Connecticut's Collateral Source Rule: When Your Health Insurer Cannot Be Repaid

By the FigureMyTax Editorial Team · How we calculate

Connecticut protects injury victims by statute rather than by a general made-whole doctrine: unless another law provides otherwise, an insurer that paid your health benefits is not entitled to recover them from the defendant or anyone else on your claim.

The rule

General Statutes 52-225c says that, unless otherwise provided by law, no insurer or other person providing collateral source benefits shall be entitled to recover the amount of those benefits from the defendant or any other person or entity as a result of any claim or action for damages for personal injury or wrongful death, whether it is resolved by settlement or judgment. It applies to insurance contracts issued, reissued or renewed on or after October 1, 1986.

What counts as a collateral source

Section 52-225b defines collateral sources as payments made to you or for you under health or sickness insurance, automobile accident insurance that provides health benefits and similar insurance (except life insurance), or any contract of an organization to provide, pay for or reimburse hospital, medical, dental or other health care. Amounts you receive as a settlement are not collateral sources.

A worked example

Suppose your insured health plan paid $9,000 of your bills and you settle for $100,000. Under the statute the plan is not entitled to recover that $9,000 from your claim, so it is not deducted in the Connecticut medical lien calculator. A self-funded employer plan governed by federal law may claim its plan terms; the calculator shows its full $9,000 as an upper bound.

The related damages rule

After a verdict, the court reduces the economic damages awarded by collateral source payments, but not by a collateral source for which a right of subrogation exists (52-225a). That rule is about the judgment, not about repaying an insurer from a settlement, so read the two together and ask an attorney how they apply to your case.

What the statute leaves open

The phrase "unless otherwise provided by law" preserves other statutes and federal law, such as the Medicaid subrogation right, the hospital lien and Medicare's federal recovery rules. We did not read Connecticut case law interpreting the statute's exceptions, so do not assume your plan has no claim before you ask for its position in writing.

Compare

See how hospital liens differ from a health insurer's claim and how Medicaid and Medicare recover.

This is general information, not legal advice, and the state comparisons above are illustrative, not an exhaustive survey. Confirm how Connecticut's rules apply to your specific case with a licensed Connecticut attorney.