CorVel Corporation v. Memorial Hospital of South Bend
CourtIndiana Court of Appeals
Date FiledNovember 10, 2026
Docket26A-EX-00181
JudgeJudge Kenworthy
StatusPublished
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Full Opinion
Pursuant to Ind. Appellate Rule 65(E), the trial court and parties shall not take any
action in reliance upon this Opinion until it is certified.
IN THE
Court of Appeals of Indiana
FILED
CorVel Corporation, Nov 10 2026, 8:46 am
CLERK
Appellant-Defendant Indiana Supreme Court
Court of Appeals
and Tax Court
v.
Memorial Hospital of South Bend,
Appellee-Plaintiff
November 10, 2026
Court of Appeals Case No.
26A-EX-181
Appeal from the Full Worker’s Compensation Board of Indiana
Linda Peterson Hamilton, Chairman
Application Nos.
P-257657
P-257882
P-258378
P-262133
P-262382
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Opinion by Judge Kenworthy
Judges Mathias and DeBoer concur.
Kenworthy, Judge.
Case Summary
[1] Memorial Hospital of South Bend (“Hospital”) filed applications with the
Worker’s Compensation Board of Indiana (“Board”) seeking adjustment of fees
CorVel Corporation (“CorVel”) paid for four people who received treatment at
the Hospital. CorVel filed motions to dismiss the actions and compel
arbitration pursuant to a clause in an agreement between CorVel and the
Hospital. A single hearing member of the Board denied the motions. After
review, the full Board affirmed that decision with modifications and remanded
for the single hearing member to determine proper payment. CorVel appeals,
claiming the Board erred in denying its motions to compel arbitration. We
affirm.
Facts and Procedural History 1
[2] CorVel “is a national provider of risk-management solutions for the worker’s
compensation, auto, health, and disability management industries.” Appellant’s
1
The Hospital agreed with CorVel’s Statement of the Case and Statement of Facts. See Ind. Appellate Rule
46(B)(1) (allowing the appellee to omit certain sections of its brief if the appellee states agreement with the
statements in the appellant’s brief); see also Appellee’s Br. at 5–6. We commend both parties: CorVel for
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Br. at 6. 2 CorVel is a Delaware corporation headquartered in California. The
Hospital is a “duly licensed healthcare facility” located in South Bend, Indiana.
Appellant’s App. Vol. 2 at 35.
[3] In 1997, the Hospital and CorVel entered into a Preferred Provider
Organization Hospital Agreement (the “Agreement”) for the Hospital to
participate “as an independent contractor in the CorVel network of preferred
providers.” Id. The Hospital agreed to “provide health and medical services to
Beneficiaries (i.e. individuals covered under a health plan), as covered by
contracts, agreements, or understandings between CorVel and Payors, in a
quality minded and efficient manner.” Id. 3 The Agreement allowed CorVel to
pay the lesser of the amount provided by the Indiana Worker’s Compensation
fee schedule or a set percentage of billed charges. See id. at 64 (July 1, 2014,
amendment to the Agreement addressing hospital reimbursement); see also Ind.
Code § 22-3-3-5.2(b) (2014) (placing a cap on reimbursement at 200 percent of
Medicare’s reimbursement rate). The Agreement also contains the following
provision at issue in this appeal:
drafting statements with which the Hospital could agree, and the Hospital for doing so. We also commend
the parties generally for their concise and collegial briefs.
2
As the facts are undisputed, we have taken some of the facts from CorVel’s brief that are not otherwise
available from the limited record.
3
“Payors” are “insurance companies, employers, third party administrators, and other groups” to which
CorVel provides services. Id.
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Appellant’s App. Vol. 2 at 39. The Agreement was amended several times after
1997—most recently in 2014—but it does not appear this provision has
changed.
[4] Four employees of CorVel clients were treated at the Hospital. 4 CorVel
reimbursed the Hospital for the medical treatment on behalf of the employees’
respective employers. The Hospital disputed that CorVel had properly applied
the fee schedule to the reimbursements and in 2022, 2023, and 2024, filed
Applications for Adjustment of Claim for Provider Fee with the Board. See id.
4
One employee was treated on two different occasions, so there are five underlying claims.
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at 2, 5, 8, 11, and 14. In each action, CorVel moved to dismiss and compel
arbitration pursuant to the Agreement. 5
[5] The single hearing member denied CorVel’s motions to dismiss and compel
arbitration, finding:
[T]he [Board] has exclusive jurisdiction to enforce the Indiana
Worker’s Compensation Act and therefore is the appropriate
venue to decide if [CorVel’s] payment is correct under the
Indiana Medicare Fee Schedule.
