Frederick Copeland v. Healthsouth/Methodist Rehabilitation Hospital, LP , 565 S.W.3d 260 ( 2018 )


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  •                                                                                                   12/20/2018
    IN THE SUPREME COURT OF TENNESSEE
    AT JACKSON
    May 31, 2018 Session Heard at Nashville1
    FREDERICK COPELAND v. HEALTHSOUTH/METHODIST
    REHABILITATION HOSPITAL, LP ET AL.
    Appeal by Permission from the Court of Appeals
    Circuit Court for Shelby County
    No. CT-000196-16 Rhynette N. Hurd, Judge
    ___________________________________
    No. W2016-02499-SC-R11-CV
    ___________________________________
    A rehabilitation hospital hired a medical transportation company to take a patient
    to a doctor’s appointment. Before the transport, the company’s driver required the
    patient to sign an agreement that, in part, released the company from any liability.
    After the appointment, the patient fell as he was getting into the company’s van.
    He sued the medical transportation company, which moved to dismiss based on the
    exculpatory provisions of the agreement. The trial court and the Court of Appeals
    ruled that the exculpatory provisions were enforceable. We hold that to determine
    the enforceability of an exculpatory agreement, a court should consider the totality
    of the circumstances and weigh these non-exclusive factors: (1) relative bargaining
    power of the parties; (2) clarity of the exculpatory language, which should be clear,
    unambiguous, and unmistakable about what the party who signs the agreement is
    giving up; and (3) public policy and public interest implications. We hold that the
    exculpatory provisions in the agreement between the medical transportation
    company and the patient are unenforceable based on the unequal bargaining power
    of the parties, the overly broad and unclear language of the agreement, and the
    important public interest implicated by the agreement. Thus, the exculpatory
    language in the agreement does not, as a matter of law, bar the patient’s claim. We
    vacate the judgment of the trial court, reverse the judgment of the Court of
    Appeals, and remand this case to the trial court for further proceedings.
    1
    We heard oral argument on the campus of Lipscomb University in Nashville, Davidson County,
    Tennessee, as part of the American Legion Auxiliary Volunteer Girls State S.C.A.L.E.S (Supreme Court
    Advancing Legal Education for Students) project.
    Tenn. R. App. P. 11 Appeal by Permission; Judgment of the Court of Appeals
    Reversed; Judgment of the Trial Court Vacated; Remanded to the
    Trial Court
    SHARON G. LEE, J., delivered the opinion of the Court, in which JEFFREY S. BIVINS,
    C.J., and CORNELIA A. CLARK, HOLLY KIRBY, and ROGER A. PAGE, JJ., joined.
    Donald K. Vowell, Knoxville, Tennessee, and David E. Gordon and Erin L.
    Hillyard, Memphis, Tennessee, for the appellant, Frederick Copeland.
    Diana M. Comes, Memphis, Tennessee, for the appellee, MedicOne Medical
    Response Delta Region, Inc.
    OPINION
    I.
    Frederick Copeland was a patient at HealthSouth Rehabilitation Hospital
    North Memphis (HealthSouth or the hospital) after having knee replacement
    surgery. On December 2, 2014, Mr. Copeland had an appointment to see his
    orthopedic surgeon. The hospital had contracted with MedicOne Medical Response
    Delta Region, Inc. (MedicOne), a medical transportation company, to provide
    transportation services for its patients, including Mr. Copeland.
    On the day of Mr. Copeland’s appointment at his orthopedic surgeon’s
    office, a MedicOne employee driving a wheelchair van2 arrived at the hospital to
    take Mr. Copeland to and from the appointment. After the driver pushed Mr.
    Copeland in a wheelchair from his room to the entrance of the hospital, Mr.
    Copeland got out of the wheelchair, walked to the van using a walker, and climbed
    into the front passenger seat. Before leaving HealthSouth, the MedicOne driver
    gave Mr. Copeland a pre-printed two-sided document that contained on one side a
    Wheelchair Van/Transportation Run Report (Run Report) and on the other side a
    Wheelchair Van Transportation Agreement (Agreement). The Run Report
    provided that HealthSouth was responsible for MedicOne’s charges. The
    Agreement consisted of nine single-spaced paragraphs, including three paragraphs
    2
    The MedicOne wheelchair van had no seats in the rear compartment, but was equipped with a
    mechanical wheelchair lift and safety restraints to secure the wheelchair and its occupant after being
    loaded into the van. The only seats in the van were the driver’s seat and the front passenger seat.
    -2-
    of exculpatory language. The exculpatory language provided that Mr. Copeland
    was releasing MedicOne from any and all claims arising from or in any way
    associated with any transportation services provided by MedicOne. After Mr.
    Copeland signed the Run Report and the Agreement, the MedicOne driver took
    him to his doctor’s appointment.
    After the appointment, the MedicOne driver returned to the doctor’s office
    to take Mr. Copeland back to the hospital. As Mr. Copeland was getting into the
    van, he lost his footing on the running board, fell, and was injured.
    Mr. Copeland sued MedicOne for negligence in the Shelby County Circuit
    3
    Court. MedicOne moved to dismiss or, in the alternative, for summary judgment
    based on the exculpatory language in the Agreement. The trial court granted
    summary judgment in favor of MedicOne.4 The trial court found that the
    Agreement was not a contract of adhesion and that the services provided by
    MedicOne were not professional services, but merely transportation services, and
    so, the exculpatory provisions were enforceable. The Court of Appeals affirmed,
    finding that the case involved non-professional transportation services and
    presented no significant public interest considerations. Copeland v.
    HealthSouth/Methodist Rehab. Hosp., LP, No. W2016-02499-COA-R3-CV, 
    2017 WL 3433130
    , at *3, *5 (Tenn. Ct. App. Aug. 10, 2017).
    II.
