Lead Opinion
delivered the Opinion of the Court.
T1 In this pre-verdiet collateral source case, we determine whether the court of appeals erred when it held that the trial court incorrectly admitted evidence of the amount paid by an insurance provider for the medical expenses Respondent Larry Cross-grove incurred as a result of Petitioner Wal-Mart's negligence. We hold that the court of appeals correctly held that the trial court should have excluded evidence of the amounts paid because the common law evi-dentiary component of the collateral source doctrine requires the exclusion. We thus affirm the judgment of the court of appeals.
I. Facts and Procedural History
¶ 2 An overhead garage door struck Cross-grove on the head while he delivered cookies to a Wal-Mart store in Trinidad, Colorado. Crossgrove required medical treatment for injuries suffered in the accident. Cross-grove's healthcare providers billed almost $250,000 for their services. Crossgrove's insurer, however, paid the providers $40,000 in full satisfaction of the bills.
¶ 3 Crossgrove brought a negligence action against Wal-Mart in Las Animas County District Court. Prior to trial, the parties submitted written arguments concerning the admissibility of evidence of the amounts paid by Crossgrove's insurer to satisfy the medical bills The trial court ruled that the amounts paid should be admitted "in regards to the reasonable and necessary value of [medical] services rendered." In so ruling, the trial court relied on the court of appeals' holding in Lawson v. Safeway, Inc.,
T4 After Crossgrove's counsel raised an ongoing objection to the trial court's ruling, the parties stipulated that Crossgrove's healthcare providers accepted $40,000 in satisfaction of Crossgrove's medical bills. The case proceeded to trial, during which Cross-grove testified that his healthcare providers billed about $250,000 for their services. The trial court instructed the jury to consider Crossgrove's past and future losses, including his "reasonable and necessary medical, hospital, and other expenses" when determining economic damages. The jury returned a verdict in Crossgrove's favor. It awarded him $50,000 in economic damages and $27,375 in noneconomic damages. It also determined that Crossgrove was 20 percent at fault for his injuries.
T5 Crossgrove moved for a new trial, arguing that the trial court erred by admitting evidence of payments made on his behalf by his insurer, a collateral source. Wal-Mart simultaneously moved the trial court to reduce Crossgrove's $50,000 economic damages award by $40,000 under section 13-21-111.6, C.R.S. (2011)-Colorado's post-verdiet collateral source statute. The trial court denied Crossgrove's motion for a new trial and granted Wal-Mart's motion for reduction of the verdict. It reduced the jury's $77,375 award by 20 percent to account for Cross-grove's attributed fault, and by $40,000 for the medical expense coverage that Cross-grove received from his insurer. The trial court then entered judgment in favor of Crossgrove in the amount of $21,900, plus interest.
16 Crossgrove appealed the judgment to the court of appeals on the grounds that the trial court erred by admitting evidence of the amounts paid by Crossgrove's insurer. Based on its application of Colorado's collateral source rule, the court of appeals reversed the trial court's ruling regarding the admissibility of the amounts paid evidence and remanded the case for a new trial. We granted Wal-Mart's subsequent petition for certiorari.
II. Standard of Review
¶ 7 We review evidentiary rulings for an abuse of discretion. Hock v. New York Life Ins. Co.,
III. Collateral Source Rule
T8 We hold that the court of appeals correctly determined that the trial court abused its discretion by admitting evidence of the amounts paid by a collateral source because the trial court did not apply the correct legal standard when it ordered the admission of the evidence. The trial court should have applied the pre-verdict evidentiary component of Colorado's collateral source rule which requires the exclusion of evidence of the amounts paid. We therefore affirm the court of appeals' decision based on the collateral source doctrine, described below.
A. Common Law
T9 Colorado's collateral source rule consists of two components: (1) a post-verdict setoff rule, codified at section 13-21-111.6; and (2) a pre-verdict evidentiary component, described by the common law.
