Larry Benton v. Vanderbilt University

CourtCourt of Appeals of Tennessee
DecidedMarch 31, 2003
DocketM2002-00085-COA-R3-CV
StatusPublished

This text of Larry Benton v. Vanderbilt University (Larry Benton v. Vanderbilt University) is published on Counsel Stack Legal Research, covering Court of Appeals of Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Larry Benton v. Vanderbilt University, (Tenn. Ct. App. 2003).

Opinion

IN THE COURT OF APPEALS OF TENNESSEE AT NASHVILLE August 6, 2002 Session

LARRY EUGENE BENTON v. THE VANDERBILT UNIVERSITY

An Appeal from the Circuit Court for Davidson County No. 99C-1906 Carol L. Soloman, Judge

No. M2002-00085-COA-R3-CV - filed March 31, 2003

This is a case of first impression regarding the enforceability of an arbitration agreement against a third party. The plaintiff was a passenger in an automobile accident and was treated at the defendant hospital. The hospital filed a statutory hospital lien against any proceeds the plaintiff might recover in any lawsuit arising out of the car accident. The plaintiff later successfully sued the tortfeasor for the injuries he sustained in the accident. Thereafter, the hospital sought to recover under its lien for the balance of the plaintiff’s medical bills that were not paid to the hospital by the plaintiff’s insurance carrier. The plaintiff filed this action against the hospital, claiming that the hospital’s practice of balance billing violates the institution agreement between the hospital and the plaintiff’s insurance carrier. The hospital filed a motion in the trial court to compel arbitration, pursuant to an arbitration provision contained in the institution agreement. The trial court denied that motion. The hospital now appeals the denial of its motion to compel arbitration. We reverse, concluding that the plaintiff, a third-party beneficiary to the institution agreement seeking to enforce his rights under that agreement, is bound by the arbitration provision contained within that agreement.

Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Circuit Court is Reversed

HOLLY KIRBY LILLARD, J., delivered the opinion of the court, in which ALAN E. HIGHERS , J., and DAVID R. FARMER , J., joined.

Robert J. Walker, John S. Bryant, and Clisby Hall Barrow, Nashville, Tennessee, for the appellant, The Vanderbilt University.

Phillip L. Davidson, Nashville, Tennessee, and Earle J. Schwarz, Memphis, Tennessee, for the appellee, Larry Eugene Benton. OPINION

On December 13, 1998, Plaintiff/Appellee Larry Eugene Benton (“Benton”) was riding as a passenger in an automobile driven by William Hays. The car in which Benton was a passenger was struck by another automobile driven by Zella Lynn (“Lynn”). Benton was injured in the accident, and he required hospitalization at Defendant/Appellant The Vanderbilt University Medical Center (“Vanderbilt” or “the hospital”). He remained at the hospital from December 13 through December 18, incurring medical expenses of $31,504.84. On January 25, 1999, Vanderbilt filed a Notice of Hospital Lien pursuant to Tennessee Code Annotated § 29-22-101, et seq., against any proceeds Benton might recover from Lynn for his medical expenses incurred at Vanderbilt. At the time of the accident, Benton was insured for his medical expenses through Blue Cross and Blue Shield of Tennessee (“Blue Cross”). Under that insurance policy, Blue Cross paid a portion of Benton’s medical expenses.

Benton later sued Lynn for the personal injuries he received in the accident, including the costs of his medical treatment at Vanderbilt. Thereafter, Vanderbilt sought to recover $14,772.09 from the proceeds of the lawsuit under its hospital lien, which was the amount of Benton’s hospital charges not paid by Blue Cross. Lynn, who admitted liability for the accident, deposited $14,772.09 with the trial court clerk’s office pending the resolution of this case.

Prior to Benton’s accident, Vanderbilt and Blue Cross had entered into an “Institution Agreement” (“Institution Agreement” or “Agreement”) under which Vanderbilt agreed to provide health care services to members of the Blue Cross health care plan at previously set discounted rates.1 Under the Institution Agreement, Vanderbilt agreed not to bill any Blue Cross member for the difference between the actual charges and the set charges agreed to by Blue Cross, a practice commonly known as “balance billing.” See River Park Hosp., Inc. v. BlueCross BlueShield of Tenn., Inc., No. M2001-00288-COA-R3-CV, 2002 WL 31302926, at *9 (Tenn. Ct. App. Oct. 11, 2002) (noting that “balance billing” is the provider’s practice of billing the patient for an amount charged by the provider but not paid by the insurance company). The Institution Agreement provided “that in no event . . . shall [Vanderbilt] bill, charge, collect a deposit from, seek compensation from, or have any recourse against [Blue Cross] members or persons . . . for Covered Services provided pursuant to this Agreement.”2 It also contained a provision requiring that all

1 The Institution Agreement itself is under seal. The provisions of the Agreement that are quoted in this Opinion, however, were quoted by the parties in their briefs and are necessary to our analysis. Therefore, those provisions need not be pro tected by the seal.

