FOR PUBLICATION
ATTORNEY FOR APPELLANT
: ATTORNEY FOR APPELLEE:
H. KENNARD BENNETT DOUGLAS B. BATES
Severns & Bennett, P.C. Stites & Harbison, PLLC
Indianapolis, Indiana Jeffersonville, Indiana
ATTORNEYS FOR AMICI CURIAE
AARP and NATIONAL CITIZENS
COALITION FOR NURSING HOME
REFORM:
GEORGE CLYDE GRAY
DANIEL L. ROBINSON
Gray Robinson Ryan & Fox
Indianapolis, Indiana
DOROTHY SIEMON
Pro Hac Vice
AARP Foundation Litigation
Washington, D.C.
MICHAEL SCHUSTER
Pro Hac Vice
AARP
Washington, D.C.
ERIC CARLSON
Pro Hac Vice
National Senior Citizens Law Center
Los Angeles, California
IN THE
COURT OF APPEALS OF INDIANA
CHERYL SANFORD, as Personal )
Representative of the Estate of )
DORTHA BAGLEY, )
)
Appellant-Plaintiff, )
)
vs. ) No. 49A02-0310-CV-885
)
CASTLETON HEALTH CARE CENTER, LLC, )
d/b/a Castleton Health Care Center, )
)
Appellee-Defendant. )
APPEAL FROM THE MARION SUPERIOR COURT
The Honorable Gerald S. Zore, Judge
Cause No. 49D07-0301-CT-183
August 13, 2004
OPINION - FOR PUBLICATION
BAILEY, Judge
Case Summary
Appellant-Plaintiff Cheryl Sanford, as Personal Representative of the Estate of Dortha Bagley (the
Estate) appeals the trial courts order compelling arbitration of the Estates survival and
wrongful death claims against Appellee-Defendant Castleton Health Care Center (Castleton Center). We
affirm.
See footnote
Issue
The Estate raises four issues on appeal, which we consolidate and restate as
whether the trial court erred by enforcing the arbitration agreement at issue and
compelling arbitration.
Facts and Procedural History
On March 7, 1996, Dortha Bagley (Bagley) designated her daughter, Cheryl A. Sanford
(Sanford), as her limited durable power of attorney. Pursuant to this power
of attorney, Sanford had the power to admit or release [Bagley] from any
hospital or health care facility. Appellees App. at 42.
Bagley suffered from Alzheimers and, as a consequence, had been a patient at
Carmel Care until that nursing home closed its Alzheimers unit. Sanford planned
to transfer her mother from Carmel Care to a nursing home in Noblesville;
however, the Noblesville facility was unable to immediately accommodate Bagley because of a
lack of room availability and would remain unable to accept Bagley as a
patient for several days. In the interim, on September 17, 2001, Sanford
checked Bagley into Castleton Center. In so doing, Sanford, acting as Bagleys
legal representative, executed an Admission and Financial Contract with Castleton Center (Contract).
The Contract contains the following provisions:
PRELIMINARY STATEMENTS:
Patient [i.e., Bagley] individually or by and through Patients Legal Representative (hereinafter referred
to as Patient) has considered appropriate care settings and is desirous of receiving
care at this Center; and
Patient has reviewed this ADMISSION AND FINANCIAL CONTRACT, has had opportunity to ask
questions of Center personnel about the contract and understands that admission to this
Center constitutes agreement to be bound by said ADMISSION AND FINANCIAL CONTRACT .
. .
* * * * *
DISPUTE RESOLUTION PROCEDURE:
1. Initial Grievance Procedure: The parties agree to follow the Grievance procedure described
in the patient Rights Booklet for any claims or disputes arising out of
or in connection with the care rendered to patient by Center and/or its
employees. Patient should know that Center is prepared to mediate any concerns
at any time upon patient request . . .
2. MEDIATION: In the event there is a dispute and/or disputes arising out
of or relating to (i) this contract or the breach thereof or any
tort claim; or (ii) whether or not there has been a violation of
any right or rights granted under state law, and the parties are unable
to resolve such dispute through negotiation, then the parties agree in good faith
to attempt to settle the dispute by mediation administered by Alternate Dispute Resolution
Service of the American Health Lawyers Association before resorting to arbitration. . .
.
3. ARBITRATION: Any disputes not settled by mediation within 60 days
after a mediator is appointed shall be resolved by binding arbitration administered by
the Alternate Dispute Resolution Service of the American Health Lawyers Association and judgment
may be entered in any court having jurisdiction thereof. . . .