Id. at 22.
[6] CorVel sought review by the full Board. After a hearing, 6 the Board issued one
order affirming all the single hearing member’s decisions, ultimately
determining:
1. The [Board] has exclusive jurisdiction to enforce the Indiana
Worker’s Compensation Act.
2. The appropriate venue to decide [CorVel’s] payment issues
rests with the [Board].
5
That CorVel filed a Motion to Dismiss and Compel Arbitration in each case is reflected in the
Chronological Case Summary for the individual cases. See id. The Appellant’s Appendix includes a copy of
the motion and single hearing member’s order in only one case, however. Id. at 22–23 (order) and 29–33
(motion). We assume the motions and orders are the same for all cases as neither party says otherwise.
6
The Board’s order reflects the Hospital and CorVel were each represented by counsel at a hearing. CorVel
did not ask for a transcript of the hearing to be prepared.
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3. [CorVel’s] Motion to Compel Arbitration is properly denied
as a violation of Indiana State Statutes.
4. This matter is remanded to the Single Hearing Member for a
hearing on the merits of what the proper payment for medical
services provided to the injured worker[s] should be in this
cause of action.
Id. at 20.
Standard of Review
[7] We review de novo a decision on a motion to compel arbitration. Decker v. Star
Fin. Grp., Inc., 204 N.E.3d 918, 921 (Ind. 2023). We also review de novo
questions of contract interpretation. Ill. Cas. Co. v. B&S of Fort Wayne Inc., 235
N.E.3d 827, 832 (Ind. 2024).
The Board did not err in denying CorVel’s motions to dismiss
and compel arbitration.
[8] CorVel contends the Board erred in denying its motions to dismiss because this
dispute must be decided pursuant to the arbitration clause in the Agreement.
The Hospital argues the dispute is outside the scope of the Agreement and
subject to the Board’s exclusive jurisdiction.
Arbitrability
[9] CorVel first argues the question of arbitrability should not have been decided by
the Board. When the question of who decides arbitrability—that is, who has
the power to decide whether a dispute must be resolved by arbitration—is
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presented, federal law guides the analysis. Ill. Cas. Co., 235 N.E.3d at 833.
Parties may choose to delegate the threshold question of arbitrability to an
arbitrator. Henry Schein, Inc. v. Archer & White Sales, Inc., 586 U.S. 63, 67–68
(2019). If a valid arbitration agreement exists, and if the agreement delegates
the arbitrability issue to an arbitrator, the court (or as in this case, board) may
not decide arbitrability. Id. at 68. To establish an intent to delegate
arbitrability, the agreement between the parties must do so by “clear and
unmistakable evidence.” Id. at 69 (quoting First Options of Chicago, Inc. v.
Kaplan, 514 U.S. 938, 944 (1995)). But the decision in Henry Schein left open
the question of what constitutes “clear and unmistakable” evidence of an intent
to delegate arbitrability.
[10] Tracking most jurisdictions to have answered that question, our Supreme Court
recently adopted the following rule as a matter of first impression in Indiana:
[A]n agreement to arbitrate in accordance with the [American
Arbitration Association] or similar rules represents clear and
unmistakable evidence that the arbitrator shall have the power to
exclusively decide the arbitrability of any claim. Thus, if the
parties entered into an arbitration agreement that incorporated
these rules, arbitrability must be decided by an arbitrator.
Ill. Cas. Co., 235 N.E.3d at 837–38 (internal quotation marks omitted) (footnote
omitted). “Simply referencing the AAA rules[,]” however, is not clear and
unmistakable evidence of intent to incorporate them. Id. at 834.
[11] The arbitration provision at issue in Illinois Casualty stated:
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Notwithstanding any provision of this form or the Policy, any
irreconcilable dispute between us and an “insured” is to be resolved
by arbitration in accordance with the then current rules of the American
Arbitration Association, except that the arbitration panel shall
consist of one arbitrator selected by the “insured,” one arbitrator
selected by us, and a third independent arbitrator selected by the
first two arbitrators. Judgment upon the award may be entered
in any court having jurisdiction. The arbitrator has the power to
decide any dispute between us and the “insured” concerning the
application or interpretation of this form. However, the
arbitrator shall have no power to change or add to the provisions
of this form. . . .