    The issue here is the validity of the exculpatory language in the Agreement
    signed by Mr. Copeland releasing MedicOne from any liability. We review the
    trial court’s summary judgment ruling on this question of law de novo with no
    presumption of correctness. Rye v. Women’s Care Ctr. of Memphis, MPLLC, 
    477 S.W.3d 235
    , 250 (Tenn. 2015) (citing Bain v. Wells, 
    936 S.W.2d 618
    , 622 (Tenn.
    1997)); Circle C Constr., LLC v. Nilsen, 
    484 S.W.3d 914
    , 917 (Tenn. 2016) (citing
    3
    Mr. Copeland also sued HealthSouth, which is not a party to this appeal.
    4
    MedicOne supported its motion with an affidavit of its records custodian and copies of the Run
    Report and the Agreement. The parties also relied on excerpts of the MedicOne driver’s deposition
    testimony. The trial court treated the motion as a motion for summary judgment. Under Tennessee Rule
    of Civil Procedure 12.02, if a motion to dismiss based on 12.02(6) is supported by matters outside the
    pleading and those matters are not excluded by the court, the court treats the motion as one for summary
    judgment.
    -3-
    Hamblen Cnty. v. City of Morristown, 
    656 S.W.2d 331
    , 335–36 (Tenn. 1983))
    (stating that contract interpretation is a question of law).
    There is a natural tension between Tennessee’s public policy that favors
    allowing parties to have freedom to contract5 and the public policy that disfavors
    allowing a party to escape the consequences of the party’s negligence. In Olson v.
    Molzen, 
    558 S.W.2d 429
    (Tenn. 1977), we adopted factors to be considered when
    determining the enforceability of an exculpatory agreement. Olson involved an
    agreement, signed by a patient before a medical procedure, releasing the doctor
    from “any present or future legal responsibility associated with” the procedure. 
    Id. at 429–30.
    The procedure was unsuccessful, and the patient sued the doctor. The
    trial court dismissed the lawsuit based on the agreement. 
    Id. at 429.
    The Court of
    Appeals affirmed the dismissal. 
    Id. On review,
    we acknowledged that parties may agree that one party will not
    be liable for negligence to the other party, subject to certain exceptions. 
    Id. at 430
    (citing Moss v. Fortune, 
    340 S.W.2d 902
    (Tenn. 1960)). This Court recognized a
    line of Tennessee cases upholding such agreements,6 but none involving a
    physician, who is a “professional person operating in an area of public interest and
    pursuing a profession subject to licensure by the state.” 
    Id. at 430
    . We
    distinguished between “tradesmen in the market place” and those “experts” who
    were practicing state regulated professions. 
    Id. This Court
    noted that because
    certain relationships require of one party “‘greater responsibility than that
    required of the ordinary person,’” an exculpatory agreement between such parties
    is “‘peculiarly obnoxious.’” 
    Id. (quoting Williston
    on Contracts § 1751 (3d ed.
    1972)). To guide the analysis, this Court adopted a series of factors from Tunkl v.
    Regents of University of California, 
    383 P.2d 441
    (Cal. 1963), to be considered in
    determining whether a transaction affected the public interest:
    a. It concerns a business of a type generally thought suitable for
    public regulation.
    5
    Adams v. Roark, 
    686 S.W.2d 73
    , 75 (Tenn. 1985); Empress Health & Beauty Spa, Inc. v.
    Turner, 503 S.W.2d, 188, 190 (Tenn. 1973); Trailmobile, Inc. v. Chazen, 
    370 S.W.2d 840
    , 844 (Tenn. Ct.
    App. 1963); Moss v. Fortune, 
    340 S.W.2d 902
    , 903–04 (Tenn. 1960).
    6
    These prior cases included Empress, 
    503 S.W.2d 188
    ; Trailmobile, 
    370 S.W.2d 840
    ; and Dixon
    v. Manier, 
    545 S.W.2d 948
    (Tenn. Ct. App. 1976).
    -4-
    b. The party seeking exculpation is engaged in performing a service
    of great importance to the public, which is often a matter of
    practical necessity for some members of the public.
    c. The party holds himself out as willing to perform this service for
    any member of the public who seeks it, or at least for any member
    coming within certain established standards.
    d. As a result of the essential nature of the services, in the economic
    setting of the transaction, the party invoking exculpation possesses
    a decisive advantage of bargaining strength against any member of
    the public who seeks his services.
    e. In exercising a superior bargaining power the party confronts the
    public with a standardized adhesion contract of exculpation, and
    makes no provision whereby a purchaser may pay additional fees
    and obtain protection against negligence.
    f. Finally, as a result of the transaction, the person or property of the
    purchaser is placed under the control of the seller, subject to the
    risk of carelessness by the seller or his agents.
    
    Olson, 558 S.W.2d at 431
    . Noting that not all of these factors must be present for
    the exception to apply, we found that all the factors were present in Olson and held
    that the exculpatory agreement was unenforceable. 
    Id. at 431–32.
    After our decision in Olson, there was some confusion about whether the
    Olson factors applied only to exculpatory agreements involving professional
    services. In two cases, the Court of Appeals determined that the Olson analysis did
    not apply because the cases did not involve contracts for professional services. In
    Schratter v. Development Enterprises, Inc., 
    584 S.W.2d 459
    , 461 (Tenn. Ct. App.
    1979), the Court of Appeals upheld an exculpatory provision in a residential lease,
    based in part on its determination that this Court had limited application of the
    Olson factors to professional service contracts.7 Likewise, in Parton v. Mark Pirtle
    Oldsmobile-Cadillac-Isuzu, Inc., 
    730 S.W.2d 634
    , 636 (Tenn. Ct. App. 1987)
    (citing 
    Olson, 558 S.W.2d at 430
    ), the Court of Appeals declined to apply the
    7
    This Court later expressly overruled Schratter in Crawford v. Buckner, 
    839 S.W.2d 754
    , 760
    (Tenn. 1992).
