Justia Insurance Law Opinion SummariesArticles Posted in Indiana Supreme Court
Indiana Spine Gp., PC v. Pilot Travel Ctrs., LLC
Appellant Indiana Spine Group provided medical services to employees of various businesses for injuries the employees sustained arising out of and during the course of their employment. The employers authorized the services and made partial payments. In each case, more than two years after the last payments were made to the injured employee, Appellant filed with the worker's compensation board an application for adjustment of claim seeking the balance of payments. The Board dismissed the applications as untimely. In each case the court of appeals reversed and remanded. At issue on appeal was what limitation period was applicable to a medical provider's claim seeking payment of outstanding bills for authorized treatment to an employer's employee when the Worker's Compensation Act was silent on the question. The Supreme Court reversed the Board, holding (1) the limitation period contained in the general statute of limitation enumerated in Ind. Code 34-11-1-2 controlled; and (2) because Appellant's claim was timely under the statute, the Board erred by dismissing Appellant's application.
Posted in: Government & Administrative Law, Health Law, Indiana Supreme Court, Injury Law, Insurance Law, Labor & Employment Law
Ind. Patient’s Comp. Fund v. Brown
Plaintiff, the executor of a decedent's estate, settled medical malpractice claims against several medical care providers for the decedent's wrongful death. Plaintiff then initiated this action against Defendant, the Indiana Patient's Compensation Fund, for damages that exceeded the $250,000 future value of her settlement with the medical providers pursuant to the Indiana Medical Malpractice Act. The trial court awarded Plaintiff the full amount. Defendant appealed, challenging the trial court's ruling that damages under the Adult Wrongful Death Statute (AWDS) included expenses of administration, contingent attorney fees, and loss of services. The court of appeals affirmed the trial court. The Supreme Court affirmed, holding that such damages may be sought under the AWDS.
Franklin Elec. Co. v. Unemployment Ins. Appeals of the Ind. Dep’t of Workforce Dev.
Franklin Electric formed two new subsidiaries and started new unemployment experience accounts with a low introductory contribution rate for each one, which equaled about half the experience rating of Franklin Electric. The Department of Workforce Development later canceled the subsidiaries' experience accounts, and all experience balances and liabilities reverted to Franklin Electric. The Department also demanded back payments, interest, and a ten percent penalty. A liability administrative law judge (LALJ) affirmed the Department's determination that the three entities were a single employer but waived the penalty imposed by the Department. The court of appeals affirmed. The Supreme Court granted transfer and vacated the opinion of the court of appeals and affirmed the determination of the LALJ, holding (1) the new subsidiaries were not new employers because they were not distinct and segregable from Franklin Electric; (2) Franklin Electric's experience rating should have applied to contributions made by the subsidiaries; and (3) because there was no evidence suggesting improper conduct on the part of Franklin Electric, the penalty was not appropriate.
Posted in: Business Law, Government & Administrative Law, Indiana Supreme Court, Insurance Law, Labor & Employment Law
McCabe v. Comm’r, Ind. Dep’t of Ins.
Following the death of his mother, Jeffery McCabe asserted a medical malpractice claim against his mother's medical care providers, who agreed to a settlement sufficient to allow McCabe to petition Indiana Patient's Compensation Fund for additional compensation. McCabe then filed an action pursuant to the Adult Wrongful Death Statute (AWDS), seeking additional recovery from the Fund for, inter alia, medical expenses and attorney fees. The trial granted granted partial summary judgment to the Fund, finding that the AWDS does not allow recovery of attorney fees. The court of appeals affirmed. The Supreme Court reversed the entry of partial summary judgment, holding that reasonable attorney fees incurred in the prosecution of an action under the AWDS are within the damages permitted by the statute. Remanded.
Ashby v. The Bar Plan Mutual Insurance Co.
Plaintiffs Michael Ashby and Randy O'Brien, inmates at the state department of correction, asserted professional malpractice complaints against attorney C. Bruce Davidson to The Bar Plan Mutual Insurance Company, Davidson's professional liability carrier. Bar Plan then intervened in consolidated actions for damages filed on behalf of plaintiffs against Davidson, asserting a cross-claim that it was not obligated to indemnify Davidson for the claims of plaintiffs because Davidson had failed to notify Bar Plan of any claims against him pursuant to Bar Plan's policy. The trial court granted summary judgment to Bar Plan. The Supreme Court held that Davidson's failure to comply with Bar Plan's policy was not dispositive because plaintiffs opposed summary judgment on grounds of waiver and estoppel. The Court then reversed summary judgment, holding that genuine issues of fact remained regarding whether Bar Plan's misrepresentation of valid coverage resulted in plaintiffs sustaining actual detriment. Remanded.
Posted in: Contracts, Criminal Law, Indiana Supreme Court, Insurance Law, Professional Malpractice & Ethics