Haynes v. Yale-New Haven Hosp., YALE-NEW

Decision Date26 August 1997
Docket NumberYALE-NEW,No. 15470,15470
Citation699 A.2d 964,243 Conn. 17
PartiesSusan M. HAYNES, Administratrix (Estate of Barbara S. Freeman) v.HAVEN HOSPITAL et al.
CourtConnecticut Supreme Court

James E. Swaine, New Haven, for appellant (plaintiff).

Mark R. Kravitz, with whom were Jeffrey R. Babbin and, on the brief, Penny Q. Seaman, New Haven, and Thomas J. Witt, Hartford, for appellees (defendants).

Philip J. O'Connor, Hartford, filed a brief for the Connecticut Defense Lawyers Association as Amicus Curiae.

Before CALLAHAN, C.J., and BORDEN, BERDON, KATZ, PALMER, McDONALD and PETERS, JJ. 1

BORDEN, Associate Justice.

The dispositive issues in this appeal are whether: (1) underinsured motorist benefits fall within the common law collateral source rule; and (2) the medical malpractice allegations in the complaint are sufficient to state a claim for a violation of the Connecticut Unfair Trade Practices Act (CUTPA), General Statutes § 42-110a et seq. The plaintiff, Susan M. Haynes, as administratrix of the estate of her mother, the decedent Barbara S. Freeman, brought an action against the defendants, Yale-New Haven Hospital (Yale-New Haven) and Charles F. McKhann, a surgeon, alleging medical malpractice and CUTPA violations. 2 The trial court granted the defendants' motion for summary judgment and the plaintiff appealed from the judgment rendered thereon. 3 The plaintiff claims that the trial court improperly concluded that: (1) on the first count, the plaintiff could not prevail because of the common law bar against double recovery for the same loss; and (2) on the second count, the plaintiff's allegations were legally insufficient to state a CUTPA violation. We affirm the judgment of the trial court.

The record reveals the following facts. The plaintiff's decedent was employed as a rural letter carrier for the United States postal service. On May 14, 1986, while in the course of her duties as a postal worker, the decedent was seriously injured when her vehicle was struck head-on by a vehicle driven by Alan G. Perrier. An ambulance transported the decedent to Yale-New Haven for emergency medical treatment. She was admitted to Yale-New Haven's emergency department at approximately 12:40 p.m. and began receiving emergency medical care for a fractured left leg and a fractured pelvis. At approximately 2:15 p.m., after being in the care of the hospital for approximately one and one-half hours, the emergency room doctors noticed that the decedent was experiencing " 'an expanding abdominal girth.' " Upon this discovery, the decedent was transported to the operating room for emergency exploratory surgery. At approximately 2:30 p.m., McKhann began the surgery and, upon opening her abdomen, he discovered large amounts of blood as a result of the laceration of her spleen, which he then removed. During the surgery, however, the decedent's circulation failed and she went into cardiac arrest. McKhann was unable to resuscitate her heart and the decedent was pronounced dead at 3:41 p.m.

The plaintiff first brought an action against Perrier, the driver of the vehicle that had struck the decedent's vehicle, for wrongful death and other compensatory damages. The plaintiff received $20,000 from Perrier's insurer, an amount that represented the limit of his automobile liability insurance policy. After exhausting Perrier's policy coverage, the plaintiff then pursued a claim against Covenant Insurance Company (Covenant), the decedent's automobile insurance carrier, which provided uninsured and underinsured motorist coverage (underinsured motorist coverage) 4 in the amount of $900,000. Unable to settle the matter, the parties submitted the plaintiff's underinsured motorist claim to arbitration under the provisions of the decedent's insurance policy. Covenant conceded Perrier's liability, and the parties stipulated that the only issue before the arbitration panel was the amount of damages for the decedent's wrongful death. A panel of three arbitrators determined the damages to be $650,000. 5 Covenant paid the plaintiff $630,000, after deducting the $20,000 that the plaintiff had recovered from Perrier's liability carrier.