    -5-
    Olson factors to a contract for automobile repair because it concluded that this
    Court did not intend for the Olson analysis to apply to tradesmen in the market
    place.8 By the same token, in Petty v. Privette, 
    818 S.W.2d 743
    (Tenn. Ct. App.
    1989), the Court of Appeals applied the Olson factors to exculpatory language in a
    will that was intended to protect the attorney who had drafted the will. Finding
    only two of the Olson factors were present, the Court of Appeals held that this was
    insufficient to render the exculpatory clause in the will unenforceable as against
    public policy. 
    Id. at 746.9
    Yet the Court of Appeals in other cases applied the Olson factors when
    ruling on the enforceability of exculpatory provisions in contracts not involving
    professional services. In Childress v. Madison County, 
    777 S.W.2d 1
    (Tenn. Ct.
    App. 1989), the Court of Appeals analyzed an exculpatory release for participation
    in the Special Olympics. The intermediate appellate court held that the release did
    not fall under the exception provided by Olson based on the lack of any business
    motivations, citing the references in Olson to “‘business, bargaining strength in
    economic settings, purchasers, and payment of additional fees, to obtain protection
    against negligence’” and concluded that “the rule was intended to operate primarily
    in the marketplace.” 
    Id. at 4
    (quoting 
    Olson, 558 S.W.2d at 431
    ). The Court of
    Appeals in Smith v. Peoples Bank of Elk Valley, No. 01A01-9111-CV-00421, 
    1992 WL 117061
    , at *5 (Tenn. Ct. App. June 3, 1992), analyzed an exculpatory
    provision in a safe deposit box rental contract using the Olson factors. The
    intermediate appellate court held that the exculpatory provision was unenforceable
    because all factors were present – safe deposit box rental was regulated by statute
    and involved a service of great importance to the public; banks hold themselves out
    as willing to perform this service for any member of the public able to pay the
    rental fees; banks have greater bargaining power because most people cannot
    provide that type of protection for their valuables; it was a standardized contract of
    adhesion not open to negotiation; and the customer’s property was placed under
    the control of the bank. 
    Id. at *4.
    8
    The Parton court held the agreement unenforceable on other grounds, finding that the
    exculpatory language hidden in fine print did not fall within the parties’ “circle of assent” and thus did not
    relieve the defendant from 
    liability. 730 S.W.2d at 638
    .
    9
    Although the Court of Appeals did not find the exculpatory clause unenforceable under Olson, it
    remanded the case so the trial court could determine whether the clause was included because of undue
    influence, overreaching, or abuse of fiduciary relationship on the part of the attorney who drafted the 
    will. 818 S.W.2d at 746
    –48.
    -6-
    In still other post-Olson cases, the Court of Appeals did not mention the
    Olson factors or any professional services requirement but relied on the language
    of the contract to determine the enforceability of the exculpatory provisions. In
    Hays v. Ernesto’s, Inc., 
    1987 WL 11119
    , at *2 (Tenn. Ct. App. May 19, 1987), the
    Court of Appeals found that exculpatory language in a release signed by a party
    before riding a mechanical bull was enforceable because parties may contract for a
    release from liability and an assumption of the risk incident to negligence.
    Similarly, in Buckner v. Varner, 
    793 S.W.2d 939
    , 941 (Tenn. Ct. App. 1990), the
    Court of Appeals upheld a waiver of liability signed by the plaintiff before
    participating in horseback riding.
    After Olson, this Court upheld contractual provisions limiting liability to a
    sum certain. In Affiliated Professional Services v. South Central Bell Telephone
    Co., 
    606 S.W.2d 671
    , 672 (Tenn. 1980), the Court declined to apply the Olson
    analysis to a provision in a contract with a telephone company that limited the
    company’s liability for errors or omissions in yellow pages advertisements to the
    cost of the advertisement. Citing Smith v. Southern Bell Telephone & Telegraph
    Co., 
    364 S.W.2d 952
    (Tenn. 1962) and noting that nearly every appellate court that
    had considered this frequently litigated issue had upheld the limitation of liability
    in these contracts with telephone companies, the Court found that the case did not
    fall within the purview of Olson and upheld the agreement. Affiliated Prof’l 
    Servs., 606 S.W.2d at 672
    . Later, in Houghland v. Security Alarms & Services, Inc., 
    755 S.W.2d 769
    , 773 (Tenn. 1988), this Court upheld a clause limiting the liability of a
    company providing security alarm monitoring to a sum certain, citing cases from
    other jurisdictions and noting that such limitations of liability have generally been
    upheld in these types of cases against providers of alarm monitoring services. The
    Court in Houghland mentioned Olson, observing that agreements such as the one
    examined there would be unenforceable if licensed professional personnel were
    involved. 
    Id. (citing Olson,
    558 S.W.2d 429
    ). Houghland and its progeny involved
    limitations of liability and liquidated damages provisions, and thus were
    distinguishable from the agreement in Olson. In addition, the alarm monitoring
    company in Houghland did not present the contract on a “take-it-or-leave-it” basis,
    but offered the customer the opportunity to pay more for the services in return for
    the company assuming greater liability. Id.; see also Underwood v. Nat’l Alarm
    Servs., Inc., No. E2006-00107-COA-R3-CV, 
    2007 WL 1412040
    (Tenn. Ct. App.
    May 14, 2007); E.B. Harvey & Co., Inc. v. Protective Sys., Inc., 
    1989 WL 9546
    (Tenn. Ct. App. 1989).
    -7-
    In another post-Olson case, Adams v. Roark, 
    686 S.W.2d 73
    , 75 (Tenn.
    1985), this Court did not reference the Olson factors in finding that a release signed
    by a participant in a motorcycle race was enforceable in a claim for ordinary
    negligence.10 Instead, the Court noted that the public policy of Tennessee favors
    freedom to contract and that releases from liability in motor racing events are
    expressly permitted by statute in Tennessee.11 
    Id. at 75–76.
