Present: All the Justices
DONALD W. RADVANY
v. Record No. 002499 OPINION BY JUSTICE ELIZABETH B. LACY
September 14, 2001
JEAN T. DAVIS
FROM THE CIRCUIT COURT OF CHESTERFIELD COUNTY
Michael C. Allen, Judge
Donald W. Radvany seeks reversal of a trial court
judgment entered on a jury verdict awarding Jean T. Davis
$65,000 in damages for injuries she suffered as a result of
Radvany's negligence. For the following reasons, we conclude
that the trial court did not err in refusing to allow the
introduction into evidence of the payment accepted by health
care providers for the medical services rendered to Davis and
did not err in instructing the jury on the aggravation of a
preexisting condition.
I. Medical Bills
Davis' medical bills showed that the health care
providers billed her $19,219.64 for the medical services
rendered to her. The bills also showed the amount accepted by
the health care providers as payment in full, $7,819.99. The
trial court held that, "under the Supreme Court decision of
Acuar v. Letournea[u] [260 Va. 180, 531 S.E.2d 316 (2000)] and
other authorities," Radvany could not introduce into evidence
the amounts paid by Davis' medical insurance carrier and
accepted by the health care providers as payment in full for
the medical services rendered to Davis.
Radvany asserts that this ruling is erroneous because
Acuar only addressed whether amounts "written off" by health
care providers could be claimed as damages and did not rule on
whether the amounts accepted by health care providers as
payment in full for medical care rendered were evidence of the
reasonable value of the services. We disagree.
In Acuar, applying the collateral source rule, we held
that a tortfeasor may not deduct from the full compensation
owed an injured party any part of the benefits the injured
party received from his contractual arrangement with his
health insurance carrier. Those benefits included not only
the amounts written off by the health care provider but also
the actual payments made by the health insurance carrier.
Those amounts written off are as much of a benefit
for which Letourneau paid consideration as are the
actual cash payments made by his health insurance
carrier to the health care providers.
260 Va. at 192, 531 S.E.2d at 322. Payments made to a medical
provider by an insurance carrier on behalf of an insured and
amounts accepted by medical providers are one and the same.
Regardless of the label used, they are payments made by a
collateral source and, thus, are not admissible in evidence
for that reason.
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Furthermore, such amounts are not evidence of whether the
medical bills are "reasonable, i.e., not excessive in amount,
considering the prevailing cost of such services." McMunn v.
Tatum, 237 Va. 558, 568, 379 S.E.2d 908, 913 (1989). The
amounts accepted by Davis' health care providers represent
amounts agreed upon pursuant to contractual negotiations
undertaken in conjunction with Davis' health insurance policy.
Such negotiated amounts, presumably inuring to the benefit of
the medical providers, the insurance carrier, and Davis, do
not reflect the "prevailing cost" of those services to other
patients.
Accordingly, the trial court did not err in ruling that
Radvany could not introduce into evidence the amounts accepted
by the medical service providers as payment in full for the
medical services rendered Davis.
II. Aggravation of a Preexisting Condition
Radvany also claims that there was no evidence to support
a jury instruction on the aggravation of a preexisting
condition and that the trial court erred in giving that
instruction. Again, we disagree with Radvany.
Davis testified that she experienced pain in her right
shoulder approximately three months after the accident and
that she did not recall having any pain or problems with her
shoulder prior to that time. Her treating physician, Dr. Mark
E. deBlois, testified that Davis' rotator cuff was injured,
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that the accident caused the tear in Davis' rotator cuff, and
that the injury required surgery. Dr. deBlois also testified
that Davis had a bone spur on her shoulder joint, which he
described as a calcium growth associated with degenerative
changes in the shoulder joint.
Radvany's expert witness, Dr. John Meyers, disagreed,
asserting that the injury was the result of degenerative
changes that would have occurred regardless of the accident.
Meyers also testified that 75% of people Davis' age have
rotator cuff tears and that many of such conditions are
asymptomatic. In response to a question by Davis' counsel,
Meyers stated that the tear in Davis' rotator cuff "may have"
developed prior to the accident.
Both experts testified that Davis had a condition which
could have pre-dated the accident, a degenerative shoulder
joint and a rotator cuff tear. Dr. Meyers' testimony
supported the inference that the torn rotator cuff could have
been asymptomatic prior to the accident. Davis testified she
had no shoulder pain until after the accident. This evidence
was "more than a scintilla" and thus was sufficient to support
a jury instruction on the aggravation of a preexisting
condition. Rosen v. Greifenberger, 257 Va. 373, 380, 513
S.E.2d 861, 865 (1999).
For these reasons, we will affirm the judgment of the
trial court.
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Affirmed.
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