Appellants App. at 16, 24-25 (emphasis and capitalization in original). A signature
line, bearing Sanfords signature, appears immediately following the arbitration provision.
In a deposition, which was filed with the court on September 22, 2003,
Andrea Philpot (Philpot), who worked at Castleton Center in 2001 as the Director
of Admissions and Marketing, testified regarding the standard admission procedures at Castleton Center.
In particular, Philpot testified that, in general, if a patient asked about
arbitration, she would inform him or her that in the event of a
dispute by the arbitration, . . . there would be no trial by
jury. Appellants App. at 31. However, Philpot did not specifically recall
meeting with Sanford during Bagleys admission.
In addition, in a deposition, which was also filed with the trial court
on September 22, 2003, Sanford testified that, although she felt rushed by the
unfortunate circumstances of admitting her mother to Castleton Centeri.e., during the admission process,
Bagley was yelling and behaving very aggressively and, at times, Sanford had to
attend to her childrenno one at Castleton Center urged her to hurry or
told her not to read the Contract. Id. at 8. Indeed,
Sanford acknowledged that, while she did not read the entire Contract including the
arbitration provision containing her signature, she was not precluded from doing so.
Sanford further testified that she worked with Philpot during the admission process and
found her to be friendly. Id. at 6. Sanford acknowledged that
Philpot told her that Castleton Center would have a meeting with Bagleys family
and would go over all of this stuff [i.e., the Contract] again at
that time. Id. As to her educational background, Sanford testified that
she graduated from high school and finished a two-year business curriculum at Porter
College, but did not receive a degree. Moreover, Sanford had worked as
a business manager for a photography studio.
On September 3, 2003, the Estate filed an amended complaint and jury demand,
alleging that, on October 2, 2001, Bagley fell twice at Castleton Center and
was transported to Community Hospital with a fractured hip and a urinary tract
infection. The amended complaint also alleged that, after undergoing surgery on her
hip, Bagley died on October 7, 2001, i.e., twenty-one days after being admitted
to Castleton Center. In response, Castleton Center filed a motion to compel
arbitration. Pursuant to the Chronological Case Summary, the trial court conducted a
hearing on Castleton Centers motion to compel wherein it heard evidence; however, no
transcript of that hearing is available on appeal. On October 7, 2003,
the trial court entered its order compelling the Estate to submit the survival
and wrongful death claims to mediation and, if necessary, arbitration. It is
from this order that the Estate now appeals.
Discussion and Decision
On appeal, the Estate argues that the trial court erred by compelling it
to arbitrate the survival and wrongful death claims against Castleton Center. It
is well settled that Indiana recognizes a strong policy favoring enforcement of arbitration
agreements. Northwestern Mut. Life Ins. Co. v. Stinnett, 698 N.E.2d 339, 343
(Ind. Ct. App. 1998). Nevertheless, because arbitration is a matter of contract,
a party cannot be required to submit to arbitration unless he or she
has agreed to do so. Intl Creative Mgmt., Inc. v. D &
R Entmt Co., 670 N.E.2d 1305, 1311 (Ind. Ct. App. 1996), trans. denied.
Accordingly, where a court is asked to compel or stay arbitration,
it faces the threshold question of whether the parties have agreed to arbitrate
the particular dispute. Id. Before a court compels arbitration, it must
resolve any claims the parties had concerning the validity of the contract containing
the arbitration clause. PSI Energy, Inc. v. AMAX, Inc., 644 N.E.2d 96,
99 (Ind. 1994). Once satisfied that the parties contracted to submit their
disputes to arbitration, however, the court is required by statute to compel arbitration.
See Ind. Code § 34-57-2-3 (On application of a party showing an
agreement described in section 1 of this chapter, and the opposing partys refusal
to arbitrate, the court shall order the parties to proceed with arbitration.).
Judicial inquiry is thus limited to the validity of the contract containing the
arbitration clause, not the construction of that clause. PSI Energy, 644 N.E.2d
at 99.
In addition, under Indiana contract law, the party seeking to compel arbitration has
the burden of demonstrating the existence of an enforceable arbitration agreement. Wilson
Fertilizer & Grain v. ADM Milling Co., 654 N.E.2d 848, 849 (Ind. Ct.
