Arbitration Agreements in Healthcare: Why Specifics Are Critical
In healthcare disputes, as in healthcare delivery itself, details can carry significant consequences. This is particularly true when patients or their families are asked to accept arbitration agreements as a condition of receiving care. Courts require that such agreements be presented in a manner that allows for informed consent. A recent decision from the California Court of Appeal, Brockman v. Kaiser Foundation Hospitals, illustrates how closely courts examine these issues.
Background of the Dispute
Chloe Brockman was born in 2004. That same year, her mother, a nurse, was hired by Kaiser Hospitals and became eligible to enroll in Kaiser’s group medical plan. In December 2004, she completed a one-page enrollment form, and in January 2005 she added Chloe as a dependent by signing an additional one-page document. Both forms included brief references to arbitration of medical malpractice claims and stated that the complete arbitration terms were contained in separate plan booklets.
In 2020, Chloe’s mother transitioned from a union position to a nonunion role with Kaiser and enrolled herself and Chloe through an online system in Kaiser’s employee medical plan. As with the earlier plans, the enrollment materials referenced arbitration and indicated that the full arbitration procedures were set forth in another document.
Medical Treatment and Allegations
Throughout her childhood and adolescence, Chloe experienced a range of mental health concerns, including social anxiety, depression, body dysmorphia, and gender-related distress.
According to the court’s summary of the allegations, when Chloe was 12 years old she told her parents she identified as male. Her healthcare providers affirmed a diagnosis of gender dysphoria, and at age 13 she began medical treatment related to gender transition. Chloe later alleged that instead of improving her mental health, these interventions coincided with a worsening of her condition. After undergoing breast removal surgery at age 15, she became suicidal.
In 2023, Chloe filed a medical malpractice action in San Joaquin County Superior Court against Kaiser Hospitals, several physicians and psychologists, and other defendants. She alleged that the treatment provided was not medically justified, that the risks and potential harms were not adequately disclosed, and that her providers failed to conduct a proper psychological evaluation.
As a result, she claimed, she suffered permanent physical changes, emotional harm, and long-term distress, along with a loss of trust in the medical system.
The Arbitration Dispute
Kaiser and the other defendants sought to compel arbitration, arguing that Chloe was bound by arbitration provisions included in the medical plans under which she had been enrolled as her mother’s dependent. Their motion relied on a voluminous record intended to show continuous enrollment in plans that referenced arbitration.
Chloe opposed the motion, contending that the arbitration provisions were unenforceable. She argued, first, that the enrollment forms did not meet California’s requirement that arbitration disclosures be prominently displayed. Instead of providing the full terms, the forms merely referred enrollees to separate documents that were not presented at the time of enrollment.
She also argued that the enrollment materials failed to include specific language required by California law stating that claims for negligently or incompetently rendered medical services would be subject to binding arbitration.
The defendants responded that the disclosures were sufficient and that federal law governing arbitration preempted California’s more detailed requirements.
Court Decisions and Key Takeaways
In April 2024, the trial court denied the petition to compel arbitration. The court noted that the one-page enrollment documents referred to a “full arbitration provision” that was not actually included and that even the court itself was unable to locate the complete arbitration agreement without assistance from the defendants.
Based on this record, the court concluded that Chloe’s mother had not provided valid, informed consent to arbitrate disputes, rendering the arbitration provisions unenforceable under both state and federal standards.
The defendants appealed, but the Court of Appeal affirmed the trial court’s ruling. The appellate court emphasized that arbitration is a matter of contract and that a party cannot be compelled to arbitrate absent a clear agreement to do so.
Merely showing that a contract references arbitration is not enough, the court explained. A party seeking to compel arbitration must establish the specific arbitration provision that governs the dispute. Because the defendants failed to do so, the arbitration clauses could not be enforced.
Conclusion
The Brockman decision serves as a reminder that in healthcare disputes, the presentation and content of arbitration agreements matter. Enrollment forms, disclosures, and referenced documents must work together to ensure that patients and their families can understand what rights they may be giving up. When those details are missing or unclear, courts may decline to enforce arbitration provisions, regardless of how long a patient has been enrolled in a health plan.