    This Court next considered the applicability of the Olson factors to a
    nonprofessional services contract in Crawford v. Buckner, 
    839 S.W.2d 754
    (Tenn.
    1992). Analyzing an exculpatory clause in a residential lease contract, the Court
    found that the landlord-tenant relationship satisfied all of the Olson factors, and
    thus the exculpatory clause in the lease was unenforceable because it was contrary
    to public policy. 
    Id. at 758–59.
    The Court explained “where there is no declaration
    in the Constitution or the statutes, and the area is governed by common law
    doctrines, it is the province of the courts to consider the public policy of the state
    as reflected in old, court-made rules.” 
    Id. at 759.
    Thus, “the exception to the
    freedom of contract rule for exculpatory [provisions] affecting the public interest is
    also a judicial declaration of public policy.” 
    Id. The Court
    in Crawford expressly overruled Schratter and other prior
    inconsistent decisions, noting Schratter’s conclusion that the Olson factors applied
    only to contracts involving professional services. 
    Id. at 760.
    The Court held that
    “under the facts here,” the exculpatory clause in the lease was against public
    policy. 
    Id. This limiting
    language appears to have added to the confusion about the
    applicability of the Olson factors because even after Crawford, the inconsistency in
    application continued.
    In some post-Crawford cases, the Court of Appeals determined that the
    Olson factors did not apply because the agreement did not involve professional
    services. Petry v. Cosmopolitan Spa Int’l, Inc., 
    641 S.W.2d 202
    , 203 (Tenn. Ct.
    App. 1982) (stating that “Olson did not overrule Empress” because spas are not
    “businesses ‘of a type generally thought suitable for regulation’”) (quoting Olson,
    10
    The Court found that there was a genuine issue of material fact as to the plaintiff’s allegations
    of gross negligence, and remanded the case to the trial court for a determination of that 
    issue. 686 S.W.2d at 74
    .
    11
    “The practice of participants in motor racing events of releasing the promoters thereof from
    liability and of assuming liability for any injuries sustained is expressly approved.” Tenn. Code Ann.
    § 55-22-105 (1968) (now Tenn. Code Ann. § 55-22-103 (2015)).
    
    -8- 558 S.W.2d at 431
    ); Floyd v. Club Sys. of Tenn., Inc., No. 01-A-01-9807-CV-
    00399, 
    1999 WL 820610
    , at *4 (Tenn. Ct. App. July 20, 1999) (finding, based on
    Petry, that the Olson test did not apply to health club contracts); Henderson v.
    Quest Expeditions, Inc., 
    174 S.W.3d 730
    , 732–33 (Tenn. Ct. App. 2005)
    (upholding an exculpatory waiver for whitewater rafting because it did not involve
    a professional trade affecting the public interest); Thrasher v. Riverbend Stables,
    LLC, No. M2008-02698-COA-RM-CV, 
    2009 WL 275767
    , at *3 (Tenn. Ct. App.
    Feb. 5, 2009) (quoting Russell v. Bray, 
    116 S.W.3d 1
    , 6 (Tenn. Ct. App. 2003))
    (upholding an exculpatory provision in a contract for boarding and training horses
    because the Olson test applied only to agreements involving a professional person).
    Yet in other post-Crawford cases, the Court of Appeals applied the Olson
    analysis to contracts that did not involve professional services. Lomax v. Headley
    Homes, No. 02A01-9607-CH-00163, 
    1997 WL 269432
    , at *7–9 (Tenn. Ct. App.
    May 22, 1997) (holding an exculpatory provision in a home construction loan
    agreement unenforceable under the Olson analysis); Hancock v. U-Haul Co. of
    Tenn., No. 01-A-01-9801-CC-00001, 
    1998 WL 850518
    , at *4–5 (Tenn. Ct. App.
    Dec. 10, 1998) (concluding an exculpatory provision was enforceable in a
    self-storage facility contract because although three of the Olson factors were
    present, the “important questions” of state regulation, reasonable alternatives for
    the plaintiff, and control over the plaintiff’s property were lacking); Lane-Detman,
    L.L.C. v. Miller & Martin, 
    82 S.W.3d 284
    , 293–94 (Tenn. Ct. App. 2002)
    (applying the Olson analysis to a contract with a law firm to provide background
    checks and holding that the contract was enforceable because “at most” three of the
    Olson factors were present, both parties to the contract were sophisticated
    commercial entities, and the services provided were not subject to regulation);
    Tompkins v. Helton, No. M2002-01244-COA-R3-CV, 
    2003 WL 21356420
    , at *4
    (Tenn. Ct. App. June 12, 2003) (applying the Olson factors to uphold a waiver
    signed at a racetrack because races are not of great importance to the public or a
    practical necessity; there was no disparity in bargaining power; and because the
    activity was voluntary, the plaintiff had not been placed under the control of the
    racetrack owner); Maxwell v. Motorcycle Safety Found., Inc., 
    404 S.W.3d 469
    ,
    474–75 (Tenn. Ct. App. 2013) (citing 
    Henderson, 174 S.W.3d at 733
    ; Tompkins,
    
    2003 WL 21356420
    at *1) (determining that a release for a motorcycle safety
    course was enforceable under the Olson analysis because it was a voluntary
    activity much like a motor speedway race or whitewater rafting).
    In other post-Crawford cases, the Court of Appeals found that exculpatory
    provisions were unenforceable and against public policy under the Olson analysis
    -9-
    specifically because the cases involved professional services or services that
    affected the public interest in a way analogous to a professional services contract.