App. 1995), trans. denied. When determining whether the parties have agreed to
arbitrate a dispute, we apply ordinary contract principles governed by state law.
Showboat Marina Casino Pship v. Tonn & Blank Const., 790 N.E.2d 595, 598
(Ind. Ct. App. 2003). Further, [w]hen construing arbitration agreements, every doubt is
to be resolved in favor of arbitration, and the parties are bound to
arbitrate all matters, not explicitly excluded, that reasonably fit within the language used.
Id. (citations omitted). However, parties are only bound to arbitrate those
issues that by clear language they have agreed to arbitrate; arbitration agreements will
not be extended by construction or implication. Id. Construction of the
terms of a written arbitration contract is a pure question of law, and
we conduct a de novo review of the trial courts conclusions in that
regard. Northern Ind. Commuter Transp. Dist. v. Chicago Southshore and South Bend
R.R., 744 N.E.2d 490, 495 (Ind. Ct. App. 2001) (discussing appellate review of
a contract), trans. denied.
The Estate argues that the trial courts order compelling it to arbitration was
erroneous because: (1) the Contract is an unconscionable adhesion contract; (2) the arbitration
clause of the Contract conflicts with the Federal Arbitration Act; (3) Sanfords waiver
of Bagleys constitutional right to a jury trial was unknowing and involuntary; and
(4) Sanford, as personal representative of the Estate, was not a party, nor
in privity with a party, to the Contract. We address each argument
separately.
A. Unconscionable Contract
First, the Estate contends that the trial court erroneously compelled it to arbitrate
the survival and wrongful death claims because the Contract is an unconscionable adhesion
contract. In so arguing, the Estate recognizes that [a] written agreement to
submit to arbitration is valid, and enforceable, an existing controversy or a controversy
thereafter arising is valid and enforceable, except upon such grounds as exist at
law or in equity for the revocation of any contract. See Ind.
Code § 34-57-2-1(a). However, the Estate maintains that the Contract, including the
arbitration clause at issue, is not enforceable because it was included in a
nursing home admission agreement and, as such, is an unconscionable adhesion contract.
The question of whether an admission agreement between a nursing home facility and
a prospective admittee may contain an arbitration clause is one of first impression
in Indiana.
Initially, and assuming arguendo that the Contract is one of adhesion, we observe
that an adhesion contracti.e., a standardized contract, which, imposed and drafted by the
party of superior bargaining strength, relegates to the subscribing party only the opportunity
to adhere to the contract or reject itis not per se unconscionable.
Pigman v. Ameritech Pub., Inc., 641 N.E.2d 1026, 1035 (Ind. Ct. App. 1994)
(citing 17 C.J.S. Contracts § 10), overruled on other grounds, Trimble v. Ameritech
Pub., Inc., 700 N.E.2d 1128 (Ind. 1998). Rather, a contract is unconscionable
if a great disparity in bargaining power exists between the parties, such that
the weaker party is made to sign a contract unwillingly or without being
aware of its terms. White River Conservancy Dist. v. Commonwealth Engrs, Inc.,
575 N.E.2d 1011, 1017 (Ind. App. 1991), rehg denied, trans. denied. To
be unconscionable, [t]he contract must be such as no sensible man not under
delusion, duress or in distress would make, and such as no honest and
fair man would accept. Progressive Constr. & Engg Co. v. Ind. &
Mich. Elec. Co., 533 N.E.2d 1279, 1286 (Ind. Ct. App. 1989). A
contract is not unenforceable merely because one party enjoys advantages over another.
Dan Purvis Drugs, Inc. v. Aetna Life Ins. Co., 412 N.E.2d 129, 131
(Ind. Ct. App. 1980), trans. denied.
Here, Sanford argues that the Contract is unconscionable because the arbitration clause at
issue is buried within the Contract in the same size font as the
rest of the agreement. Appellants Br. at 9. However, the arbitration
clause is not buried or hidden in the Contract. Rather, it appears
on page ten of the Contract with the following heading: 3.
ARBITRATION. Appellants App. at 25 (emphasis and capitalization in original). Even
more compelling for purposes of our analysis, the arbitration clause is immediately followed
by a signature line, which bears Sanfords signature. Under Indiana law, a
person is presumed to understand and assent to the terms of the contracts
he or she signs. Buschman v. ADS Corp., 782 N.E.2d 423, 428
(Ind. Ct. App. 2003). Accordingly, because Sanford as Bagleys legal representative executed
the arbitration clause, we will presume that she read it and understood its
contents.
