of those concepts governs depends on whether the person providing the payments in question is assimilated to a co-obligor of the judgment debtor or to a casualty insurer of the injured party. The choice is clearly in favor of treating them as co-obligors when, for example, one was guilty of an intentional tort and the other only of negligence. The choice is clear, for the opposite conclusion, when the injured party himself purchased accident insurance covering the loss. Such insurance is universally held to be a ‘collateral source.’ In other cases, the choice involves selecting a beneficiary for a windfall.” 2 Restatement (Second), Judgments § 50, comment (e) (1979).
Underinsured motorist benefits clearly fall within the collateral source rule, and do not come within the single recovery rule, because, among other reasons, they are paid as a result of a contract between the tort victim and the underinsured motorist carrier. This is so even though the damages caused by an underinsured motorist, who is legally liable for the injury to a plaintiff, provide the measuring rod for the benefits to be paid to a plaintiff.9 I arrive at this conclusion based upon an insurance regulation of this state, our own precedent, and the overwhelming weight of authority from other jurisdictions that have addressed the issue.
Although addressed in a different context, we recently decided two cases clearly designating payments made by the underinsured/uninsured motorist carrier to its insured as contractual in nature, and, therefore, concluding in both cases that those benefits were independent of the underinsured/uninsured motorist tortfeasor. In Mazziotti v. Allstate Ins. Co., supra, 240 Conn. at 817, 695 A.2d 1010, we held that payment to the insured under an underinsured motorist policy was contractual. In that case, we made clear that underinsured motorist benefits were made, not on behalf of the uninsured tortfeasor, but, rather, on behalf of the insured. We stated the following: “The obligation of [an] insurance carrier providing uninsured motorist coverage as a part of its liability insurance coverage on the automobile of the insured person is a contractual obligation arising under the policy of insurance․ Payments made pursuant to an uninsured motorist policy are paid on behalf of the insured, and not on behalf of the financially irresponsible motorist who has caused the insured's injuries․ The insurer is not the alter ego of the tortfeasor and, although its contractual liability is premised in part on the contingency of the tortfeasor's liability, they do not share the same legal right. The commonality of interest in proving or disproving the same facts is not enough to establish privity.” (Citations omitted; internal quotation marks omitted.) Id. This proposition from Mazziotti was later reaffirmed in Dodd v. Middlesex Mutual Assurance Co., supra, 242 Conn. at 384-85, 698 A.2d 859, where the court held that an employer could not be reimbursed for workers' compensation payments made to an employee from the proceeds of uninsured motorist benefits received by, and payable to, that employee.
Indeed, the precise issue presented in this case has arisen in the context of several factual situations in which plaintiffs have sought damages from defendants even though the plaintiff already had recovered his or her damages in underinsured/uninsured motorist benefits. See, e.g., Respess v. Carter, supra, 585 So.2d at 988-90 (with facts similar to present case, where deceased insured's survivors settled with [uninsured motorist] carrier for $405,000 in uninsured motorist benefits, and then brought action against uninsured motorist's doctor and hospital for negligently treating and releasing uninsured motorist when he had complained of heart attack symptoms shortly before automobile accident in dispute; court held that defendants were not entitled to have setoff for benefits paid by deceased insured's uninsured motorist carrier because benefits fell within collateral source rule); Bradley v. H.A. Manosh Corp., supra, 157 Vt. at 483-85, 601 A.2d 978 (jury awarded $250,000 in damages and defendant, employer of uninsured motorist, argued that trial court should have reduced award by $200,000 that plaintiff had received from her father's uninsured motorist policy; court held that defendant was not entitled to setoff for amount of timely payment by uninsured motorist carrier because of collateral source rule, and because through uninsured motorist statute, and most policies, “any potential windfall to the plaintiff will instead pass through to the [uninsured motorist] carrier as reimbursement for payments already made”); Johnson v. General Motors Corp., supra, 190 W.Va. at 240 n. 1, 243-44, 438 S.E.2d 28 (plaintiffs received approximately $300,000 underinsured motorist settlement for automobile collision with underinsured motorist and subsequently litigated products liability claim against defendant for injuries in same accident caused by allegedly inadequate seat belt restraint system; court held that defendant could not minimize its damages by offsetting them by underinsured motorist benefits that plaintiffs received); Hagedorn v. Adams, supra, 854 S.W.2d at 478-79 (plaintiff received uninsured motorist benefits in amount of $20,000 from his insurer due to collision with police vehicle while he was passenger on motorcycle driven by uninsured motorist; court held that defendant city could not obtain credit for uninsured motorist benefits paid to plaintiff because of collateral source rule).