10 Prior to the enactment of section 13-21-111.6, the common law collateral source rule required that "compensation or indemnity received by an injured party from a collateral source, wholly independent of the wrongdoer and to which the wrongdoer has not contributed, will not diminish the damages otherwise recoverable [by the injured party] from the wrongdoer." Colo. Permanente Med. Grp., P.C. v. Evans,
¶ 11 To effectuate this policy goal, the collateral source rule applied post-verdiect to prevent a trial court from reducing a successful plaintiff's damages on account of the plaintiff's receipt of a collateral source benefit. See Van Waters,
112 The common law doctrine also applied pre-verdiet to bar evidence of collateral source benefits because such evidence could lead the fact-finder to improperly reduce the plaintiff's damages award on the grounds that the plaintiff already recovered his loss from the collateral source. Carr v. Boyd,
113 As the United States Supreme Court reasoned in Eichel v. New York Central Railroad Co.,
B. Section 13-21-111.6 Abrogates the Post-Verdict Component of the Common Law Collateral Source Rule
¶ 14 The common law collateral source rule, applied both pre- and post-verdiet, often resulted in a tort plaintiff's double recovery of medical expenses because a collateral source would cover expenses incurred as a result of a tortfeasor's negligence, and then the plaintiff could recover the expenses again from the tortfeasor in the form of damages. To limit these double recoveries, the General
115 The statute also, however, preserves the common law post-verdict component of the collateral source doctrine to a limited extent by prohibiting trial courts from reducing a plaintiff's verdict by the amount of indemnification or compensation that the plaintiff has received, or will receive in the future, from "a benefit paid as a result of a contract entered into and paid for by or on behalf of" the plaintiff. § 13-21-111.6; see also Van Waters,
1 16 Like the common law collateral source rule, the contract exception prevents the tortfeasor from benefitting from the plaintiffs purchase of insurance. It does not necessarily, however, result in double recovery by the plaintiff because the plaintiff must often subrogate the party with whom he contracted. Under the common subrogation framework, an insurer pays for the plaintiff's medical expenses up front, then the plaintiff collects the cost of the treatment from the tortfeasor under the contract exception in section 13-21-111.6. Gardenswartz,
C. Section 13-21-111.6 Does Not Abrogate the Pre-Verdict Evidentiary Component of the Common Law Rule
117 To determine whether section 13-21-111.6 also abrogates the pre-verdict evidentiary component of the collateral source doctrine, we employ standard constructs of statutory interpretation. We interpret statutes to give effect to the intent of the General Assembly, looking first to the statute's plain language. Vigil v. Franklin,
¶ 18 As the court of appeals correctly held, the plain language of section 13-21-111.6 indicates that the statute only abrogates the post-verdiet portion of the common law collateral source rule. Crossgrove v. Wal-Mart Stores, Inc.,
IV. Resolving the Tension between the Collateral Source and Reasonable Value Rules
I 19 We recognize the tension between the pre-verdict evidentiary component of the collateral source rule that controls this case and the reasonable value rule stated in Kendall v. Hargrave,
¶ 20 To resolve this friction between our collateral source precedent and the reasonable value rule, we hold that the pre-verdict evidentiary component of the collateral source rule prevails in collateral source cases to bar the admission of the amounts paid for medical services. Admitting amounts paid evidence for any purpose, including the purpose of determining reasonable value, in a collateral source case carries with it an unjustifiable risk that the jury will infer the existence of a collateral source-most commonly an insurer-from the evidence, and thereby improperly diminish the plaintiffs damages award. See Gardenswartz,
121 Due to the nature of modern healthcare billing practices, a reasonable juror could easily infer the existence of a collateral source if presented with evidence, for example, that the provider accepted $40,000 in satisfaction of a $250,000 medical bill. Healthcare providers routinely accept payment from private insurance companies significantly below the amount billed to a patient because the provider receives advantages from dealing with insurance companies beyond simple payment. Crossgrove, 280 P.3d at -. These benefits include the assurance of prompt reimbursement, assured collectability of the reduced amount, increased administrative efficiency in collection, and access to a larger patient pool comprised of the insurer's customers. Id.
22 Additionally, the government sets the rates that providers who honor public insurance programs, like Medicare and Medicaid, must accept for certain services. See generally 42 C.F.R. pt. 412 (2011) (setting out the procedure used by Medicare to set its rates). These amounts are often significantly lower than those billed by the provider. Id. Thus, as is the case with private insurance companies, healthcare providers accept significantly less than the amount billed for certain services in satisfaction of government insured patients' bills.
1 23 On the other hand, healthcare providers rarely accept discounted amounts to satisfy the bills of uninsured patients. See, e.g., Nygaard v. Sioux Valley Hosp. & Health Sys.,
124 Furthermore, neither Kendall nor its progeny provided the appellate courts with occasion to analyze the negative ramifi
V. Amounts Paid Evidence is Inadmissible in this Case
¶ 25 Evidence of the $40,000 paid by Crossgrove's insurance provider is inadmissible under the controlling pre-verdiet ev-identiary component of the collateral source rule because it is evidence of a collateral source benefit. A plaintiff's insurer is a collateral source because it is a third party wholly independent of the tortfeasor to which the tortfeasor has not contributed. Van Waters,
VI. Conclusion
126 The court of appeals correctly determined that the common law pre-verdiet evi-dentiary component of the collateral source rule bars the admission of evidence of the amounts paid for medical services in collateral source cases. We therefore affirm the court of appeals' decisions to vacate the trial court's judgment as to the amount of damages, and to remand the case for a new trial on the damages issue.
Justice EID dissents, and Justice COATS and Justice BOATRIGHT join in the dissent.
Notes
. The trial court also cited, as persuasive support, two unpublished collateral source cases out of the federal district court. Grabau v. Target Corp., No. CIVAO6CV01308-WDMKLM,
. We granted certiorari on the following issue: Whether the court of appeals erred in holding that the amount accepted in full payment for medical treatment was inadmissible in light of Kendall v. Hargrave,
. The Legislature codified the evidentiary component of the collateral source rule in 2010. See § 10-1-135(10)(a), CRS. (2011). While this opinion is consistent with section 10-I-
. We do not opine as to whether evidence of amounts paid by a collateral source for medical expenses is relevant to the reasonable value of those expenses because, whether relevant or not, the evidence is excluded under the collateral source doctrine.
. Wal-Mart and amicus curiae Copic Insurance Company argue that a jury instruction could eliminate any confusion surrounding the purpose of admitted evidence of the amounts paid by a collateral source. We reject this position because the evidentiary component of the collateral source rule does not say that evidence of amounts paid is admissible for certain purposes and inadmissible for others. It simply says that such evidence is inadmissible. Carr,
Dissenting Opinion
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,
¶ 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,
(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,
¶ 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."
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.
132
¶ 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
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].
¶ 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."
