Volunteers of America Colorado Branch v. Gardenswartz
2010 Colo. LEXIS 861
| Colo. | 2010Background
- Tucker was injured at a VOA event and incurred medical expenses totaling $74,242.
- Tucker had health insurance with Aetna, which paid $43,236 and secured $31,006 in discounts with providers.
- Aetna’s policy includes a subrogation clause enabling repayment of benefits when another party is responsible.
- A jury awarded Tucker $81,385 economic and $60,000 non-economic damages ($141,385 total); Tucker was 49% at fault.
- The trial court offset damages by applying a section 13-21-111.6 post-verdict deduction for collateral-source benefits, reducing to $54,290 after fault allocation.
- The court of appeals reversed, holding the healthcare discounts fell within the contract exception and could not reduce the award.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does section 13-21-111.6 allow setoff of collateral-source benefits from health insurance discounts? | Tucker argues discounts are governed by the contract exception and not offset. | VOA contends discounts are not paid benefits and should be offset. | Yes; the contract exception applies to benefits paid under a contract. |
| Are healthcare provider write-offs due to insurance pricing contracts recoverable by Tucker under the contract exception? | Tucker asserts write-offs resulted from contracts negotiated on his behalf and cannot be offset. | VOA argues write-offs are not benefits paid under a contract for which Tucker paid consideration. | Yes; the write-offs are protected by the contract exception and cannot offset Tucker's damages. |
| Do discounts arising from insurer-provider pricing contracts constitute benefits paid under the contract clause? | Discounts are benefits paid via Tucker's insurance and should be preserved from offset. | Discounts are not directly paid or negotiated on Tucker's behalf and thus may be offset. | Yes; discounts tied to Tucker's contract with the insurer fall within the contract clause. |
Key Cases Cited
- Van Waters & Rogers, Inc. v. Keelan, 840 P.2d 1070 (Colo. 1992) (abrogation and function of contract clause in 13-21-111.6; limits on double recovery)
- Colo. Permanente Med. Grp., P.C. v. Evans, 926 P.2d 1218 (Colo. 1996) (collateral source rule interpretation and contract clause scope)
- Trevino v. HHL Financial Services, Inc., 945 P.2d 1345 (Colo. 1997) (overview of collateral-source concepts (supported factual context))
- Acuar v. Letourneau, 531 S.E.2d 316 (2000) (treatment of collateral sources in damages (non-state reporter citation provided here for context))
- Hardi v. Mezzanotte, 818 A.2d 974 (D.C. 2003) (policy rationale of collateral-source rule and damages)