A widely recognized treatise on underinsured/uninsured motorist insurance makes clear that those benefits are wholly independent of the tortfeasor(s): “[An][u]ninsured [or underinsured] motorist [payment] is not for the benefit of the tortfeasor. The disposition of an uninsured [or underinsured] motorist claim generally has no relation to or effect on the liability of the uninsured motorist (or other joint tortfeasors). One reason for this is that in most states the insurer is entitled to be subrogated to the insured's tort claim against the uninsured [or underinsured] motorist. Thus, courts have repeatedly concluded that ordinarily ․ the insurance payment does not diminish the damages that may be recovered from an uninsured [or underinsured] tortfeasor or a joint tortfeasor who is insured.” 2 A. Widiss, Uninsured and Underinsured Motorist Insurance (2d Ed.1992) § 19.11, pp. 138-39, citing Erickson v. Hinckley Municipal Liquor Store, 373 N.W.2d 318, 326 (Minn.App.1985) (“An uninsured motorist policy is a private contract between the insured and the insurer. As such, it does not run to the benefit of [the defendant]. The policy was not purchased to protect [the defendant], it was purchased to protect ․ the insured. [The defendant] does not become a third party beneficiary to the uninsured motorist policy․ It is the general rule that co-tortfeasors are jointly and severally liable to injured plaintiffs.”).
In this case, the decedent was required by law to purchase underinsured motorist coverage in the amount of only $20,000; see General Statutes §§ 38a-336 18 and 14-112; 19 but opted to pay additional premiums for $880,000 in additional coverage. If she had carried the mandated amount of only $20,000, this case would surely not be here. To allow a defendant to receive the benefit of these underinsured motorist benefits flies in the face of the core principle behind the collateral source rule-the public policy favoring avoidance of unjust enrichment on the part of a tortfeasor. Gurliacci v. Mayer, supra, 218 Conn. at 556-57, 590 A.2d 914 (basis of our collateral source rule is that wrongdoer shall not benefit from windfall from source wholly independent of tortfeasor and paid to plaintiff); Gorham v. Farmington Motor Inn, Inc., supra, 159 Conn. at 580, 271 A.2d 94 (it is more just that injured person, rather than wrongdoer, shall profit from windfall). Furthermore, although one of the bases to justify the collateral source rule is that if there should be a windfall it should go to the tort victim, there was no windfall in the present case. The plaintiff's decedent paid insurance premiums for the $900,000 coverage year after year to protect her (or her estate) from the contingency that unfortunately occurred. In essence, the underinsured motorist insurance coverage in this case was no different than a life insurance policy, except that the amount of the payment for the death was not fixed but, rather, based upon the value of the decedent's life. Finally, “[t]he collateral source rule expresses a policy judgment in favor of encouraging citizens to purchase and maintain insurance for personal injuries and for other eventualities․ If [a court] were to permit a tortfeasor to mitigate damages with payments from [a] plaintiff's insurance, [the] plaintiff would be in a position inferior to that of having bought no insurance, because his payment of premiums would have earned no benefit.” (Emphasis added.) Helfend v. Southern California Rapid Transit District, 2 Cal.3d 1, 10, 465 P.2d 61, 84 Cal.Rptr. 173 (1970).
Indeed, we so interpreted this regulation in Pecker v. Aetna Casualty & Surety Co., 171 Conn. 443, 449-52, 370 A.2d 1006 (1976). In Pecker, we stated, in discussing whether “other insurance” clauses were valid under another provision in the regulations, that “§ 38-175a-6 (a) [of the Regulations of Connecticut State Agencies, now § 38a-334-6 (a) ] clearly indicates that an insurer making payment under the uninsured motorist coverage provisions of its policy makes that payment ‘on behalf of’ the insured, not the uninsured motorist.” (Emphasis added.) Id. at 452, 370 A.2d 1006. We reinforced this proposition, as I previously pointed out, in Mazziotti v. Allstate Ins. Co., supra, 240 Conn. at 817, 695 A.2d 1010, and Dodd v. Middlesex Mutual Assurance Co., supra, 242 Conn. at 384.