Sanford also asserts that the Contract is unconscionable because, while it required the
nursing home admittee to accept the arbitration clause on a take-it-or-leave-it basis, it
did not delineate to unsuspecting admittees the process of arbitration. We have
not found any case precedent supporting the proposition that arbitration agreements are only
binding and enforceable when they describe in detail the process of arbitration.
In addition, we note that, in this case, Sanford was not precluded from
asking questions regarding the process of arbitration. The record demonstrates that if
a patient asked about arbitration, Philpot would inform him or her that in
the event of a dispute by the arbitration, . . . there would
be no trial by jury. Appellants App. at 31.
In addition, Sanford testified that, although she felt rushed by the unfortunate circumstances
of admitting her mother to Castleton Centeri.e., during the admission process, Bagley was
yelling and behaving very aggressively and, at times, Sanford had to attend to
her childrenno one at Castleton Center urged her to hurry or told her
not to read the Contract. Id. at 8. Indeed, Sanford acknowledged
that, although she did not read the entire Contract including the arbitration provision
containing her signature, she was not precluded from doing so. Sanford further
testified that she worked with Philpot during the admission process and found her
to be friendly. Appellants App. at 6. Thus, on appeal, the
Estate has failed to show that Sanford signed the Contract containing the arbitration
clause unwillingly and without being legally aware of its terms. Consequently, the
trial court did not err by compelling the Estate to arbitrate the survival
and wrongful death claims.
Further, the amici curiae caution that the potential for abuse
surrounding the inclusion of arbitration clauses in nursing home admission contracts, such as
the one at issue, is great because admittees are typically older, suffer diminished
physical and/or mental health, and enjoy reduced mobility. In addition, in most
cases, the family members have resorted to seeking admission to the nursing home
because they are no longer able to care for their loved ones.
We are mindful that the decision to place a family member or loved
one in a nursing home is a difficult one. We note, however,
that the arbitration clause at issue does not limit the Estate, in any
way, from seeking to recover for the alleged negligent acts of Castleton Center.
Moreover, the arbitration agreement does not prevent admittees from challenging the validity
of any of the remaining contractual provisions. Rather, the only limitation imposed
on an admittee by virtue of the arbitration clause is the forums wherein
the issues may be raised, i.e., mediation followed by arbitration, if necessary.
B. The Federal Arbitration Act
Second, the Estate argues that the trial court erred by compelling it to
arbitrate its survival and wrongful death claims because the arbitration clause of the
Contract conflicts with the Federal Arbitration Act. To support this assertion, the
Estate relies upon 42 U.S.C. 1396r(c)(5)(A)(iii), which provides, in relevant part, that [w]ith
respect to admissions practices, a nursing facility must:
in the case of an individual who is entitled to medical assistance for
nursing facility services, not charge, solicit, accept, or receive, in addition to any
amount otherwise required to be paid under the State plan under this subchapter,
any gift, money, donation, or other consideration as a precondition of admitting (or
expediting the admission of) the individual to the facility or as a requirement
for the individuals continued stay in the facility.
(Emphasis added). The Estate urges us to conclude that an arbitration clause
in an admission to nursing home contract constitutes other consideration and is, thus,
in violation of the Federal Arbitration Act.
Resolution of this contention requires us to apply tools of statutory construction.
Because the general phrase other consideration follows a specific enumeration of items including
gift, money, or donation, we apply the principle of ejusdem generis, which maintains
that where words of specific and limited signification in a statute are followed
by general words of more comprehensive import, the general words shall be construed
as embracing only such persons, places, and things as are of like kind
or class to those designated by the specific words, unless a contrary intention
is clearly shown by the statute. Cunningham v. Bakker Produce, Inc., 712
N.E.2d 1002, 1006 (Ind. Ct. App. 1999), trans. denied. Put another way,
ejusdem generis is a cannon of construction that when a general word or
phrase follows a list of specific persons or things, the general word or
phrase will be interpreted to include only persons or things of the same
type as those listed. Blacks Law Dictionary 535 (7th ed. 1999).
Here, the Estate argues that the phrase other consideration is broad enough to
encompass the arbitration clause, because such clause was an inducement to contract.
