Indiana Spine Group v. Pilot Travel
2011 Ind. LEXIS 1011
Ind.2011Background
- ISG provided medical services to Pilot's employee Wetnight in 2004 and billed Pilot for the services.
- Pilot paid partial amounts in 2004 and 2008, leaving a balance of $21,750.96.
- ISG filed an Application for Adjustment of Claim for Provider's Fee with the Board on June 17, 2009.
- Pilot moved to dismiss arguing the claim was time-barred under IC 22-3-3-27 and IC 22-3-3-3.
- Board dismissed; Court of Appeals reversed; Supreme Court granted transfer to resolve which statute of limitations applies.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Which statute of limitation governs provider fee claims? | ISG argues no provider-fee limit exists under the Act. | Pilot contends two-year limits in 22-3-3-3 and 22-3-3-27 apply. | General civil statute applies; Act is silent on provider limits, so 34-11-1-2 controls. |
| Does 22-3-3-3 bar ISG's claim? | ISG's claim is not a traditional employee compensation claim. | Section 22-3-3-3 bars claims not timely filed for compensation. | Section 22-3-3-3 does not bar ISG's claim. |
| Does 22-3-3-27 apply to provider fee claims? | No change in conditions to modify an award; the provision is inapplicable. | Section 27 creates a two-year limit for modifications after last compensation. | Section 22-3-3-27 does not apply to simply seeking unpaid provider fees. |
| Is the ten-year general limitation under 34-11-1-2 applicable to ISG's civil-action-style claim in an administrative proceeding? | General limitation should apply when the Act is silent. | Board cannot apply civil statute of limitations to administrative proceedings. | Yes; 34-11-1-2 applies and ISG timely filed. |
Key Cases Cited
- Colburn v. Kessler's Team Sports, 850 N.E.2d 1001 (Ind.Ct.App.2006) (interprets 'compensation' as employee benefits, not provider payments)
- Danielson v. Pratt Indus., Inc., 846 N.E.2d 244 (Ind.Ct.App.2006) (provider must show underlying compensable claim)
- Wawrinchak v. U.S. Steel Corp., Gary Works, 267 N.E.2d 395 (Ind. Ct. App. 1971) (IBD procedures not bound by civil code for limitations, but topic addressed)
- Int'l Entm't, 940 N.E.2d 383 (Ind.) (general statutes of limitation supply limits where none exist in special schemes)