142 Conn. App. 641
Conn. App. Ct.2013Background
- Gianetti treated Rutkin in the St. Vincent’s emergency department on Aug 8, 1999; Gianetti had no contract with Rutkin’s insurer, PHS; Rutkin’s insurer network status was in dispute.
- Rutkin believed hospital-based physicians were in-network; Gianetti later informed he was out-of-network.
- Rutkin signed a New Patient Information form acknowledging payment responsibility; Gianetti did not bill the insurer at that time.
- Gianetti billed Rutkin in Jan 2000 for ED and Aug 1999 follow-up; Rutkin did not submit the claim to insurer; Rutkin received escalating delinquency notices.
- In 2003 Gianetti sent a new bill totaling $8,945; Rutkin’s response contradicted insurer payment expectations.
- Trial court awarded Gianetti $320 on a contract claim for follow-up visits and $8,625 under quantum meruit for ED services; Elizabeth Rutkin was held jointly liable.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does quantum meruit support recovery for ED services? | Rutkin argues no implied contract. | Gianetti contends implied promise to pay. | Yes; quantum meruit awarded. |
| Does § 20-7f(b) prohibit balance billing by out-of-network providers? | Rutkins contend statute bars billing patients directly. | Gianetti argues statute applies only to in-network providers. | No; statute does not apply to out-of-network providers. |
| Was estoppel a valid defense to the billing claims? | Rutkins rely on office representations to submit insurer claim. | Gianetti asserts no such promise; inquiry required. | Estoppel rejected. |
| Did the New Patient Information form create a contract for follow-up visits? | Form created contract for subsequent services. | No contract for ED; only follow-ups via form. | Court found contract for follow-up visits; breach as to payment. |
Key Cases Cited
- Butler v. Solomon, 127 Conn. 613 (Conn. 1941) (implied contract elements and payment expectation)
- Derr v. Moody, 6 Conn. Cir. Ct. 718 (Conn. Cir. Ct. 1969) (quantum meruit—implied promise to pay)
- Schreiber v. Connecticut Surgical Group, P.C., 96 Conn. App. 731 (Ct. App. 2006) (scope of factual review on quantum meruit)
- Reinke v. Greenwich Hospital Assn., 175 Conn. 24 (1978) (estoppel—due diligence and truth)
- Ancona v. Manafort Bros., Inc., 56 Conn. App. 701 (Ct. App. 2000) (CUTPA/estoppel context disclaimer)
- Gianetti v. Siglinger, 279 Conn. 130 (Conn. 2006) (balance billing context and out-of-network)