The majority also reasons that the plaintiff's right to pursue her claim must fail because of what it asserts as the “fundamental principle” behind underinsured motorist insurance, namely, that the insured should not be placed in a better position than she would be in had the underinsured tortfeasor been fully insured. Simply put, the public policy behind underinsured motorist insurance does not embody this enunciated principle and the majority's assertion appears to be an overly broad generalization from our previous case law. I agree that our case law provides that “[t]he public policy established by the uninsured motorist statute is that every insured is entitled to recover for the damages he or she would have been able to recover if the uninsured motorist had maintained [an adequate] policy of liability insurance.” (Internal quotation marks omitted.) Rydingsword v. Liberty Mutual Ins. Co., 224 Conn. 8, 18, 615 A.2d 1032 (1992); see also Williams v. State Farm Mutual Automobile Ins. Co., 229 Conn. 359, 366-67, 641 A.2d 783 (1994); Smith v. Safeco Ins. Co. of America, 225 Conn. 566, 573, 624 A.2d 892 (1993); Bodner v. United Services Automobile Assn., 222 Conn. 480, 499, 610 A.2d 1212 (1992). For example, we have previously held that an insured cannot recover punitive damages against its own uninsured motorist carrier, because had the uninsured motorist maintained a policy of liability insurance, the insured would not have been able to recover punitive damages from the tortfeasor's insurer; Bodner v. United Services Automobile Assn., supra at 499-500, 610 A.2d 1212; that the statutory collateral source credits mandated by § 52-225a limits the amount of benefits that a claimant may recover through underinsured motorist insurance, the same way that the underinsured motorist would be allowed to reduce the damages for which he or she is liable; Smith v. Safeco Ins. Co. of America, supra at 573, 624 A.2d 892; and that “[w]hether the uninsured motorist was legally liable must be determined in light of any substantive defenses that would have been available to the uninsured motorist.” Williams v. State Farm Mutual Automobile Ins. Co., supra at 368, 641 A.2d 783.
Those cases merely indicate that the insured is entitled to no greater recovery from his or her underinsured motorist carrier than he or she would have been able to recover from the underinsured motorist. See Smith v. Safeco Ins. Co. of America, supra, 225 Conn. at 573, 624 A.2d 892 (“underinsured motorist protection is not intended to provide a greater recovery than would have been available from the tortfeasor”). The plaintiff in this case is not seeking an enhanced right of recovery from her decedent's underinsured motorist carrier beyond that which she would have been entitled to recover from the underinsured tortfeasor. Instead, she has received insurance proceeds for which the decedent contracted with Covenant in consideration for premiums she paid. The other side of the coin, however, is that the majority's decision places the defendants in a better position, indeed, it gives them a windfall, just because the decedent had the foresight to purchase $880,000 more underinsured motorist insurance than the minimal $20,000 amount required by statute.
In what it finds as further support for its position, the majority asserts that the plaintiff's right to recover depends solely on the order of litigation. The thrust of the majority's reasoning is that if the plaintiff had first brought an action against the defendants, she would not be entitled to recover the underinsured motorist benefits. As I see it, the answer to that reasoning is that the contractual relationship between insurer and insured allows the insured to promptly seek benefits from its insured. The underinsured motorist carrier is required to make prompt payment of a claim that it finds to be clearly payable.24 Indeed, the public policy requiring prompt payment of just claims demands no less. See generally General Statutes § 38a-815 et seq. (Connecticut Unfair Insurance Practices Act); General Statutes § 42-110a et seq. (Connecticut Unfair Trade Practices Act). The fact that the plaintiff, as administratrix of the decedent's estate, was able to recover a prompt payment, based upon the decedent's contractual arrangement with her insurer, before the plaintiff brought an action against the defendants in this case should not be used to create a windfall for the defendants. The Vermont Supreme Court has aptly stated that “[i]t would be inequitable to allow a tortfeasor to escape liability whenever a plaintiff receives timely payment from [his or] her [uninsured motorist] carrier.” (Emphasis added; internal quotation marks omitted.) Bradley v. H.A. Manosh Corp., supra, 157 Vt. at 485, 601 A.2d 978.
With respect to the order of litigation, allowing the plaintiff to recover in this case makes sense for another reason. The conclusion that underinsured motorist benefits are not a collateral source jeopardizes the subrogation rights of underinsured motorist carriers and also impermissibly interferes with the contractual relationship of the insurer and insured. An underinsured motorist carrier, based on the insurance contract or a settlement agreement, after fulfilling its duty of making prompt payment, would surely seek reimbursement of all or part of a payment if the insured later recovers from the tortfeasor. This is common practice in the world of underinsured motorist benefits. “Uninsured [or underinsured] motorist coverages usually include a provision that states the insurer has a right to be reimbursed to the extent of any payment the insurer has made.” 2 A. Widiss, supra, § 19.2, p. 110.25 In addition, “[an uninsured or underinsured motorist carrier] will often require a claimant to sign an agreement, prior to receiving any payment, which acknowledges the receipt of the insurance payment and reiterates the terms of the [insurance contract with respect to reimbursement]․” Id., § 19.6, pp. 129-30. Nothing prevents underinsured motorist carriers from doing this. See, e.g., Bradley v. H.A. Manosh Corp., supra, 157 Vt. at 483, 601 A.2d 978 (“[i]n a pretrial settlement agreement, the [uninsured motorist] carrier agreed to pay [the] plaintiff $200,000, provided it would receive reimbursement up to $200,000 out of any recovery from the defendant, whom it agreed to sue jointly with [the] plaintiff”); International Sales-Rentals Leasing Co. v. Nearhoof, supra, 263 So.2d at 570 (in order to settle uninsured motorist claim, uninsured motorist carrier required plaintiffs to sign a trust agreement wherein plaintiffs agreed to “hold in trust” all rights, claims, and causes of action against any party responsible for plaintiffs' injuries and, based upon this, uninsured motorist carrier intervened in plaintiffs' action against defendant.) As the Vermont Supreme Court has pointed out, in the context of an action against an uninsured motorist's employer brought after uninsured motorist benefits were collected, “tortfeasors jointly liable with an uninsured motorist may not reduce their liability by the amount of payments made under [uninsured motorist] coverage because any potential windfall to the plaintiff will instead pass through to the [uninsured motorist] carrier as reimbursement for payments already made.” Bradley v. H.A. Manosh Corp., supra at 485, 601 A.2d 978.