See footnote
In essence, the Estate maintains that Bagleys agreement to arbitrate any claims arising
out of the Contract and, thereby, relinquish her right to a jury trial
was tantamount to a gift, money, or donation made on behalf of Bagley
to Castleton Center, such that when Castleton Center accepted the arbitration agreement, it
was in violation of 42 U.S.C. 1396r(c)(5)(A)(
iii). We disagree.
Employing the doctrine of ejusdem generis, we hold that the general phrase other
consideration, when followed by a specific enumeration of the terms gift, money, or
donation, does not encompass an arbitration agreement. In fact, we note that
requiring a nursing-home admittee to sign an arbitration agreement is not akin to
charging an additional fee or other consideration as a prerequisite of admittance.
Rather, an arbitration agreement merely establishes a forum for future disputes; both parties
are bound to it and both parties receive whatever benefits and detriments accompany
the arbitral forum. Accordingly, the arbitration clause of the Contract is not
in violation of the Federal Arbitration Act.
See footnote
C. Knowing and Voluntary Waiver of Civil Jury Trial Right
Next, the Estate claims that the trial courts enforcement of the arbitration clause
of the Contract unconstitutionally deprived it of a jury trial by requiring that
the survival and wrongful death claims be submitted to the arbiter. In
so arguing, the Estate relies upon Article I, Section 20 of the Indiana
Constitution, which dictates: In all civil cases, the right of trial by jury
shall remain inviolate. Ind. Const. art. I, § 20. However, [t]his
constitutional right is not absolute and may be waived. Scott v. Crussen,
741 N.E.2d 743, 746 (Ind. Ct. App. 2000), trans. denied. Indeed, Indiana
Trial Rule 38, which governs a jury trial of right, provides, in part,
that:
(E) Arbitration. Nothing in these rules shall deny the parties the right
by contract or agreement to submit or to agree to submit controversies to
arbitration made before or after commencement of an action thereon or deny the
courts power to specifically enforce such agreements.
This trial rule recognizes a very strong presumption of enforceability of contracts that
represent the freely bargained agreement of the parties. Ransburg v. Richards, 770
N.E.2d 393, 395 (Ind. Ct. App. 2002) (quotations omitted), trans denied.
In the present case, Sanford, acting as Bagleys legal representative, executed the Contract,
which contained the arbitration clause. In so doing, Sanford waived Bagleys right
to a trial by jury and, instead, agreed to submit any future controversies
to arbitration. Moreover, the evidence reveals that Sanford, who received her high
school diploma and completed the curricula for a two-year business degree, was granted
the opportunity to read the Contract. Indeed, a signature line bearing Sanfords
signature immediately follows the arbitration clause. It is unfortunate that Sanford felt
rushed by circumstances beyond Castleton Centers control, i.e., Bagleys behavior and distractions by
her children. However, such circumstances did not render Sanfords waiver of Bagleys
constitutional right to trial by jury unknowing and involuntary.
D. Party or Privy to the Contract
Lastly, the Estate maintains that it is not bound by the arbitration clause
because it was not party or privy to the Contract. An arbitration
agreement, like any other contract, only binds parties to the agreement or those
in privity with a party. Mislenkov v. Accurate Metal Detinning, Inc., 743
N.E.2d 286, 289 (Ind. Ct. App. 2001). Privity is found if a
non-party holds a mutual or successive relationship with [a party] with regard to
property or [when] their interests are so identical as to represent the same
legal right. Isp.com LLC. v. Theising, 805 N.E.2d 767, 776 (Ind. 2004),
rehg denied.
Here, we find the Estates argument unpersuasive, however, because regardless of whether Sanford,
i.e., Bagleys legal representative and the Estates personal representative, was privy to the
contract containing the arbitration clause, the Estates survival and wrongful death claims arose
out of Castleton Centers alleged negligent treatment of Bagley. For example, Count
I of the amended complaint, which encompasses the survival action, alleges that Castleton
Center was negligent for failing to:
. . . provide adequate medical and nursing care, including appropriate assistance with
her activities of daily living;
. . . provide proper assessment of [Bagleys] mental, physical, and psychological needs,
and [failing] to define and/or implement a plan of care to meet those
needs;
. . . prevent the fall that occurred on the morning of October
2, 2001;
. . . properly assess [Bagley] after the fall on the morning of
October 2, 2001;
. . . prevent the second fall that occurred on the afternoon of
October 2, 2001;
. . . prevent incontinence;
. . . prevent urinal tract infection; [and]
. . . notify [Bagleys] family of changes in [Bagleys] condition.
