Kuntz v. Kaiser Foundation Hospital

CourtCalifornia Court of Appeal
DecidedApril 12, 2021
DocketC087967
StatusPublished

This text of Kuntz v. Kaiser Foundation Hospital (Kuntz v. Kaiser Foundation Hospital) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kuntz v. Kaiser Foundation Hospital, (Cal. Ct. App. 2021).

Opinion

Filed 4/12/21 CERTIFIED FOR PARTIAL PUBLICATION*

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA THIRD APPELLATE DISTRICT (Sacramento) ----

EDWARD WILLIAM KUNTZ et al., C087967

Plaintiffs and Appellants, (Super. Ct. No. 34201400165348CUPOGDS) v.

KAISER FOUNDATION HOSPITAL et al.,

Defendants and Respondents.

APPEAL from a judgment of the Superior Court of Sacramento County, Christopher E. Krueger, Judge. Affirmed.

The Law Office, Edward P. Dudensing, Jay P. Renneisen and Andrew J. Collins for Plaintiffs and Appellants.

Muro & Lampe, Inc., Mark A. Muro, Marion’s Inn LLP, Mark Palley, Yvonne M. Pierrou and Denise Ngo for Defendants and Respondents.

* Pursuant to California Rules of Court, rules 8.1105 and 8.1110, this opinion is certified for publication with the exception of Parts I – II.

1 Plaintiffs, consisting of the estate of decedent Edward William Kuntz (decedent), his wife, and his three children, sued, among others, the Kaiser Foundation Hospital and the Permanente Medical Group, Inc. (collectively Kaiser), asserting against Kaiser causes of action sounding in elder abuse, negligent infliction of emotional distress, and wrongful death. Kaiser filed a petition to stay the action and compel arbitration. The trial court granted the petition as to the elder abuse cause of action, staying the other causes of action. Ultimately, the trial court entered judgment in favor of Kaiser. On appeal, plaintiffs assert that (1) Kaiser failed to satisfy its burden of producing a valid agreement to arbitrate, and (2) Kaiser failed to comply with the mandatory requirements of Health and Safety Code section 1363.1 concerning the disclosure of arbitration requirements.1 We affirm. FACTUAL AND PROCEDURAL BACKGROUND Plaintiffs commenced this action against Kaiser, among others, by filing a complaint alleging causes of action to recover damages, inter alia, for elder abuse (Welf. & Inst. Code, § 15600 et seq.), negligent infliction of emotional distress,2 and wrongful death. Decedent’s estate asserted the elder abuse cause of action, while decedent’s wife and children asserted the negligent infliction of emotional distress and wrongful death causes of action. We dispense with the underlying factual allegations because they are not relevant to any issue presented on appeal.

1 Further undesignated statutory references are to the Health and Safety Code. 2 “ ‘[T]he negligent causing of emotional distress is not an independent tort but the tort of negligence . . . .’ ” (Marlene F. v. Affiliated Psychiatric Medical Clinic, Inc. (1989) 48 Cal.3d 583, 588; accord, Burgess v. Superior Court (1992) 2 Cal.4th 1064, 1072.)

2 Petition to Stay Action and Compel Arbitration Kaiser filed a petition to stay the action and compel arbitration. Kaiser asserted that decedent was enrolled as a member of the Kaiser Foundation Health Plan, Inc. (Health Plan), pursuant to his wife’s employment under an “Agreement for Group Coverage” (CalPERS Agreement) between Health Plan and the Board of Administration of the California Public Employees’ Retirement System (CalPERS). Decedent and his wife enrolled under the CalPERS Agreement by an enrollment process administered exclusively by CalPERS. According to Kaiser, an arbitration provision required binding arbitration of all of plaintiffs’ claims. The arbitration provision was contained in the versions of the CalPERS Combined Evidence of Coverage and Disclosure Form for the Basic Plan operative in 2012 and 2013, the time period relevant to plaintiffs’ claims. This document is incorporated into the CalPERS Agreement. Kaiser included a copy of the Combined Evidence of Coverage and Disclosure Form for the Basic Plan, effective January 1, 2013, as an exhibit in support of its petition. The arbitration provision in that document, under the heading, “Binding Arbitration,” stated, in part, “For all claims subject to this ‘Binding Arbitration’ section, both Claimants and Respondents give up the right to a jury or court trial and accept the use of binding arbitration.”3 The 2012 version of the Combined Evidence of Coverage and Disclosure Form for the Basic Plan contained essentially the same arbitration provisions. Kaiser further asserted that section 1363.1, which requires that the enrollment form signed by the subscriber contain a prominently displayed arbitration notice, did not

3 We need not set forth the applicable arbitration provisions in any further detail. No issue is raised on appeal concerning, for example, the scope of disputes subject to the arbitration provisions or the definitions of Member Parties or Kaiser Parties.

3 apply to CalPERS enrollments.4 Kaiser relied on Government Code section 22869, which states that information disseminated by the CalPERS Board pursuant to section 22863 “shall be deemed to satisfy the requirements of Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code.” Chapter 2.2, known as the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act) (§ 1340), includes section 1363.1. Kaiser asserted that CalPERS administers its own enrollment process with its own enrollment forms, and that Health Plan is not allowed to substitute its own enrollment form or modify CalPERS’s enrollment forms. Thus, because the enrollment materials at issue are disseminated pursuant to Government Code section 22869 by the CalPERS Board and not by Kaiser, those materials are deemed to satisfy the requirements of the Knox-Keene Act, and specifically section 1363.1. In a declaration submitted with Kaiser’s petition, Angela Kohls, Area Vice President, Strategic Accounts, described CalPERS’s practice of providing enrollment publications to CalPERS members prior to the open enrollment period each year. Kohls also stated that these publications were available through the CalPERS website. The Health Benefit Summary advised CalPERS members that the Kaiser plan required binding arbitration of claims, and indicated that the applicable arbitration provision was set forth in the Kaiser Evidence of Coverage, which was posted on the CalPERS website. Kohls also stated that, each year, prior to open enrollment, CalPERS mailed to its

4 As will be discussed in greater detail post, section 1363.1 addresses binding arbitration provisions included as a contract term. Such a disclosure “shall appear as a separate article in the agreement issued to the employer group or individual subscriber and shall be prominently displayed on the enrollment form signed by each subscriber or enrollee.” (§ 1363.1, subd. (b).) Subdivision (d) of section 1363.1 requires that, “[i]n any contract or enrollment agreement for a health care service plan, the disclosure required by this section shall be displayed immediately before the signature line provided for the representative of the group contracting with a health care service plan and immediately before the signature line provided for the individual enrolling in the health care service plan.”

4 members an open enrollment packet that included a newsletter, a Health Benefit Statement, and a business reply card for requesting a written copy of the Health Benefit Summary and other information. Further, CalPERS’s agreement with Health Plan required Health Plan to mail subscribers an Evidence of Coverage after confirmation of enrollment, which Health Plan routinely did. Additionally, beginning in 2009, each year, Health Plan sent subscribers a card that could be submitted to request a copy of the new Evidence of Coverage. The card also instructed subscribers how to view and download the Evidence of Coverage online. Kohls stated that Health Plan could not unilaterally amend the Evidence of Coverage, and that any change Health Plan proposed had to be approved by CalPERS. In another declaration, Alice E.

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Kuntz v. Kaiser Foundation Hospital, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kuntz-v-kaiser-foundation-hospital-calctapp-2021.