Id. at 831 (emphasis added). Applying its new rule to this clause, the Court
held this provision is clear and unambiguous: the parties agreed to arbitration
“in accordance with the then current rules of [the AAA]” which “include Rule
7(a), which grants the arbitrator power to rule on his or her own jurisdiction,”
including the determination of the “existence, scope, or validity of the
agreement.” Id. at 839 (internal quotations omitted).
[12] CorVel contends the arbitration provisions in Illinois Casualty and this case are
“functionally identical[.]” Appellant’s Br. at 12. Arbitration is a matter of
contract. Ill. Cas. Co., 235 N.E.3d at 832. When interpreting an arbitration
clause, we apply general contract interpretation principles. Decker, 204 N.E.3d
at 920. “The goal of contract interpretation is to ascertain and give effect to the
parties’ intent as reasonably manifested by the language of the agreement.” Id.
(quoting Reuille v. E.E. Brandenberger Constr., Inc., 888 N.E.2d 770, 771 (Ind.
2008)). As with all contracts, clear and unambiguous language in an arbitration
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provision “must be given its plain and ordinary meaning.” Id. at 920–21
(quoting Reuille, 888 N.E.2d at 771).
[13] In applying these rules of contract interpretation, we agree with the Hospital
that there is a significant difference between the two clauses: the clause in
Illinois Casualty leads with “any irreconcilable dispute . . . is to be resolved by
arbitration in accordance with the then current rules” of the AAA but the clause
in this Agreement leads with the manner of selecting arbitrators and then
provides that the AAA rules apply to “all procedures conducted before the
arbitration panel.” See Appellee’s Br. at 11–12. In other words, the language of
the Agreement indicates the parties intended for the AAA rules to apply only
after arbitrability has been decided in favor of arbitration by a court.
[14] Moreover, unlike the Illinois Casualty arbitration clause, the clause in this
Agreement does not invoke the “then current rules” of the AAA. See id. at 831.
The clause here simply states that procedures conducted before the arbitration
panel will be governed by “the rules and regulations of the [AAA].” Appellant’s
App. Vol. 2 at 39. The goal of our interpretation is to discover the intent of the
parties at the time the contract was made by examining the language used to
express their rights and duties. Ill. Cas. Co., 235 N.E.3d at 833. According to
the record before us, the Agreement between CorVel and the Hospital was last
amended in July 2014. The AAA rules about jurisdiction at that time provided:
“(a) The arbitrator shall have the power to rule on his or her own jurisdiction,
including any objections with respect to the existence, scope, or validity of the
arbitration agreement.” AAA Healthcare Payor Provider Arbitration Rules
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(Jan. 31, 2011), R-7(a) at page 8,
https://www.adr.org/media/opqlsmjw/healthcare-payor-provider-arbitration-
rules-jan-2011.pdf [https://perma.cc/WHR5-YU9R]. In contrast, the current
rule provides: “(a) The arbitrator shall have the power to rule on his or her own
jurisdiction, including any objections with respect to the existence, scope, or
validity of the arbitration agreement or to the arbitrability of any claim or
counterclaim, without any need to refer such matters first to a court.” AAA
Healthcare Payor Provider Arbitration Rules and Mediation Procedures (Oct.
1, 2022), R-7(a) at page 14 (emphasis added),
https://www.adr.org/media/l3clkyye/2022_healthcare_payor_provider_rules_
web.pdf [https://perma.cc/WRK8-KLPB].
[15] The United States Supreme Court has noted the question of who should decide
arbitrability is “rather arcane[,]” and “[a] party often might not focus upon the
question or upon the significance of having arbitrators decide the scope of their
own powers.” First Options, 514 U.S. at 945. A party can be forced to arbitrate
only those issues it has agreed to submit to arbitration, and therefore courts
should not assume parties have agreed to arbitrate arbitrability where the record
is silent or ambiguous on that point. Id.; see Ill. Cas. Co., 235 N.E.3d at 833–34
(“As a practical matter, this rule flips the ordinary policy presumption in favor
of arbitration when it comes to questions of arbitrability.”) (internal quotation
omitted). Here, the terms incorporating the AAA rules in the arbitration clause
are at best ambiguous and the AAA rule itself was not clear that arbitrability
was delegated when the parties signed the most recent amendment to the
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Agreement. Under these circumstances, there is not clear and unmistakable
evidence the parties intended to delegate arbitrability.
Scope of the Arbitration Agreement
[16] Because there is not clear and unmistakable evidence the parties delegated the
question of arbitrability, the Board had the power to decide whether this dispute
must be resolved by arbitration.