    In Russell v. Bray, 
    116 S.W.3d 1
    , 6 (Tenn. Ct. App. 2003) (citing 
    Olson, 558 S.W.2d at 430
    ; 
    Parton, 730 S.W.2d at 636
    ), the Court of Appeals stated that the
    Olson analysis should be “limited to situations involving a contract with a
    professional person, rather than a tradesman.” The Russell court found that an
    exculpatory provision in a home inspection contract was suitable for analysis under
    the Olson test because unlike tradesmen, home inspectors do not perform hands-on
    tasks but sell their expert analysis and opinions. Id.; see also Carey v. Merritt, 
    148 S.W.3d 912
    (Tenn. Ct. App. 2004) (holding an exculpatory clause in a home
    inspection contract unenforceable based on the holding in Russell). In Maggart v.
    Almany Realtors, Inc., No. M2005-02532-COA-R3-CV, 
    2007 WL 2198204
    at *5
    (Tenn. Ct. App. July 26, 2007) (quoting 
    Olson, 558 S.W.2d at 430
    –31), aff’d on
    other grounds, 
    259 S.W.3d 700
    (Tenn. 2008), the Court of Appeals analogized an
    exculpatory agreement between employer and employee to exculpatory provisions
    in business contracts with consumers, observing that the relationship was one
    requiring greater responsibility on the part of the employer, which would render an
    exculpatory release in favor of the employer “obnoxious.”
    There are also post-Crawford cases in which the Court of Appeals did not
    mention Olson, but relied solely on the common law of contracts and the language
    of the agreement to determine the enforceability of an exculpatory provision. Pettit
    v. Poplar-Union Extended Mini-Storage, 
    1995 WL 30602
    , at *2 (Tenn. Ct. App.
    Jan. 26, 1995) (holding an exculpatory provision in a self-storage contract
    enforceable because the language was unambiguous); Burks v. Belz-Wilson Props.,
    
    958 S.W.2d 773
    , 777 (Tenn. Ct. App. 1997) (citation omitted) (finding a release
    for participation in a work-sponsored athletic event unenforceable because the
    wording was ambiguous and thus construed against the drafter); Fleming v.
    Murphy, No. W2006-00701-COA-R3-CV, 
    2007 WL 2050930
    , at *14 (Tenn. Ct.
    App. July 19, 2007) (citing Ouzts v. Womack, 
    160 S.W.3d 883
    , 885 (Tenn. Ct.
    App. 2004)) (“Under the common law of contracts, we interpret exculpatory
    clauses according to the plain meaning of their terms.”); Gibson v. Young Men’s
    Christian Ass’n of Middle Tenn., No. M2015-01465-COA-R9-CV, 
    2016 WL 2937320
    , at *2–3 (Tenn. Ct. App. May 16, 2016) (applying the rules of contract
    interpretation and looking at the plain meaning of the words to find the exculpatory
    provision enforceable where the agreement was clear and the plaintiff was injured
    while using the facilities as contemplated by the parties).
    - 10 -
    Federal courts have followed suit by inconsistently applying Olson. See
    Teles v. Big Rock Stables, L.P., 
    419 F. Supp. 2d 1003
    , 1008–09 (E.D. Tenn. 2006)
    (analyzing a contract with a horse stable under the Olson test and finding that it did
    not fall under the Olson exception prohibiting exculpatory provisions, although
    there was a genuine issue of material fact as to gross negligence that precluded
    summary judgment); Farris v. KTM N. Am., Inc., No. 3:04-CV-354, 
    2006 WL 73618
    , at *3 (E.D. Tenn. Jan. 11, 2006) (quoting 
    Olson, 558 S.W.2d at 430
    ) (citing
    Olson in support of enforcing an exculpatory waiver for test driving motorcycles
    because it did not involve a service of great importance to the public, but noting
    that application of the Olson factors is typically limited to a contract for
    professional services).
    This Court has not addressed the enforceability of exculpatory agreements
    since Crawford in 1992.12 Because of the inconsistency in how these agreements
    have been reviewed, we take this opportunity to restate the proper analysis to be
    applied to these agreements.
    III.
    Although courts throughout the country have taken numerous and varied
    approaches to exculpatory agreements, there are some common principles.13 First,
    a party may not, for public policy reasons, exempt itself from liability for gross
    negligence, reckless conduct, or intentional wrongdoing. Restatement (Second) of
    12
    This Court granted permission to appeal in Stewart v. Chalet Village Properties, Inc., No.
    E2007-01499-COA-R3-CV, 
    2008 WL 836136
    (Tenn. Ct. App. Mar. 31, 2008). In Stewart, the Court of
    Appeals applied the Olson analysis, holding that an exculpatory clause in a short-term vacation rental
    agreement was unenforceable because it affected the public interest and was contrary to public policy. 
    Id. at *6.
    This Court, in an opinion designated not for publication under Tennessee Supreme Court Rule 4,
    agreed that an analysis under Olson was appropriate, but reversed and remanded the case to the trial court
    because the trial court had failed to apply the Olson factors and this Court’s application of the Olson
    factors was hampered by an incomplete record. Stewart v. Chalet Vill. Props., Inc., No. E2007-01499-SC-
    R11-CV, 
    2009 WL 3616611
    , at *1 (Tenn. Nov. 3, 2009).
    13
    In two states, exculpatory agreements are unenforceable in personal injury cases. In Louisiana,
    agreements excluding or limiting liability for personal injuries are void and unenforceable by statute. La.
    Civ. Code Ann. art. 2004 (1985). Similarly, in Virginia, parties may contract for the release of liability
    and indemnification of third parties for property damage, but not for personal injury. Hiett v. Lake
    Barcroft Cmty. Ass’n, 
    418 S.E.2d 894
    , 895–96 (Va. 1992).
    - 11 -
    Contracts § 195 (1981); 
    Maxwell, 404 S.W.3d at 476
    (citing 
    Buckner, 793 S.W.2d at 941
    ).
    Second, exculpatory provisions in contracts involving common carriers are
    unenforceable on the grounds of public policy and disparity of bargaining power.