2 The Institution Agreement provided that Vanderbilt:

shall be reimbursed for the p rovisio n of Covered S ervices provided to [B lue Cross] M emb ers in accordance with the terms set forth in this Institution Agreement and the applicable Network Attachment. [Vanderbilt] agrees to accept . . . [a] percent of covered charges as payment in full for services rendered to [Blue Cross] Members not covered through a Network product. Such reimbursement as is described in this section shall rep resent the maximum amo unt payable to (continued...)

-2- disputes under the Institution Agreement be submitted to arbitration. Under that provision, the parties agreed that all disputes “involving a contention by either party that the other has failed to perform its obligations and responsibilities under [the Institution] Agreement . . . shall be promptly submitted to inexpensive and binding arbitration.”3

On July 13, 1999, Benton filed a class action lawsuit against Vanderbilt.4 In the complaint, Benton asserted that he was a third-party beneficiary to the Institution Agreement. Under the Institution Agreement, Benton contended, Vanderbilt had agreed to accept the set charges from Blue Cross as payment in full, and Vanderbilt’s practice of routinely filing and pursuing hospital liens against him and other class members to recover charges in excess of those set charges constituted an abuse of process, breach of contract, and a violation of the Tennessee Consumer Protection Act. On July 24, 2001, Vanderbilt filed a motion to compel arbitration, pursuant to the provision in the Institution Agreement, and to stay proceedings pending the arbitration. See Tenn. Code Ann. § 29-5- 303. In its motion, Vanderbilt argued that Benton, as a third-party beneficiary of the Institution Agreement, was bound by the provision requiring arbitration. Benton objected, arguing that he was

2 (...continued) [Va nderbilt] for Co vered Services and [V anderbilt] shall not bill any [Blue Cross] Me mber for any contractual difference between billed charges and such reimbursement. [Vanderbilt] agrees that in no event, including, but not limited to, non-payment by [Blue Cross] . . . , rebundling or down cod ing of charges by [B lue Cross] . . . , [Blue Cross’s] inso lvency, o r brea ch of this Agreem ent, shall [Va nderbilt] bill, charg e, collect a deposit from, seek comp ensation from, or have any reco urse against [Blue Cross] members or persons, other than [Blue Cross], acting on the behalf of [Blue Cro ss] Memb ers, for C overed S ervices provided pursuant to this A greem ent.

Institution Agreement ¶ 6.1.

3 The arbitration p rovisio n in the Institution Agreem ent states in full:

8.2 Arbitration.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

At&T Technologies, Inc. v. Communications Workers
475 U.S. 643 (Supreme Court, 1986)
Allied-Bruce Terminix Cos., Inc. v. Dobson
513 U.S. 265 (Supreme Court, 1995)
Jeanes v. Arrow Insurance Company
494 P.2d 1334 (Court of Appeals of Arizona, 1972)
State v. Osborne
607 P.2d 369 (Alaska Supreme Court, 1980)
Rath v. Managed Health Network, Inc.
844 P.2d 12 (Idaho Supreme Court, 1992)
Sydnor & Hundley, Inc. v. Wilson Trucking Corp.
194 S.E.2d 733 (Supreme Court of Virginia, 1973)
Petty v. Sloan
277 S.W.2d 355 (Tennessee Supreme Court, 1955)
Ex Parte Dyess
709 So. 2d 447 (Supreme Court of Alabama, 1997)
Ex Parte Napier
723 So. 2d 49 (Supreme Court of Alabama, 1998)
Wachtel v. Shoney's, Inc.
830 S.W.2d 905 (Court of Appeals of Tennessee, 1991)
C.O. Christian & Sons Co. v. Nashville P.S. Hotel, Ltd.
765 S.W.2d 754 (Court of Appeals of Tennessee, 1988)
Georgia Power Co. v. Partin
727 So. 2d 2 (Supreme Court of Alabama, 1998)
Cook's Pest Control, Inc. v. Boykin
807 So. 2d 524 (Supreme Court of Alabama, 2001)
District Moving & Storage Co. v. Gardiner & Gardiner, Inc.
492 A.2d 319 (Court of Special Appeals of Maryland, 1985)
Zac Smith & Co. v. MOONSPINNER CONDO. ASSOCIATION, INC.
472 So. 2d 1324 (District Court of Appeal of Florida, 1985)
City of Peru v. Illinois Power Co.
630 N.E.2d 454 (Appellate Court of Illinois, 1994)
Rae F. Gill, P.C. v. DiGiovanni
612 N.E.2d 1205 (Massachusetts Appeals Court, 1993)
Johnson v. Pennsylvania National Insurance Companies
594 A.2d 296 (Supreme Court of Pennsylvania, 1991)

Cite This Page — Counsel Stack

Bluebook (online)
Larry Benton v. Vanderbilt University, Counsel Stack Legal Research, https://law.counselstack.com/opinion/larry-benton-v-vanderbilt-university-tennctapp-2003.