Court Opinion

ID: 9780657
Source: CourtListenerOpinion
Date Created: 2023-08-30 02:19:32.469543+00
Date Added: 2024-06-11T07:34:09.881236
License: Public Domain

Justice EID,
dissenting.
127 The medical providers in this case billed the plaintiff $242,000 for medical services, but accepted $40,000 from plaintiff's health insurer as payment in full Under longstanding precedent recognizing that what is paid for something is relevant to its value, see Quimby v. Boyd, 8 Colo. 194, 6 P. 462 (Colo.1885), the $40,000 figure was properly admitted in this case as relevant to the reasonable value of the medical services provided. The majority, however, would permit the jury to hear only the $242,000 figure, on the ground that the $40,000 figure runs afoul of the collateral source doctrine. In my view, however, the collateral source doctrine is not implicated in this case. The $40,000 figure represents the amount accepted by the medical providers as payment for their services, regardless of who paid it. Indeed, the fact that a health insurer-or, for that matter, the plaintiff or another party-paid the amount is entirely irrelevant, and the jury may, at the discretion of the district court, be so instructed. Because the majority concludes otherwise, I respectfully dissent.
¶ 28 Since the early years of statehood, this court has recognized the common sense proposition that the amount paid for something is relevant to its reasonable value. See, e.g., Quimby, 8 Colo. at 208, 6 P. at 471 (the "amount paid" for mining work is evidence of reasonable value of work performed, but not "conclusive" evidence); McCormick v. Parriott, 33 Colo. 382, 80 P. 1044, 1045 (Colo.1905) (the "amount paid" for assessment work "was admissible, as bearing upon its value" (citing Quimby )). Almost ninety years ago, this court applied this principle to the amount paid for medical services, holding that "the amount paid for [medical] services is some evidence as to their reasonable value." Oliver v. Weaver, 72 Colo. 540, 547, 212 *569P. 978, 981 (1923) (citing Townsend v. Keith, 34 Cal.App. 564, 168 P. 402 (1917)); accord Kendall v. Hargrave, 142 Colo. 120, 349 P.2d 993, 994 (1960); and Palmer Park Gardens, Inc. v. Potter, 162 Colo. 178, 425 P.2d 268, 272 (1967). In this case, although plaintiff was billed $242,000 for the medical services he received, he actually paid (through his insurer) $40,000 for the services. Under a straightforward application of the amount-paid principle, the $40,000 accepted by the providers in this case is relevant to the reasonable value of the services that were provided.
(29 The majority, however, would keep the $40,000 figure from the jury, and instead only permit it to hear the $242,000 figure-an amount that no one actually paid. Cf. Volunteers of America v. Gardenswartz, 242 P.3d 1080, 1092 (Colo.2010) (Rice, J., dissent ing) (noting that "neither the plaintiff nor his insurer ever actually incurfs]" damage for amounts billed that are not paid). Under the majority's approach, evidence that we have repeatedly held to be relevant is excluded, and the jury is left with what is at best an incomplete picture of the services' reasonable value. See Grabou v. Target Corp., No. 06-CV-01308, 2008 WL 659776, at *2 (D.Colo. Mar. 6, 2008) (holding that "the probative value of the amounts billed without the corresponding evidence of the amounts paid in satisfaction of those bills would be a substantial risk of unfair prejudice to [the] [dJefen-dant"); Gardenswartz, 242 P.3d at 1090 (Rice, J., dissenting) (characterizing the amounts billed by providers as "theoretical damages").
¶ 30 The majority arrives at this result by citing the common law collateral source doctrine, under which, as we stated in Carr v. Boyd, "[blenefits received by the plaintiff from a source other than the defendant and to which he has not contributed are not to be considered in assessing the damages." 123 Colo. 350, 356-57, 229 P.2d 659, 663 (1951). The majority concludes that because plaintiff's health insurer paid $40,000 for the medical services, the common law collateral source rule must be implicated. Maj. op. at 11 20. But the scope of the collateral source doctrine is not so broad. Under our precedent, the $40,000 figure represents the amount accepted by the providers as payment for their services Who paid the amount-be it the plaintiff himself, a relative or friend of the plaintiff, or an insurer-is entirely irrelevant. See, e.g., Kendall, 142 Colo. at 122, 349 P.2d at 994 (plaintiff paid for medical services). The key is that the collateral source doctrine is implicated only where, in the words of Carr, the defendant seeks to introduce evidence of "benefits received" for "the purpose of mitigating damages." 123 Colo. at 356-57, 359, 229 P.2d at 663-64. Where the defendant does not seek to introduce evidence of "benefits received," but rather only evidence of amounts accepted as payment, the collateral source doctrine does not come into play.