    14 Am. Jur. 2d Carriers § 853 (Nov. 2018 update) (noting that public policy
    forbids relieving carriers of responsibility based on their position of advantage over
    members of the public who are compelled to deal with them); see also Trailmobile,
    Inc. v. Chazen, 
    370 S.W.2d 840
    , 841–42 (Tenn. Ct. App. 1963); 
    Moss, 340 S.W.2d at 904
    . The same rule applies to inns and airports that assume “a duty of public
    service” to certain segments of the public. 1A Stuart M. Speiser et al., American
    Law of Torts § 5:39 (Mar. 2018 update).14
    Third, although exculpatory agreements are generally enforceable, in many
    states they are disfavored. See 8 Williston on Contracts § 19:25 (4th ed. 1993).15
    14
    See also Maxwell Operating Co. v. Harper, 
    200 S.W. 515
    (Tenn. 1918); Ellerman v. Atlanta
    Am. Motor Hotel Corp., 
    191 S.E.2d 295
    , 296 (Ga. Ct. App. 1972) (observing that the public does not have
    equal bargaining power when dealing with innkeepers, who are in a position to deny needed services);
    Northwest Airlines, Inc. v. Alaska Airlines, Inc., 
    351 F.2d 253
    , 256 (9th Cir. 1965) (quoting Restatement
    (Second) of Contracts § 575(1)) (noting that exemption from liability for negligence is unenforceable if
    one of the parties has a duty to the public for which it is to be compensated and the agreement relates to
    negligence in the performance of that public duty).
    15
    Exculpatory provisions are not disfavored in Tennessee. See, e.g., 
    Trailmobile, 370 S.W.2d at 844
    . In other states, exculpatory agreements are disfavored and strictly construed against the party
    seeking enforcement. See Kissick v. Schmierer, 
    816 P.2d 188
    , 191–92 (Alaska 1991); Salt River Project
    Agric. Improvement and Power Dist. v. Westinghouse Elec. Corp., 
    694 P.2d 198
    , 213 (Ariz. 1984),
    abrogated in part on other grounds by Phelps v. Firebird Raceway, Inc., 
    111 P.3d 1003
    , 1010–11 & n.5
    (Ariz. 2005); Plant v. Wilbur, 
    47 S.W.3d 889
    , 893 (Ark. 2001); Am. Auto. Ins. Co. v. Seaboard Sur. Co.,
    
    318 P.2d 84
    , 87–88 (Cal. Dist. Ct. App. 1957); Chadwick v. Colt Ross Outfitters, Inc., 
    100 P.3d 465
    , 467
    (Colo. 2004); Hanks v. Powder Ridge Rest. Corp., 
    885 A.2d 734
    , 739 (Conn. 2005); Sanderson v.
    Firestone Tire & Rubber Co., Civ. A. No. 89C-MR-212, 
    1994 WL 807899
    (Del. Super. Ct. July 28,
    1994); Zinz v. Concordia Props., Inc., 
    694 So. 2d 120
    , 121 (Fla. Dist. Ct. App. 1997); Fujimoto v. Au, 
    19 P.3d 699
    , 738 (Haw. 2001); Jesse v. Lindsley, 
    233 P.3d 1
    , 6 (Idaho 2008); Hawkins v. Capital Fitness,
    Inc., 
    29 N.E.3d 442
    , 447 (Ill. App. Ct. 2015); Belger Cartage Svc., Inc. v. Holland Constr. Co., 
    582 P.2d 1111
    , 1119 (Kan. 1978); Cumberland Valley Contractors, Inc. v. Bell Cnty. Coal Corp., 
    238 S.W.3d 644
    ,
    649 (Ky. 2007); Schlobohm v. Spa Petite, Inc., 
    326 N.W.2d 920
    , 923 (Minn. 1982); Turnbough v. Ladner,
    
    754 So. 2d 467
    , 469 (Miss. 1999); Warren v. Paragon Techs. Grp., Inc., 
    950 S.W.2d 844
    , 845 (Mo.
    1997); Agric. Aviation Eng’g Co. v. Bd. of Clark Cnty. Comm’rs, 
    794 P.2d 710
    , 713 (Nev. 1990); Barnes
    v. N.H. Karting Ass’n, 
    509 A.2d 151
    , 154 (N.H. 1986); Stelluti v. Casapenn Enters., LLC, 
    1 A.3d 678
    ,
    688–90 (N.J. 2010); Princetel, LLC v. Buckley, 
    944 N.Y.S.2d 191
    , 193 (N.Y. App. Div. 2012); Hyatt v.
    - 12 -
    Fourth, most courts require that the exculpatory language be unequivocal
    and clear. Williston § 19:22. An exculpatory clause must “clearly, unequivocally,
    specifically, and unmistakably” state the intention to exempt one of the parties
    from liability for its own negligence. 
    Id. § 19:25;
    see also, e.g., 
    Parton, 730 S.W.2d at 638
    (holding an exculpatory clause invalid based on a lack of evidence
    that it had been pointed out to the plaintiff or that “a person of ordinary intelligence
    and experience” would understand that the agreement relieved the defendant of all
    liability); Sirek v. Fairfield Snowbowl, Inc., 
    800 P.2d 1291
    , 1295 (Ariz. Ct. App.
    1990) (stating that exculpatory language should alert the party signing the release
    that “it is giving up a very substantial right”); Sanislo v. Give Kids the World, Inc.,
    
    157 So. 3d 256
    , 261 (Fla. 2015) (holding exculpatory agreements enforceable if the
    language is “so clear and understandable that an ordinary and knowledgeable
    person will know what he or she is contracting away”).
