Opinion ID: 2210412
Heading Depth: 2
Heading Rank: 1

Heading: Privileges and Immunities Clause, Article I, Section 23

Text: The Privileges and Immunities Clause of the Indiana Constitution provides: The General Assembly shall not grant to any citizen, or class of citizens, privileges or immunities, which, upon the same terms, shall not equally belong to all citizens. IND. CONST. art. I, § 23. Plaintiff argues that Indiana Code section 34-18-7-1(b) is unconstitutional under Section 23 because, under that statute, victims of medical malpractice are treated differently than other tort victims, and because there is nothing about malpractice victims which warrants this differing treatment. The specific treatment about which plaintiff complains relates to the manner in which the two-year statute of limitations is construed and applied. This Court has held that, under Indiana Code section 34-1-2-2 (1993) (now amended and recodified as Indiana Code section 34-11-1-1 (1998)), the general tort statute of limitations, a tort claim must be filed within two years from the date the cause of action accrues, and that a tort claim accrues when the plaintiff knew or, in the exercise of ordinary diligence, could have discovered that an injury had been sustained as a result of the tortious act of another. Wehling v. Citizens Nat'l Bank, 586 N.E.2d 840, 843 (Ind.1992). At the same time, this Court has interpreted section 34-18-7-1(b) as an occurrence rather than a discovery statute, that is, a statute of limitations which commences running at the time of the act of malpractice rather than from the date on which the malpractice is discovered. See supra text accompanying note 6. Thus, plaintiff asserts, while most tort victims can avail themselves of the more liberal discovery rule, only victims of medical malpractice are required to file a claim within two years of the act of malpractice, regardless of whether they have discovered the malpractice, and this is not a distinction based on reason. Plaintiff also specifically urges this Court to reject prior precedent discussing the medical malpractice statute of limitations, because the legislative goals supposedly furthered by the statute are no longer furthered by the statute, if they ever were. Defendant argues that the relevant classification for the purpose of Article I, Section 23 is not malpractice victims and all other tort victims but rather the health care provider and all other tortfeasors. Defendant also correctly asserts that this Court has previously upheld the statute of limitations against a challenge that it unconstitutionally granted special privileges to medical professionals. Specifically, the Court held that the statute was rationally related to the legitimate legislative goal of maintaining sufficient medical treatment and controlling medical malpractice insurance costs. See Rohrabaugh v. Wagoner, 274 Ind. 661, 666-67, 413 N.E.2d 891, 894-95 (1980); Johnson v. St. Vincent Hosp., Inc., 273 Ind. 374, 379-80, 404, 404 N.E.2d 585, 589-90, 604 (1980). In considering the trial court's decision to reject plaintiff's argument and grant defendant's motion for summary judgment, the Court of Appeals weighed the arguments of the parties and concluded that the statute was unconstitutional under Article I, Section 23. 674 N.E.2d at 1019-1023. In doing so, the Court of Appeals correctly identified the appropriate analysis as that which we set out in Collins v. Day, 644 N.E.2d 72 (Ind.1994), but incorrectly applied that precedent here, with the result that the Court of Appeals found it necessary to strike down the statute as unconstitutional. Although we agree with plaintiff and with the Court of Appeals that it was error to grant summary judgment for defendant, we need not strike down the statute to reach this conclusion. Rather, giving due deference to the function of the legislature and to its legislative enactment, we conclude only that the statute of limitations is unconstitutional as applied to plaintiff. Our decision in Collins focused on the grant of a special privilege to the relevant class in that case, which involved the exemption of agricultural employers from the compulsory scope of coverage of the worker's compensation scheme. Nevertheless, we recognized that implicit in an enactment that imposes an unequal burden is the grant of a special privilege or immunity to persons or classes exempted from the new burden. Id. at 77. Thus, a statute which either grants unequal privileges or imposes unequal burdens may be the subject of a claim under Section 23. Id.; see also Indiana High School Athletic Ass'n v. Carlberg, 694 N.E.2d 222, 239-40 (Ind.1997). In Collins, we concluded that nothing compels the application of a federal equal protection analytical methodology to claims under Section 23, and that courts should give Section 23 independent interpretation and application. 