The underinsured motorist carrier's assertion of its rights to reimbursement for payments made to an insured greatly reduces the prospects of double recovery.26 Whether there is a double recovery on the part of the plaintiff obviously depends upon the insurance contract between the tort victim (the insured) and the underinsured motorist carrier. That, however, is a matter between the insured and the insurer. Nevertheless, the tort victim is benefited, as are insureds in general, by placing the ultimate financial responsibility upon the defendants in a case such as this one, and by allowing the tort victim's underinsured motorist carrier to be reimbursed from any recovery that the victim receives from any third party that is liable for the injuries, because the end result will be that the costs of insurance premiums for such protection will be driven down.
In sum, I conclude that the underinsured motorist benefits paid to the plaintiff as a result of the decedent's death constitute a collateral source that cannot be taken advantage of by the defendants in order to mitigate the damages for which they may be found liable. Therefore, I find that the trial court improperly rendered summary judgment on the medical malpractice count.
2. The plaintiff also brought claims for wrongful retention of moneys paid for medical services rendered on behalf of the decedent by a federal agency, and for breach of an implied contract, both of which were subsequently withdrawn.
4. Throughout this discussion, all references to “underinsured” motorist coverage encompass uninsured motorist coverage as well.
5. Accordingly, because the plaintiff and Covenant stipulated before the arbitration panel that “the only issue is just damages for [the decedent's] death, the loss of earning capacity, conscious pain and suffering, [and] loss of enjoyment of life's activities,” for purposes of this case the $650,000 award must be considered the full legal value of the damages. The plaintiff does not dispute this fact. Moreover, as a rule, the decision of an arbitration panel is binding as res judicata in a subsequent judicial proceeding. See, e.g., Fink v. Golenbock, 238 Conn. 183, 195, 680 A.2d 1243 (1996).
6. The rule precluding double recovery is a “simple and time-honored maxim that [a] plaintiff may be compensated only once for his just damages for the same injury․ Plaintiffs are not foreclosed from suing multiple defendants, either jointly or separately, for injuries for which each is liable, nor are they foreclosed from obtaining multiple judgments against joint tortfeasors․ The possible rendition of multiple judgments does not, however, defeat the proposition that a litigant may recover just damages only once․ Double recovery is foreclosed by the rule that only one satisfaction may be obtained for a loss that is the subject of two or more judgments.” (Citations omitted; internal quotation marks omitted.) Gionfriddo v. Gartenhaus Cafe, 211 Conn. 67, 71-73, 557 A.2d 540 (1989).
7. “The collateral source rule provides that a defendant is not entitled to be relieved from paying any part of the compensation due for injuries proximately resulting from his act where payment [for such injuries or damages] comes from a collateral source, wholly independent of him․ The basis of [this] rule is that a wrongdoer shall not benefit from a windfall from an outside source. That rule is applicable ․ in any tort case.” (Citations omitted; internal quotation marks omitted.) Gurliacci v. Mayer, 218 Conn. 531, 556-57, 590 A.2d 914 (1991).
8. We acknowledge that many jurisdictions agree with the plaintiff that underinsured motorist benefits should be treated as a collateral source that does not affect the insured's right of recovery against a different tortfeasor. See, e.g., International Sales-Rentals Leasing Co. v. Nearhoof, 263 So.2d 569, 571 (Fla.1972) (joint tortfeasor not entitled to setoff equal to amount of recovery injured plaintiff received from his uninsured motorist coverage carrier); Respess v. Carter, 585 So.2d 987, 988-90 (Fla.App.1991) (same); State Farm Mutual Automobile Ins. Co. v. Board of Regents of the University System of Georgia, 226 Ga. 310, 311-12, 174 S.E.2d 920 (1970) (same). For the reasons expressed herein, however, we agree with those cases, though fewer in number, that hold to the contrary. See, e.g., Petrella v. Kashlan, 826 F.2d 1340, 1344 (3d Cir.1987) (under New Jersey law, recovery on underinsured motorist coverage should be regarded as same as recovery from tortfeasor, because both dependent on there being underlying tort); Cooper v. Aplin, 523 So.2d 339 (Ala.1988) (satisfaction of litigated judgment against uninsured motorist carrier prevents subsequent action against other tortfeasors); Waite v. Godfrey, 106 Cal.App.3d 760, 773, 163 Cal.Rptr. 881 (1980) (uninsured motorist benefits not collateral source).