Appellees App. at 15-16.
Indiana Code Section 34-9-3-1, commonly referred to as Indianas Survival Statute, provides as
follows:
(a) If an individual who is entitled or liable in a cause of
action dies, the cause of action survives and may be brought by or
against the representative of the deceased party except actions for:
* * * * *
(6) personal injuries to the deceased party;
which survive only to the extent provided in this chapter.
(b) An action under this chapter may be brought, or the court, on
motion, may allow the action to be continued by or against the legal
representatives or successors in interest of the deceased. The action is considered
a continued action and accrues to the representatives or successors at the time
the action would have accrued to the deceased if the deceased had survived.
Ind. Code § 34-9-3-1 (emphasis added). In addition, Indiana Code Section 34-9-3-4,
which applies when a person receives personal injuries caused by the wrongful act
or omission of another and subsequently dies from causes other than those personal
injuries, provides that:
The personal representative of the decedent who was injured may maintain an action
against the wrongdoer to recover all damages resulting before the date of death
from those injuries that the decedent would have been entitled to recover had
the decedent lived. The damages inure to the exclusive benefit of the
decedents estate.
Pursuant to these statutes, the only claims that survive a decedents death are
those that the decedent would have been entitled to bring, or liable to
defend against, during his or her lifetime.
In the present case, all of the claims asserted by the Estate
in Count I of the amended complaint relate to Castleton Centers negligent treatment
and supervision of Bagley. These claims arise out of or relate to
the Contract or the breach thereof or any tort claim. Appellants App.
at 24-25. As such, these claims are governed by the arbitration clause
of the Contract and, consequently, Bagley, if alive, would not have been entitled
to bring this cause of action against Castleton Center. Because the allegations
asserted in Count I of the amended complaint would not have been justiciable,
absent review of an arbitral award, during Bagleys lifetime, they clearly did not
become justiciable upon her death. Accordingly, the trial court did not err
by compelling the Estate to arbitrate the claims alleged in Count I of
the amended complaint.
Further, Count II of the amended complaint, which encompasses the wrongful death action,
alleges that Castleton Center failed to prevent Bagleys falls and to timely diagnose
her urinary tract infection and that, as a result, Bagley required surgical intervention
that she did not survive. Appellees App. at 16. Indiana Code
Section 34-23-1-1 governs wrongful death actions and provides, in pertinent part, that:
When the death of one is caused by the wrongful act or omission
of another, the personal representative of the former may maintain an action therefor
against the latter, if the former might have maintained an action had he
or she, as the case may be, lived, against the latter for an
injury for the same act or omission.
Thus, pursuant to Indiana Code Section 34-23-1-1, a personal representative may maintain a
cause of action against an alleged wrongdoer only if the decedent, if alive,
might have maintained such a cause of action.
Here, because the claims asserted in Count II of the amended complaint arose
out of or related to the Contract or any tort claim, they are
governed by the arbitration clause of the Contract. As such, regardless of
whether these claims were asserted by Bagley, while alive, or the Estate, upon
her death, they are not justiciable in a court of law, except as
a review of an arbitral award. Accordingly, the trial court did not
err when it compelled the Estate to arbitrate the wrongful death claims alleged
in Count II of the amended complaint.
For the foregoing reasons, we affirm the trial courts order compelling the Estate
to arbitrate its survival and wrongful death claims.
Affirmed.
BAKER, J., and FRIEDLANDER, J., concur.
Footnote:
We hereby deny the Estates motion for oral argument.
Footnote: We observe that the Estates argument that the arbitration clause was an
inducement in the execution of the Contract is contrary to its contention that
the arbitration clause was buried or hidden in the Contract.
Footnote: In light of exclusive arbitration clauses, like the one at issue, we
query whether qualified medical health care providers retain the ability to avail themselves
of the provisions and attendant benefits of the Medical Malpractice Act, including a
limitation on the amount of the providers liabilityi.e., Indiana Code Section 34-18-14-3and review
of the plaintiffs claim by a medical review paneli.e., Indiana Code Section 34-18-8-4.
Thus, these qualified providers need to be cognizant that, should they include
these exclusive arbitration clauses in their contracts, they might be relinquishing not only
their rights to a jury trial and to a broader review on appeal,
but also their right to avail themselves of the Medical Malpractice Act.