644 N.E.2d at 75. We held that Section 23 imposes two requirements upon statutes that create classifications and that either grant privileges or impose burdens: First, the disparate treatment accorded by the legislation must be reasonably related to inherent characteristics which distinguish the unequally treated classes. Second, the preferential treatment must be uniformly applicable and equally available to all persons similarly situated. Id. at 80. We emphasized that, in determining whether a statute complies with or violates Section 23, courts must exercise substantial deference to legislative discretion. Id. We also held that, unlike the federal equal protection analytical framework, the resolution of Section 23 claims does not necessarily require the application of different degrees of scrutiny depending on the class or right at issue. Id. In applying the Collins standard, the Court of Appeals correctly concluded that this Court already has answered the first question, that is, whether the disparate treatment accorded by the legislation was reasonably related to the inherent characteristics which distinguish the unequally treated classes, Collins, 644 N.E.2d at 80, and properly refrained from re-examining the question in this case. Martin, 674 N.E.2d at 1023. Simply put, this Court has held that a classification scheme which distinguishes between victims of medical malpractice and victims of other torts, or viewed from another perspective, between health care providers and other tortfeasors, is reasonably related to the goal of maintaining sufficient medical treatment and controlling malpractice insurance costs in Indiana, and therefore is not unreasonable. Id.; see Rohrabaugh, 413 N.E.2d at 894-95; Johnson, 404 N.E.2d at 589-90, 604; see also Havens v. Ritchey, 582 N.E.2d 792, 794-95 (Ind. 1991). Specifically, this Court has held that the medical malpractice statute of limitations rationally furthers the goal of controlling malpractice costs by encouraging the prompt presentation of claims and, in so doing, limiting unfair exposure to defending health care providers that stems from dimmed memories or the loss of evidence over time. Rohrabaugh, 413 N.E.2d at 894-95; Johnson, 404 N.E.2d at 604. [8] Nothing in Collins changes our conclusion. Although as we stated in Collins, a classification which was proper when enacted may later cease to satisfy the requirement of Section 23 because of intervening changes in social or economic conditions, 644 N.E.2d at 81, nothing in the record and briefs before us in this case warrants a re-examination of the legitimacy of the legislative goal underlying the Medical Malpractice Act or its statute of limitations. See Cha v. Warnick, 476 N.E.2d 109, 112-13 (Ind.1985). We disagree, however, with the Court of Appeals' analysis of the second prong of the Collins test. The Court of Appeals correctly observed that victims of medical negligence who are unable to discover their injury and the medical malpractice before the expiration of the two-year statute of limitations are treated differently than plaintiffs who are able to discover the injury and the malpractice before the expiration of the two-year period and that the treatment is not uniformly applicable to all malpractice victims within the meaning of Collins. 674 N.E.2d at 1022-23. The Court of Appeals then concluded that the statute must fall. Id. at 1023. While we agree that the treatment is not uniformly applicable to all malpractice victims as required under Collins, it is not necessary to strike down the statute to administer the justice required by the Indiana Constitution, and, in fact, to do so is to ignore the final point we emphasized in Collins, that is, that courts must exercise substantial deference to legislative discretion. 644 N.E.2d at 80. The second prong of the Collins test is not a test that goes only to the facial validity of the statute, as the Court of Appeals apparently assumed. In fact, when, as here, the language of the relevant statutory provisions creates the primary classifications of medical malpractice victims and the victims of other torts but does not by its terms expressly create the assertedly unfair or disadvantaged subclassification of medical malpractice plaintiffs, the question presented by the second prong of Collins is whether the statute is unconstitutional as applied. In the context of this case, we agree with plaintiff that, under the second prong of Collins, the medical malpractice statute of limitations is not uniformly applicable to all medical malpractice victims. Moreover, this is not a case where the subclassification itself furthers the statutory goal of lowering medical costs by encouraging the prompt filing of claims, because plaintiffs who are unable to discover their injury and the malpractice are not empowered to file a claim at all. [9] Effectively, the doors of the courthouse are forever closed to them. Section 23 does not permit an application of the statute of limitations that would deprive plaintiff of the two-year statutory period for identifying and pursuing a claim against her doctor simply because she has a disease which may not manifest significant pain or debilitating symptoms until several years after the initial diagnosis or misdiagnosis. Stated another way, consistent with Section 23, plaintiff cannot be foreclosed from bringing her malpractice suit when, unlike many other medical malpractice plaintiffs, she could not reasonably be expected to discover the asserted malpractice and resulting injury within the two-year period given the nature of the asserted malpractice and of her medical condition. Accordingly, under Section 23, the medical malpractice statute of limitations is unconstitutional as applied to plaintiff.