    Fifth, most jurisdictions do not enforce exculpatory provisions that are
    contrary to public policy. There is no bright line rule defining when a provision is
    contrary to public policy, but Williston suggests that whether an exculpatory
    agreement is void as against public policy depends on:
    all of the facts and circumstances surrounding the making of the
    agreement; society’s expectations; the identity and nature of the
    parties involved, including their relative education, experience,
    sophistication, and economic status; and the nature of the transaction
    itself, including the subject matter, the existence or absence of
    competition, the relative bargaining strength and negotiating ability of
    the economically weaker party, and the terms of the agreement itself,
    including whether it was arrived at through arm’s length negotiation
    or on terms dictated by the stronger party and on an adhesive, take-it-
    or-leave-it basis.
    Williston § 19:22.
    Mini Storage on the Green, 
    763 S.E.2d 166
    , 169 (N.C. Ct. App. 2014); Konrad ex rel. McPhail v.
    Bismarck Park Dist., 
    655 N.W.2d 411
    , 413 (N.D. 2003); Schmidt v. United States, 
    912 P.2d 871
    , 874
    (Okla. 1996); Mann v. Wetter, 
    785 P.2d 1064
    , 1066 (Or. Ct. App. 1990); Fisher v. Stevens, 
    584 S.E.2d 149
    , 152 (S.C. Ct. App. 2003); Housing Vermont v. Goldsmith & Morris, 
    685 A.2d 1086
    , 1089 (Vt.
    1996); Atkins v. Swimwest Family Fitness Ctr., 
    691 N.W.2d 334
    , 338 (Wis. 2005).
    - 13 -
    This Court adopted the Olson factors based on the Tunkl analysis. Tunkl,
    however, is the minority approach, with only five other states currently relying on
    the Tunkl factors to determine the enforceability of exculpatory provisions.16
    Courts in several states have observed that the factors fail to consider the totality of
    circumstances and, as a result, are overly rigid and arbitrary. See Wolf v. Ford, 
    644 A.2d 522
    , 527 (Md. 1994) (declining to adopt Tunkl because of concern that the six
    fixed factors may be too rigid and arbitrary); Schlobohm v. Spa Petite, Inc., 
    326 N.W.2d 920
    , 924 (Minn. 1982) (noting that although a number of courts cite Tunkl
    with approval, post-Tunkl cases generally consider disparity in bargaining power
    and whether the agreement involves a public or essential service); Hanks v.
    Powder Ridge Rest. Corp., 
    885 A.2d 734
    , 744 (Conn. 2005) (stating that public
    interest cannot adequately be defined within the four corners of a formula, and thus
    the analysis should be guided but not limited by the Tunkl factors).
    After reviewing precedent in this state and across the country, we conclude
    that the public policy in Tennessee has historically favored freedom of contract.
    Thus, contracts exempting one party from liability for negligence are not
    disfavored and are generally enforceable. 
    Olson, 558 S.W.2d at 430
    . That said, not
    16
    See Morgan v. S. Cent. Bell Tel. Co., 
    466 So. 2d 107
    , 117 (Ala. 1985); City of Santa Barbara v.
    Superior Court, 
    161 P.3d 1095
    , 1099–1102 (Cal. 2007); Bodyslimmer, Inc. v. Sanford, 
    398 S.E.2d 840
    ,
    841 (Ga. Ct. App. 1990); Glassford v. Brickkicker, 
    35 A.3d 1044
    , 1050 (Vt. 2011); Vodopest v.
    MacGregor, 
    913 P.2d 779
    , 786 (Wash. 1996). Courts in other states have cited Tunkl and applied the
    Tunkl factors in certain cases without adopting them. See Cudnik v. William Beaumont Hosp., 
    525 N.W.2d 891
    , 895 (Mich. Ct. App. 1994) (citing Tunkl as the leading case addressing an exculpatory
    agreement between a hospital and a patient, and finding that the agreement at issue fulfilled all of the
    Tunkl criteria); Schutkowski v. Carey, 
    725 P.2d 1057
    , 1060 (Wyo. 1986) (citing the four-part test adopted
    by the Colorado Supreme Court and applying the Tunkl factors to determine whether a private
    recreational business involved a public duty or was a matter of great necessity as required by that
    four-part test); Banfield v. Louis, 
    589 So. 2d 441
    , 446 (Fla. Dist. Ct. App. 1991) (quoting Bituminous Cas.
    Corp. v. Williams, 
    17 So. 2d 98
    , 102 (Fla. 1944)) (applying the Tunkl factors in finding that the plaintiff
    had failed to show sufficient evidence to invalidate an exculpatory agreement based on “‘great prejudice
    to the dominant public interest’”). Several other states use the Tunkl factors to guide their analysis of
    public policy or the public interest as one part of a multi-part test. See Jones v. Dressel, 
    623 P.2d 370
    , 376
    (Colo. 1981) (using the Tunkl factors to determine whether the public interest prong of Colorado’s
    four-part test has been met); Courbat v. Dahana Ranch, Inc., 
    141 P.3d 427
    , 438–39 (Haw. 2006)
    (determining the public interest element of Hawaii’s three-part test by application of the Tunkl factors);
    Berlangieri v. Running Elk Corp., 
    76 P.3d 1098
    , 1109–10 (N.M. 2003) (adopting the Tunkl factors for
    guidance, but noting that they are only “indicators” helpful to determine “the larger question of whether
    enforcement of the release would be unjust”); Pearce v. Utah Athletic Found., 
    179 P.3d 760
    (Utah 2008)
    (adopting the Tunkl factors to determine whether the public interest prong of Utah’s two-part test has been
    met), abrogated in part on other grounds by Penunuri v. Sundance Partners, Ltd., 
    423 P.3d 1150
    (Utah
    2017).
    - 14 -
    all exculpatory agreements should be enforceable, and courts should determine
    their enforceability by consideration of the circumstances of the parties, the
    language used in the agreement, and the public interest. While the factors adopted
    in Olson remain instructive and may be considered when relevant, the Olson
    approach is too rigid, fails to consider all the relevant circumstances, and is
    followed by only a handful of jurisdictions.
