Example of Court Annexed Arbitration Opinion: One
HOSPITAL COLLECTING FEES FOR MEDICAL SERVICES
This matter came before me as arbitrator pursuant
to ORS 36.400 et seq.
Plaintiff filed an action against defendants,
seeking $4,936.87 plus interest at 9% from October 7, 2002 and ‘reasonable
costs.’ Defendant 1 filed an answer denying plaintiff’s complaint.
Apparently defendant 2 did not file an answer. No default order was
presented to me with respect to defendant 2. Plaintiff may seek
an order of default from the court. I render no opinion on the question
of whether defendant 2 has any liability, which would arise under Oregon
Revised Statutes 108.040 if at all, or whether the complaint is sufficient
to plead a claim against defendant 2.
At the time for the hearing, plaintiff appeared
with its attorney and two witnesses, witness 1 and witness 2. Defendant
1 appeared in person. No other party or witnesses appeared.
All witnesses were sworn and various documents
were received without objection. From the evidence, I find that
Defendant 1 had surgery at a local Hospital on June 15. Defendant
1 signed a contract to pay for the surgery even if his insurance did
not, paragraph 6 of the Conditions of Admission. Defendant 1 thought
that he had insurance, and may well have. In any event, the insurance
has not paid. Defendant 1 may have thought and / or intended that he
would only have to pay about twenty per cent of the bill, but that is not
what the contract says that he signed. Defendant 1 agreed that he signed
the Conditions of Admission, that he had the surgery, and that the cost which
the hospital is claiming was reasonable.
At least under Oregon law, the hospital does
not have to make efforts to collect from Defendant 1 before filing a
Nor does the hospital have to make any efforts
to collect from a patient’s insurance. It does that because that
is an efficient business practice for it. Whether or not the hospital’s
efforts to collect from the insurance were adequate, as to which I render
no opinion because it was not an issue in the case, they were not successful.
It is not relevant to my decision, but I think that further efforts should
be made cooperatively between Defendant 1 and the business office of the
hospital to determine if in fact there is coverage for the treatment that
Defendant 1 had, and whether some money can be obtained from the insurance
The hospital’s witness testified that the account
was assigned to the plaintiff, and the collection agency’s witness testified
that the effective date of the assignment is October 7. I find
that the account was so assigned.
Plaintiff is claiming interest at the statutory
rate of 9% from October 7. Under Oregon Revised Statutes 82.010,
the hospital might have been able to recover interest from the time of
service, even without so stating in the Conditions of Admission, so I
will award the interest claimed.
Plaintiff is claiming that the contract provision
in paragraph 6 of the Conditions of Admission “I acknowledge that if this
account is placed in the hands of any attorney or collection agency, I
will be obligated to pay reasonable associated costs,” means that the loser
will have to pay attorney fees. I disagree. The phrase does
not mention payment of attorney fees. Such clauses almost always
refer specifically to attorney fees. I believe that is a requirement
of case law, but even if it is not, a question that I will not investigate
here, I believe that they should. And the hospital would have good reason
to choose not to have an attorney fee provision in its Conditions of Admission,
because the reciprocity provisions of ORS 20.096 and ORS 20.097 could expose
the hospital to a patient’s attorney fees in a counterclaim to a collection
action. This risk could also explain as well as the reason no attorney
fees are sought under ORS 20.082 in assigned hospital accounts. Furthermore,
ORCP 68C requires that attorney fees be sought in a complaint and no such
claim was made.
I direct plaintiff to submit a cost bill including
any properly collectible costs. At first blush, it appears to
me that those are the filing fee, fee for service on Defendant 1 only,
the arbitrator’s fee for which I will submit an itemized bill, and any
statutory prevailing fee. Of course, that should be served on Defendant
As soon as I receive the cost bill, I will
prepare a separate award, serve it on the parties, and notify the parties
when I sign and file it with the court.