9. The plaintiff relies upon Pecker v. Aetna Casualty & Surety Co., 171 Conn. 443, 370 A.2d 1006 (1976), to support her argument that underinsured motorist payments are purely contractual in nature, and thus that the collateral source rule should apply. In Pecker, we held that “an insurer making payment under the [under]insured motorist coverage provisions of its policy makes that payment ‘on behalf of’ the insured, not the uninsured motorist.” Id. at 452, 370 A.2d 1006; see also Regs., Conn. State Agencies § 38a-334-6 (a). We do not dispute that, because they are based on the insured's contract with her underinsured carrier, the benefits are paid on her behalf. This fact, however, in and of itself, is not dispositive of the manner in which we should treat such payments in the context of the present case. Even if they are made “on behalf of” the insured, underinsured motorist payments are still exclusively premised upon a third party's tort liability. Pecker, therefore, does not resolve the fundamental tension caused by the hybrid nature of underinsured motorist coverage.
10. Indeed, the peculiar hybrid nature of underinsured motorist insurance limits the utility of broad statements of policy, such as those found in the Restatement of Judgments and the Restatement of Torts. For example, the Restatement of Judgments notes that, with regard to the tension between the collateral source rule and the principle against double recovery for the same loss, “[w]hich one of those concepts governs depends on whether the person providing the payments in question is assimilated to a co-obligor of the judgment debtor or to a casualty insurer of the injured party.” (Emphasis added.) 2 Restatement (Second), Judgments § 50, comment (e) (1982). As previously observed, however, underinsured motorist coverage is unlike casualty insurance, which pays for the loss irrespective of who is legally liable for the loss.Similarly, the Restatement of Torts directs that “[p]ayments made by one who is not himself liable as a joint tortfeasor will go to diminish the claim of the injured person against others responsible for the same harm if they are made in compensation of that claim, as distinguished from payments from collateral sources such as insurance, sick benefits, donated medical or nursing services, voluntary continuance of wages by an employer, and the like.” (Emphasis added.) 4 Restatement (Second), Torts § 885(3), comment (f) (1979). The reference to “insurance,” however, does not provide real guidance for the question before us. Although life and medical insurance, for example, are likely contemplated by this reference, they are types of insurance that, unlike underinsured motorist coverage, do not depend on proof of an underlying tort and do not act as a surrogate for the tortfeasor's liability coverage. Indeed, because underinsured motorist payments do act as a surrogate for tort liability, they can reasonably be seen as being made “in compensation of” the underlying tort injury. Accordingly, this passage can be read both as supporting and precluding the plaintiff's recovery against the defendants in the present case, depending on which portion of the passage one emphasizes.
11. Under the plaintiff's allegations against the defendants in the present case, it is clear that the underinsured motorist tortfeasor himself and the defendants were joint tortfeasors because the decedent did not die solely from her injuries from the accident, but also because of the hospital's negligence. Analytically, in terms of basic tort principles, the underinsured motorist's conduct was a proximate cause of the death, and another, concurrent proximate cause was the defendants' alleged negligence. The underinsured motorist carrier was liable for the entire wrongful death damages of $650,000, reduced by the $20,000 collected from the tortfeasor's liability carrier, only because the defendants' subsequent negligence was not, under the plaintiff's allegations, an independent, intervening cause that cut off the underinsured motorist's negligence.
12. For convenience, we carry the damages for the decedent's death in this case over into our hypothetical.
13. At oral argument, the plaintiff attempted to avoid this double recovery problem by reference to § 38a-334-6 (e) of the Regulations of Connecticut State Agencies, which provides: “Recovery over. The insurer may require the insured to hold in trust all rights against third parties or to exercise such rights after the insurer has paid any claim, provided that the insurer shall not acquire by assignment, prior to settlement or judgment, its insured's right of action to recover for bodily injury from any third party.” The plaintiff argues that this regulation would allow Covenant to seek reimbursement or restitution from the plaintiff, should the plaintiff prevail in its case against the defendants subsequent to receiving payment from Covenant, and, moreover, that barring the plaintiff from pursuing its claim against the defendants would effectively nullify the regulation.The problem with the plaintiff's position is that, as the plaintiff acknowledged at oral argument, this court has never decided whether this regulation permits an underinsured motorist carrier that has paid benefits to its insured, in a case such as this, to create in its policy a right over, not only against the underinsured motorist whose conduct was the risk that was insured against, but against a different, joint tortfeasor. Cf. Westchester Fire Ins. Co. v. Allstate Ins. Co., 236 Conn. 362, 672 A.2d 939 (1996). We need not decide that question until a case presents it, which the present case does not. The plaintiff has nowhere alleged, nor is there any indication in the record, that such a subrogation or reimbursement clause was contained in the decedent's contract with Covenant. Accordingly, whether the existence of such a clause could have obviated the present double recovery problem is not before the court in this case. Our conclusion, however, that, in the absence of such a clause, there is a double recovery problem does not bear on the effect of the regulation when such a clause is present. If there were such a clause, however, and if it did operate against the defendants in this case as the plaintiff suggests, the net effect would still be that the plaintiff would recover nothing further, because she would be required to hold the proceeds of her action against the defendants “in trust” for Covenant.
