Article l -Agreement to Arbitration: It is understood that any dispute as to medical malpractice, that is, as to whether any medical service rendered will be determined by submission to arbitration as provided by North Carolina law, and not by a lawsuit or resort to cow-r process except as North Carolina law provides for judicial review of arbitration processing. Both parties to this contract by entering into it, are giving up their constitutional right to have any such dispute decided in a court of law before a jury, and are instead accepting the use of arbitration.
Article 2 -All Claims must be decided by Arbitration: Jt is the intention of the parties that this agreement binds all parties whose claims may arise out of or relate to treatment or services provided by the Provider including any spouse or heirs of the patient and any children, whether born or unborn at that time of the occurrence given rise to any claim. In the case of any pregnant mother the term “patient” herein shall mean both the mother and the mothers expected child or children.
All claims for monetary damages exceeding the jurisdictional limit of small claims court against the Provider and Provider’s partners, associates, association or partnership and employees, agents and estates of any of them must be arbitrated including without limitations, claims for loss of consortium, wrongful death, emotional distress or punitive damages. Filing of any actions in any court by Provider to collect any fee from U1e patient shall not waive the right to compel arbitration of any malpractice claim. However, following the assertion of any claim against the Provider, any fee dispute shall be resolved by arbitration, whether or not the subject of any existing court action.
Article 3 -Procedures and Applicable Law: A demand for arbitration must be communicated in writing to all parties. Each party shall select an arbitrator (party arbitrator) within thirty days and a third arbitrator (neutral arbitrator) shall be selected by the arbitrators appointed by the parties within thirty days thereafter. Each party to the arbitration shall pay such party’s pro rata share of the expenses and fees of the neutral arbitrator, not including counsel fees or witness fees, or other expenses incurred by a party for such party’s own benefit.
Either party shall have absolute right to arbitrate separately the issue of liability and damages upon written request to the neutral arbitrator.
The parties consent to the intervention and joinder in this arbitration of any person or entity which would otherwise be a proper additional party in a court action, and upon such intervention and joinder any existing court action against such additional person or entity shall be stayed pending arbitration.
The parties agree that provisions of North Carolina law applicable to health care providers shall apply to disputes within this arbitration agreement.
Article 4 -General Provisions: All claims based upon the same incident, transaction or related circumstances shall be arbitrated in one processing. A claim shall be waived and forever barred if (1.) on the date notice thereof is received the claim, if asserted in a civil action, would be barred by the applicable North Carolina statute of limitation, or (2) the claimant fails to pursue arbitration claim in accordance with the procedures prescribed herein with reasonable diligence. With respect to any matter not herein expressly provided for the arbitration shall be governed by the North Carolina Arbitration Statute.
Article 5 -General Provisions: This agreement may be revoked by written notice delivered to the
Provider within 30 days of signature and if revoked will govern all medical services received by the patient.
Article 6 -Retroactive Effect: If patient intents this agreement to cover services rendered before the date it is signed (including, but limited to emergency treatment) patient should initial below:
Effective as of the date of first received medical service.
If any provision of this arbitration agreement is held invalid or unenforceable, the remaining provisions shall remain fuJI forced and sh.all not be affected by invalidity of any other provision. I understand that I have the right to receive a copy of the arbitration agreement. By my signature below I acknowledge that 1 have received a copy.
Notice: By signing this contract you are agreeing to have any issue of medical malpractice decided by neutral arbitration and you are giving up your right to a jury or court trial (see Article 1 of contract).