Under Connecticut law, in a personal injury case, a fact-finder determines the amount of the total damages, including economic and non-economic damages (such as pain and suffering).
After a determination of total damages, a Judge will usually be asked to determine if there is a collateral source reduction, for economic damages. The idea of a collateral source reduction is that an injured party should not be allowed to get a double recovery, such as a payment by a health insurance company for medical care, and recovery of the same amount of money as part of a damages award.
Economic Damages – medical bills of $7,000
Non-Economic Damages – $10,000
Total Damages of $17,000.
If the medical bills are paid by health insurance, in general, the damages awarded is reduced to $10,000.
There are two important exceptions
- An ERISA health care plan.
- Connecticut General Statutes § 52–225a (c) permits plaintiffs an offset for health insurance premium payments that they or members of their family have made indirectly to obtain health insurance coverage. See Alvarado v. Black, Supreme Court Case # 16044.
§ 52–225a (c) permits claimants to offset any collateral source benefits paid by the claimant’s health insurance carrier by the amount of premiums paid by the claimant, directly or indirectly to obtain benefits. Payments made by a claimant’s employer to purchase the claimant’s health insurance constitute indirect payments on the claimant’s behalf.
Situation #2 – a claimant has medical bills of $7,000 which are covered by insurance.
A. The health insurance is provided by an employer who pays the premiums on behalf of the insured. There is $12,000 in health insurance premium costs to provide the insurance associated with the medical bills. Therefore, there is no collateral source reduction.
B. Assuming that the health insurance premiums were $5,000, the $5,000 premiums would reduce the $7,000 medical bills, so that there is still a $2,000 collateral source reduction. The total award then becomes $15,000 ($17,000 less $2,000 reduction).
If you have personal injury claim, please feel free to contact
Attorney Robert M. Singer
2572 Whitney Avenue
Hamden, CT 06518