14. In Gionfriddo v. Gartenhaus Cafe, supra, 211 Conn. at 71-72, 557 A.2d 540, we relied on the principle, recognized since at least 1863, that “[t]he possible rendition of multiple judgments does not ․ defeat the proposition that a litigant may recover just damages only once.” Indeed, in Gionfriddo we recognized that the principle against double recovery for the same loss applies in both tort and contract law. See id. at 74 n. 9, 557 A.2d 540. To the extent, therefore, that the present case involves both contract law-the contract of underinsured motorist coverage-and tort law-the action against the hospital-the same principle against double recovery should apply.
15. Of course, one could also resolve the order of litigation problem by, instead of precluding double recovery whatever the order of litigation, as we choose to do, allowing the plaintiff to maintain her additional claim against the underinsured motorist carrier even after receiving full compensation from the two tortfeasors. The plaintiff does not, however, argue for such a rule. In any event, we believe that that would be an even more bizarre result than what the plaintiff is seeking.
17. We review this issue, as the plaintiff and the defendants did in their arguments before this court, as if the motion for summary judgment were a motion to strike testing the legal sufficiency of the allegations of the CUTPA claim. Accordingly, we decide the issue raised by the parties as if the allegations of fact were true.
18. “In determining whether certain acts constitute a violation of [CUTPA], we have adopted the criteria set out in the cigarette rule by the federal trade commission ․ (1)[W]hether the practice, without necessarily having been previously considered unlawful, offends public policy as it has been established by statutes, the common law, or otherwise-whether, in other words, it is within at least the penumbra of some common law, statutory, or other established concept of unfairness; (2) whether it is immoral, unethical, oppressive, or unscrupulous; (3) whether it causes substantial injury to consumers [ (competitors or other businessmen) ].” (Emphasis added; internal quotation marks omitted.) Williams Ford, Inc. v. Hartford Courant Co., 232 Conn. 559, 591, 657 A.2d 212 (1995).We have previously noted that “[a]ll three criteria do not need to be satisfied to support a finding of unfairness. A practice may be unfair because of the degree to which it meets one of the criteria or because to a lesser extent it meets all three․ Thus a violation of CUTPA may be established by showing either an actual deceptive practice ․ or a practice amounting to a violation of public policy․ Furthermore, a party need not prove an intent to deceive to prevail under CUTPA.” (Internal quotation marks omitted.) Associated Investment Co. Ltd. Partnership v. Williams Associates IV, 230 Conn. 148, 155-56, 645 A.2d 505 (1994).
19. In Williams Ford, Inc. v. Hartford Courant Co., supra, 232 Conn. at 590, 593, 657 A.2d 212, the underlying claim was negligent misrepresentation and the plaintiffs were found to have been 10 percent contributorily negligent.
20. In Nelson, the Michigan Court of Appeals relied on statements made by the United States Supreme Court in Goldfarb v. Virginia State Bar, 421 U.S. 773, 786 n. 15, 95 S.Ct. 2004, 2012 n. 15, 44 L.Ed.2d 572 (1975). Specifically, the Court of Appeals stated: “This theoretical distinction [between learned professions and the practice of a trade] was specifically addressed in Goldfarb ․ where the United States Supreme Court considered the issue of whether a minimum-fee schedule for lawyers enforced by the Virginia State Bar constituted price-fixing in violation of the Sherman Act․ The state bar argued that it was exempt from the Sherman Act because the practice of law was a ‘learned profession,’ not ‘trade or commerce.’ The ․ Court stated that while ‘it would be unrealistic to view the practice of professions as interchangeable with other business activities, and automatically to apply to the professions antitrust concepts which originated in other areas'; [id. at 788 n. 17, 95 S.Ct. at 2013 n. 17] ․ ‘[i]t is no disparagement of the practice of law as a profession to acknowledge that it has this business aspect.’ [Id. at 788, 95 S.Ct. at 2013]․” (Citations omitted.) Nelson v. Ho, supra, 564 N.W.2d at 484-85. As the Court of Appeals in Nelson noted, “[s]ubsequently, in Arizona v. Maricopa County Medical Society, 457 U.S. 332, 102 S.Ct. 2466, 73 L.Ed.2d 48 (1982), the United States Supreme Court, relying in part on Goldfarb, struck down ․ the defendant's maximum-price schedule for fees charged by doctors for services provided” as price fixing in violation of the Sherman Act. Nelson v. Ho, supra, 564 N.W.2d at 485 n.3.