131 This case well illustrates the point. Here, the parties stipulated to the fact that the medical providers accepted $40,000 as payment for their services. This fact was introduced to the jury through the statement of counsel.
1321 No mention was made of who paid the $40,000. Plaintiffs counsel had the opportunity to argue that the amount billed, rather than the amount paid, was the proper measure of reasonable value of the services. When presented in this way, "the difference [between the amount billed and the amount accepted as payment] served only to give the jury a financial benchmark for the extent of [the plaintiff's injuries] without introducing prejudicial evidence that [the plaintiff] carried insurance." Gardenswartz, 242 P.3d at 1091 (Rice, J., dissenting).
¶ 33 The majority believes that if a jury learns that a medical provider has accepted an amount less than what was billed, it will assume that a health insurer negotiated the lesser amount, and then further assume that the plaintiff has already been fully compensated, leading it to award no damages. Maj. op. at 11 20-28. Yet the majority's theory is belied by the very facts of this case, in which the jury awarded the plaintiff $50,000 in economic damages, not zero-despite the intro*570duction of the fact that the medical providers accepted an amount less than what was billed. Id. at ¶ 4. Indeed, "[dJue to the nature of modern" insurance practices, id. at € 21, a jury is just as likely to infer that the insurer will recover from the plaintiff any sum it may have paid to the medical provider. See, e.g., § 10-1-135(3)(I) C.R.S. (2011) ("Reimbursement or subrogation pursuant to an insurance policy ... is permitted only if the injured party has first been fully compensated for all damages arising out of the claim."); Gardenswartz, 242 P.3d at 1092 (Rice, J., dissenting) (discussing subrogation). The point is that, as noted above, the jury is being asked to arrive at the reasonable value of medical services provided to the plaintiff. The fact that an insurer or other party paid for those services is irrelevant- and the jury may be so instructed, at the discretion of the trial court.
Furthermore, the court's decision in Gardenswartz does not preclude the introduction of the fact that a medical provider has accepted an amount less than what was billed, maj. op. at ¶¶ 19-20, 25, and in fact supports it. In that case, this court determined the impact of the collateral source doctrine in the post-verdict, not pre-verdict, context. In fact, in addressing the pre-ver-dict context, the court stated that:
the trial setting is the proper forum for the parties to present evidence regarding the proper value of an injured plaintiff's damages.... [The defendant] conceded at oral argument that it chose not to contest the valuation of [the plaintiff's medical services]. ... The jury determined [the plaintiff's]) award accordingly. It is unwarranted speculation to substitute [the insurer's] discounted healthcare provider rates for the jury's determination regarding the reasonable value of the medical services rendered to [the plaintiff].
242 P.3d at 1087 (emphasis added). In other words, this court suggested that the defendant could have presented evidence of the amount accepted by the medical providers as it related to reasonable value, but simply chose not to. Applying Gardenswartz's reasoning to the case at bar, the $40,000 figure was properly introduced at trial as relevant to the reasonable value of medical services provided.
¶ 35 Finally, the majority's rationale leads to unintended consequences for those plaintiffs who themselves negotiate a reduction in the billed amount. For example, had the plaintiff in this case negotiated the $40,000 amount and paid it, there is no question that the figure would be admitted under the reasonable value precedent discussed above. In other words, under the majority's reasoning, if the plaintiff pays the discounted amount himself, the jury hears the $40,000 and the $242,000 figures; if insurance pays, it hears only the $242,000 figure. This example demonstrates the danger of tying the reasonable value calculation to who paid the medical provider, rather than to the medical provider's acceptance of the payment.
¶ 36 In the end, the majority jettisons our longstanding reasonable value precedent because of the irresolvable "tension" with the collateral source doctrine in this case. Maj. op. at T 19. But as noted above, the collateral source doctrine and the reasonable value principle have lived comfortably side-by-side for decades, and do so in this case. Put differently, the "tension" the majority perceives in this case is of its own making. Because the $40,000 figure was properly admitted in this case, I respectfully dissent from the majority's opinion.
I am authorized to state that Justice COATS and Justice BOATRIGHT join in the dissent.

. Defense counsel stated: "The parties have stipulated that $40,000 was accepted by the health care providers in full payment of all [plaintiff's] medical bills ... in this action."