113 N.E.3d 636
Ind. Ct. App.2018Background
- In 2010 Celadon driver David Downey was cleared to drive by a Community Hospitals nurse practitioner (NP), later diagnosed with severe obstructive sleep apnea; Downey subsequently caused a multi-vehicle crash that led to ~ $3M in liability paid by Celadon’s insurers (Aspen and Hiscox).
- Aspen/Hiscox filed proposed IMMA claims with the Indiana Department of Insurance (IDOI) and contemporaneously sued Community in Marion Superior Court, repeatedly representing the Community staff were "health care providers" under the Indiana Medical Malpractice Act (IMMA).
- The trial court stayed the civil case pending the Medical Review Panel opinion; the Panel issued an unfavorable opinion for Aspen/Hiscox in October 2016.
- After the adverse IMMA panel opinion, Aspen/Hiscox moved for summary judgment asking the court to rule the IMMA did not apply and to bar Community from asserting IMMA-based defenses (e.g., liability cap, procedural protections).
- The trial court granted summary judgment for Aspen/Hiscox, precluding Community from invoking IMMA defenses; Community appealed.
Issues
| Issue | Plaintiff's Argument (Aspen/Hiscox) | Defendant's Argument (Community) | Held |
|---|---|---|---|
| Whether Insurance Companies may deny IMMA applies after having filed IMMA claims and litigated under the IMMA | They contended the conduct at issue was non-medical/administrative and therefore outside IMMA; after an adverse panel ruling they were entitled to disavow the IMMA | Community argued Insurance Companies are estopped/judicially estopped from denying IMMA because they repeatedly invoked it and delayed litigation pending the panel | Court held Insurance Companies cannot disavow the IMMA after invoking it; reversal and remand (trial court erred) |
| Whether the claims substantively fall within the IMMA (medical malpractice vs. ordinary negligence) | The alleged failure to relay a facsimile constituted non-medical, administrative negligence outside IMMA | Community: the substance of the claims arises from provider behavior while acting in professional capacity, bringing claims under IMMA | Court did not finally decide substantive merits here; decision focused on procedural estoppel (IMMA applicability could not be disclaimed after filing under IMMA) |
| Whether summary judgment precluding IMMA defenses was proper | Summary judgment was proper because the acts were non-medical as a matter of law and IMMA defenses therefore unavailable | Community argued procedural and equitable defenses (estoppel) barred Plaintiffs from abandoning IMMA; summary judgment improperly resolved disputed procedural-equitable issues | Court reversed summary judgment because Plaintiffs had previously invoked IMMA and could not now repudiate it after an unfavorable panel opinion |
Key Cases Cited
- Preferred Prof'l Ins. Co. v. West, 23 N.E.3d 716 (Ind. Ct. App.) (discusses interplay of IMMA filing and later civil litigation; equitable considerations where parties simultaneously pursued IMMA and non-IMMA avenues)
- Manley v. Sherer, 992 N.E.2d 670 (Ind.) (party that filed a proposed IMMA claim cannot later disavow that the IMMA governs their claim)
- Eads v. Community Hosp., 932 N.E.2d 1239 (Ind.) (amount of claimed damages does not alone determine IMMA applicability; hospitals are equipped to evaluate IMMA consequences)