[17] A party seeking to compel arbitration must prove: (1) the existence of an
enforceable agreement to arbitrate, and (2) the disputed matter is the type of
claim the parties agreed to arbitrate. Rechlicz v. Price Point Builders, LLC, 276
N.E.3d 132, 138 (Ind. Ct. App. 2026), trans. denied. Here, there is no dispute
that the Agreement contains an arbitration provision. But the Board
determined the arbitration clause was unenforceable as contrary to Indiana law,
because the Worker’s Compensation Act gives the Board exclusive jurisdiction
to adjudicate worker’s compensation matters. See Appellant’s App. Vol. 2 at 19.
[18] CorVel contends the Board’s decision was erroneous because “both Indiana
and Federal law mandate the conclusion that the arbitration clause is
enforceable and applicable.” Appellant’s Br. at 13. Specifically, CorVel claims
the Indiana Uniform Arbitration Act covers worker’s compensation claims and
does not explicitly preclude arbitration. CorVel also claims the Federal
Arbitration Act preempts the application of any statutes that impair
enforcement of an arbitration provision in a contract involving interstate
commerce. Without addressing CorVel’s preemption argument, the Hospital
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echoes the Board’s determination that it has exclusive jurisdiction to hear
disputes regarding the Worker’s Compensation Act and argues “there is no
dispute that arises out of the [Agreement] in this matter.” Appellee’s Br. at 9.
We need not decide whether the Indiana Worker’s Compensation Act or the
arbitration clause under the Federal and Indiana Arbitration Acts controls here
because CorVel has not shown the scope of the arbitration provision reaches
this dispute.
[19] Indiana policy strongly favors arbitration agreements. Ill. Cas. Co., 235 N.E.3d
at 832. Any doubts concerning the scope of arbitrable issues should be resolved
in favor of arbitration, “and the parties are bound to arbitrate all matters, not
explicitly excluded, that reasonably fit within the language used.” Nat’l Wine &
Spirits, Inc. v. Ernst & Young, LLP, 976 N.E.2d 699, 706 (Ind. 2012) (citation
omitted), cert. denied; see also Precision Homes of Ind., Inc. v. Pickford, 844 N.E.2d
126, 131 (Ind. Ct. App. 2006) (“Arbitration must be compelled unless it may be
said with positive assurance that the arbitration clause is not susceptible of an
interpretation that covers the asserted dispute.”), trans. denied. However, parties
are only bound to arbitrate those issues that by clear language they have agreed
to arbitrate; arbitration agreements will not be extended by construction or
implication. Showboat Marina Casino P’ship v. Tonn & Blank Constr., 790 N.E.2d
595, 597–98 (Ind. Ct. App. 2003).
[20] The arbitration clause at issue begins with the intention to meet and confer in
good faith with respect to “any disputes or problems that may arise under this
Agreement[.]” Appellant’s App. Vol. 2 at 39. In the event “a dispute or problem”
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cannot be resolved informally, “any and all matters in controversy shall be
settled by arbitration.” Id. Although the second sentence does not spell it out,
it is clear from the provision as a whole that “a dispute or problem” to be
resolved by arbitration means—referring back to the first sentence—“a dispute
or problem that arises under the Agreement.” The dispute here is not over whether
CorVel should have applied the fee schedule or the fixed percentage in
reimbursing the Hospital pursuant to the hospital reimbursement provision of
the Agreement. Such a claim would be based on a contract term and therefore
arise under the Agreement. Instead, the dispute is solely over whether CorVel
properly applied the statutory fee schedule to its payment. The fee schedule is
found at Indiana Code Section 22-3-3-5.2, not in the Agreement. Because the
fee schedule is not part of the Agreement, the dispute about its application does
not arise under it, and the parties did not agree to arbitrate it. The dispute over
application of the fee schedule is properly left to the Board charged with the
“right to order payment for all services or products provided” under the
Worker’s Compensation Act. I.C. § 22-3-3-5(c).
Conclusion
[21] The Board did not err in denying CorVel’s motions to dismiss and compel
arbitration. The ruling of the Board remanding the Hospital’s applications to
the Single Hearing Member is affirmed.
[22] Affirmed.
Mathias, J., and DeBoer, J., concur.
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ATTORNEYS FOR APPELLANT
Daniel R. Kelley
Andrew D. Dettmer
Dinsmore & Shohl LLP
Indianapolis, Indiana
ATTORNEY FOR APPELLEE
Matthew L. Williams
Hardamon & Williams
Indianapolis, Indiana
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