2. Throughout this opinion, as in the majority opinion, references to “underinsured” motorist coverage are intended to encompass uninsured motorist coverage as well. Therefore, I refer only to underinsured motorist benefits, except in places where I cite to case law and authorities specifically dealing with uninsured motorist benefits.
3. In the arbitration proceedings against the decedent's underinsured motorist insurance carrier, Covenant Insurance Company (Covenant), the decedent's estate was awarded $650,000 as the full value of the decedent's life. Because the decedent's estate was paid $20,000 by the underinsured motorist tortfeasor (through his liability insurance), Covenant paid the balance of $630,000. I concede that, under the single recovery rule, the $20,000 paid on behalf of the underinsured motorist tortfeasor should be deducted from any recovery obtained against the defendants in this case.
4. “The reason for the [collateral source] rule given by a majority of the jurisdictions which have adopted it is that a ‘windfall’ ought not to be granted to a defendant․ If there must be a windfall certainly it is more just that the injured person shall profit therefrom, rather than the wrongdoer [being] relieved of his full responsibility for his wrongdoing.” (Citation omitted; internal quotation marks omitted.) Gorham v. Farmington Motor Inn, Inc., supra, 159 Conn. at 580, 271 A.2d 94.
5. The collateral source rule “provides that benefits received by a plaintiff from a source wholly collateral to and independent of the tortfeasor will not diminish the damages otherwise recoverable.” (Internal quotation marks omitted.) Todd v. Malafronte, supra, 3 Conn.App. at 23, 484 A.2d 463.
6. I am aware that there is a school of thought that the collateral source rule should be abandoned or restricted. Those who advocate the elimination of the collateral source rule, to the extent that a tortfeasor is relieved of all liability, however, lose sight of an important aspect of the law of torts. “The ‘prophylactic’ factor of preventing future harm has been quite important in the field of torts. The courts are concerned not only with compensation of the victim, but with admonition of the wrongdoer. When the decisions of the courts become known, and defendants realize that they may be held liable, there is of course a strong incentive to prevent the occurrence of the harm. Not infrequently one reason for imposing liability is the deliberate purpose of providing that incentive.” W. Prosser & W. Keeton, Torts (5th Ed.1984) § 4, p. 25. In other words, with respect to the alleged facts of this case, the policy of the law must also be concerned with discouraging further conduct of hospital emergency room personnel from negligently allowing patients to bleed to death.
7. The United States Supreme Court first embraced what subsequently came to be known as the collateral source rule in Propeller Monticello v. Mollison, supra, 58 U.S. (17 How.) 152, 15 L.Ed. 68. In Mollison, the owner of a schooner, which sank after colliding with a steamship, received insurance proceeds from his own insurer and also brought a negligence action against the steamship for damages to the schooner and its cargo. The court held that “[t]he defense set up in the answer, that the [owner of the schooner has] received satisfaction from the insurers, cannot avail the [steamship]. The contract with the insurer is in the nature of a wager between third parties, with which the [steamship] has no concern. The insurer does not stand in the relation of a joint [tortfeasor], so that satisfaction accepted from [it] shall be a release of others. This is a doctrine well established at common law and received in courts of admiralty.” Id. at 155, 15 L.Ed. at 70.
9. The harm caused by the tortfeasor is the measuring rod in most instances for the amount of damages due from a collateral source. For example, the injury caused by the tortfeasor is determinative of the number of weeks that an injured victim is unable to work. Therefore, the number of weeks of unemployment compensation, a collateral source under Apuzzo v. Seneco, supra, 178 Conn. 230, 423 A.2d 866, is also measured by the tortfeasor's harm.
13. See Public Acts 1967, No. 510, § 4.
14. See Public Acts 1979, No. 79-235.
15. See Public Acts 1985, No. 85-574, § 1.
16. “Number 86-338 of the 1986 Public Acts is commonly known as ‘Tort Reform I,’ and was codified at General Statutes (Rev. to 1987) §§ 52-225a through 52-225d, 52-251c and 52-572h. Number 87-227 of the 1987 Public Acts, commonly known as ‘Tort Reform II,’ revised those sections.” Childs v. Bainer, 235 Conn. 107, 120 n. 9, 663 A.2d 398 (1995).