The plaintiff then commenced this action against the defendants. In the medical malpractice count, the plaintiff sought damages against both defendants on the grounds that they allegedly had failed to meet the requisite standard of care in applying emergency room care to the decedent, that the emergency department was inadequately staffed, and that the existing staff was inadequately trained and supported. In the CUTPA count, against Yale-New Haven only, the plaintiff alleged that Yale-New Haven had engaged in unfair and deceptive trade practices because, although the hospital was certified as a major trauma center, it had failed to meet the requisite standards of care for such a center for essentially the same reasons stated in the medical malpractice count. The defendants filed a special defense to the medical malpractice count, alleging that the plaintiff had already received full compensation for the harm suffered by the plaintiff's decedent. Yale-New Haven essentially denied the allegations of the CUTPA count.

The trial court granted the defendants' motion for summary judgment on the medical malpractice count because it concluded that as a result of the plaintiff's having been fully compensated for the death of her decedent, she was precluded from pursuing this claim against the defendants by the common law rule barring a double recovery for the same injury. In addition, the trial court rendered summary judgment on the CUTPA count, based upon the reasoning that a malpractice claim cannot be recast as a CUTPA claim. This appeal followed.

I

We first address the plaintiff's argument that underinsured motorist benefits, because of their contractual nature, are not within the ambit of the common law rule precluding double recovery for the same harm, 6 but, rather, come within the common law collateral source rule. 7 Accordingly, the plaintiff argues that the trial court improperly rendered summary judgment on the malpractice count. The defendants argue that the trial court properly found the rule barring double recovery for a single harm to be controlling. We agree with the defendants. 8

This case forces us to confront the tension between two competing principles. The first is that a tortfeasor should not be rewarded by collateral sources that have benefited an injured party. This principle recognizes the social value in making the tortfeasor pay the injured party even for already "compensated" losses in order to prevent a windfall to the tortfeasor; 2 S. Speiser, C. Krause & A. Gans, American Law of Torts (1985 & Sup.1997) § 8.16, p. 526; and to fulfill the general tort policy of deterring similar tortfeasors from wrongful conduct. W. Prosser & W. Keeton, Torts (5th Ed.1984) § 4, pp. 25-26. The second, competing principle is that a litigant may recover just damages for the same loss only once. The social policy behind this concept is that it is a waste of society's economic resources to do more than compensate an injured party for a loss and, therefore, that the judicial machinery should not be engaged in shifting a loss in order to create such an economic waste. See, e.g., 4 G. Palmer, Law of Restitution (1978 & Sup.1997) § 23.15, p. 437. The question we must decide is which of these two policies should control in the present case.

The plaintiff contends that this conflict is resolved by the contractual basis of underinsured motorist payments. She argues that because Covenant's liability was based entirely upon its contract with the decedent, all payments made pursuant to the underinsured motorist insurance policy should be viewed as purely contractual in nature. Thus, according to the plaintiff, the collateral source rule should apply.

We are not persuaded that payments made pursuant to an underinsured motorist contract can be so easily classified. In our view, underinsured motorist benefits are sui generis. They are contractual, but they depend on principles of tort liability and damages. Whether in any particular case underinsured motorist benefits should be treated as are other types of insurance must depend on a case-by-case analysis of the underlying purpose and the principles that apply to such benefits.

It is true that Covenant would have had no liability to the plaintiff's decedent but for the existence of the insurance contract, and that, generally speaking, an action by an insured against an underinsured motorist carrier is in form "an action in contract." Dodd v. Middlesex Mutual Assurance Co., 242 Conn. 375, 384, 698 A.2d 859 (1997). We do not dispute, moreover, that the collateral source rule would apply to various other contractual insurance payments, such as life, disability, or medical insurance. Underinsured motorist insurance, however, is unlike those traditional types of insurance, all of which pay upon proof of the occurrence of the particular loss insured against, irrespective of the legal liability of others for causing that loss. Although in form first party insurance, underinsured motorist insurance operates in part as a surrogate for a third party who lacks sufficient liability insurance. It provides benefits only upon proof that a third party, namely, an underinsured motorist for whose liability it acts as a surrogate, was a tortfeasor who injured the insured. Moreover, the amount of an underinsured motorist payment is determined, within contractual limits, by the measure of tort damages. See Williams v. State Farm Mutual Automobile Ins. Co., 229 Conn. 359, 368, 641 A.2d 783 (1994) (in order to recover under underinsured motorist policy, insured must prove amount of damages and that other motorist was underinsured and legally liable).

Thus, underinsured motorist benefits, although contractual in nature, operate in part as a...

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