17. In partially abrogating the common law rule for certain specified collateral sources, the legislature was careful to limit these credits to provide merely a reduction against the economic damages awarded to the plaintiff by the trier of fact; see General Statutes § 52-225a (a) and (b); and subject to reducing the collateral source credit for any amount that has been paid by, or on behalf of, the plaintiff or his or her family in securing the right to the collateral source benefit-i.e., insurance premiums paid by the insured are used to offset the collateral source credit. See General Statutes § 52-225a (c). In this case, the majority does not even allow a credit for the premiums that the plaintiff's decedent was obligated to pay for the underinsured motorist coverage.
20. In addition, the majority considers underinsured motorist benefits “sui generis,” making much of the fact that those benefits are measured by the tort damages caused by the underinsured motorist tortfeasor. The majority uses this fact to justify treating that insurance differently from more traditional types of insurance. What this approach ignores is that, although underinsured motorist insurance is prompted by statute, the relationship between insurer and insured is contractual. To show the weakness in the majority's reliance on the underinsured motorist label, I pose the following hypothetical. What if the decedent had the minimal amounts under her underinsured motorist endorsement to her automobile liability insurance policy and she also bargained separately for a second policy that would provide up to $880,000 in insurance benefits, and this insurance functioned just like underinsured motorist insurance (i.e., the measuring rod for the required payment under the policy is the damages caused by the tortfeasor). Would the majority say that this is not a collateral source because the insured and the insurer contracted for the measuring rod of the damages to be the damages caused by the tortfeasor? I think the answer is no. The fact that the insurance in this case falls under the rubric of underinsured motorist insurance should not cause it to be reclassified as a noncollateral source-in other words, a surrogate for the tortfeasor's inability to pay. The simple fact is that underinsured motorist insurance, is not really any different than any other insurance that has historically been classified as collateral sources-i.e., fire insurance, commercial loss insurance, life insurance-because it is still based upon an insurance contract where the insured pays the premiums.
21. See footnote 10 of this opinion.
22. Section 38a-334-6 (a) of the regulations was adopted pursuant to the authority of General Statutes §§ 38a-336 (a)(1) and 38a-334. “Not only is the [insurance] commissioner obligated to adopt regulations with respect to the minimum provisions to be included in the policy of insurance issued in this state; see General Statutes § 38a-334; we presume that these regulations are ‘an accurate reflection of the legislative intent articulated in the statute's more general language.’ AFSCME v. New Britain, 206 Conn. 465, 470, 538 A.2d 1022 (1988). This presumption is further underscored by the Uniform Administrative Procedure Act, General Statutes § 4-166 et seq., which provides for legislative oversight through the legislative regulation review committee prior to approval of the regulations. General Statutes § 4-170.” General Accident Ins. Co. v. Wheeler, 221 Conn. 206, 211, 603 A.2d 385 (1992).
23. Moreover, the fact that underinsured motorist benefits are mandated by statute does not take them out of the definition of a collateral source. First, only $20,000 of coverage is required by statute. Second, we have held that statutorily mandated benefits in the form of unemployment compensation benefits are a collateral source and should not be considered by the trier of fact in awarding damages. See Apuzzo v. Seneco, supra, 178 Conn. at 233, 423 A.2d 866; see also 4 Restatement (Second), Torts § 920A, comment (c) (1979) (payments within collateral source rule are “benefits arising by statute, as in worker[s'] compensation acts” or through “[s]ocial legislation benefits ․ [such as] [s]ocial security benefits [or] welfare payments”).
24. I recognize, of course, that an underinsured motorist carrier is only obligated to make payment “after the limits of liability under all bodily injury liability bonds or insurance policies applicable at the time of the accident have been exhausted by payment of judgments or settlements․” General Statutes § 38a-336 (b).
26. Professor Tait has noted that “[o]dd as it may seem, to reap the fruits of subrogation requires a continued recognition of the Collateral Source Rule. This is so because if the tortfeasor's liability to the plaintiff is reduced by the amount of the collateral benefits, the plaintiff will have no cause of action for that amount to which the collateral source can be subrogated.” C. Tait, “Connecticut's Collateral Source Rule: Stepchild of the Law of Damages,” 1 Conn.L.Rev. 93, 116 (1968). As Professor Tait aptly stated, subrogation creates a middle ground between abolishing the collateral source rule and allowing absolute double recovery: “[Subrogation] offers a recognized alternative to [double recovery, a solution] that would further the basic tort principles of compensation and indemnity within the concept of fault liability. As long as ․ fault remains the keystone of our tort law, it is subrogation that merits the attention of our courts and legislature, and its adoption in appropriate new areas should help legitimize the Collateral Source Rule within the law of damages.” Id., 123. I cannot agree more.
In this opinion CALLAHAN, C.J., and PALMER and PETERS, JJ., concurred.

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