    We, therefore, need to restate our approach to determining the validity of
    exculpatory agreements. After surveying the factors adopted by courts in other
    states17 and considering Tennessee precedent, we hold that the enforceability of an
    17
    See Plant v. Wilbur, 
    47 S.W.3d 889
    , 893–94 (Ark. 2001) (three factors: public interest
    considerations; equality of bargaining power; clarity of language); Jones v. Dressel, 
    623 P.2d 370
    , 376
    (Colo. 1981) (four factors: existence of a duty to the public (determined by the Tunkl factors); the nature
    of the service performed; whether the agreement was fairly entered into; clear and unambiguous
    language); Moore v. Waller, 
    930 A.2d 176
    , 181–83 (D.C. 2007) (three factors: whether the exculpatory
    language is clear and unambiguous; bargaining power, specifically including whether the contract
    involves a necessary service; public policy); 
    Sanislo, 157 So. 3d at 260
    (two factors: unambiguous
    language; public policy); Courbat v. Dahana Ranch, Inc., 
    141 P.3d 427
    , 438–39 (Haw. 2006) (three
    factors: not violative of a statute; public interest (defined by Tunkl); equality of bargaining power); Jesse
    v. Lindsley, 
    233 P.3d 1
    , 6 (Idaho 2008) (two factors: bargaining power; existence of a public duty);
    Hawkins v. Capital Fitness, Inc., 
    29 N.E.3d 442
    , 446–47 (Ill. App. Ct. 2015) (three factors: disparity in
    bargaining power; public policy; social relationship between the parties that “militates against upholding
    the clause”); McAdams v. Foxcliff Estates Cmty. Ass’n, 
    92 N.E.3d 1144
    , 1150 (Ind. Ct. App. 2018) (four
    factors: bargaining power; unconscionability; whether the contract affects public interest; public policy);
    B.J.’s Wholesale Club, Inc. v. Rosen, 
    80 A.3d 345
    , 351–52 (Md. 2013) (three factors: clear and specific
    language; bargaining power; whether the contract affects the public interest); Xu v. Gay, 
    668 N.W.2d 166
    ,
    171–73 (Mich. 2003) (two factors: whether the release was fairly and knowingly made; explicit and
    unambiguous language); 
    Schlobohm, 326 N.W.2d at 923
    (two factors: bargaining power; whether the
    contract affects the public interest); Turnbough v. Ladner, 
    754 So. 2d 467
    , 469 (Miss. 1999) (two factors:
    whether the agreement was “fairly and honestly negotiated and understandingly entered into”; clear and
    precise language); Stelluti v. Casapenn Enters., LLC, 
    1 A.3d 678
    , 689 (N.J. 2010) (four factors: whether
    the agreement affects the public interest; existence of a legal duty to perform the service; no public utility
    or common carrier is involved; bargaining power/unconscionability); Princetel, LLC v. Buckley, 
    944 N.Y.S.2d 191
    , 193 (N.Y. App. Div. 2012) (three factors: no contravening public policy; clear,
    unequivocal language; the existence of a special relationship between the parties “such that an overriding
    public interest prohibits enforcement”); Hyatt v. Mini Storage on the Green, 
    763 S.E.2d 166
    , 169 (N.C.
    Ct. App. 2014) (three factors: not violative of a statute; bargaining power; public interest); Schmidt v.
    United States, 
    912 P.2d 871
    , 874 (Okla. 1996) (three factors: clear and unambiguous language; bargaining
    power; public policy); Topp Copy Prods., Inc. v. Singletary, 
    626 A.2d 98
    , 99 (Pa. 1993) (four factors:
    public policy; the contract relates entirely to the parties’ private affairs; bargaining power; clear and
    unambiguous language); K.N. v. Life Time Fitness, Inc., No. 2:16-cv-39, 
    2018 WL 1472483
    at *6 (D.
    Utah March 23, 2018) (citing Pearce v. Utah Athletic Found., 
    179 P.3d 760
    (Utah 2008)) (two factors:
    clear and unambiguous language; public interest). Roberts v. T.H.E. Ins. Co., 
    879 N.W.2d 492
    , 501–02
    (Wis. 2016) (three-factor public policy analysis: exculpatory language must not be overly broad and
    all-inclusive; adequate notice of the waiver’s nature and significance; bargaining power); Massengill v.
    - 15 -
    exculpatory agreement should be determined by considering the totality of the
    circumstances and weighing these non-exclusive factors: (1) relative bargaining
    power of the parties; (2) clarity of the exculpatory language, which should be clear,
    unambiguous, and unmistakable about what the party who signs the agreement is
    giving up; and (3) public policy and public interest implications. The totality of the
    facts and circumstances of each case will dictate the applicability of and the weight
    to be given to each of these factors. The factors need not be weighed equally in any
    given case – rather, the analysis should involve balancing each of these
    considerations given the facts and circumstances surrounding the formation of the
    agreement. In addition, we hold that there is no “professional services criterion”
    that restricts application of this analysis to contracts for professional services.
    Therefore, we overrule Parton, 
    730 S.W.2d 634
    ; Petty, 
    818 S.W.2d 743
    ; Petry,
    
    641 S.W.2d 202
    ; Floyd, 
    1999 WL 820610
    ; Henderson, 
    174 S.W.3d 730
    ; Thrasher,
    
    2009 WL 275767
    ; Russell, 
    116 S.W.3d 1
    ; Carey, 
    148 S.W.3d 912
    ; and any other
    previous decisions to the extent these cases conflict with our holding.
    We next turn to defining these factors to provide additional guidance in their
    application to the facts and circumstances of each case.
    Relative bargaining power. Although there is no precise rule by which to
    define sufficient disparity in bargaining power between the parties to invalidate an
    exculpatory agreement, two key criteria are the importance of the service at issue
    for the physical or economic well-being of the party signing the agreement and the
    amount of free choice that party has in seeking alternate services. Schmidt v.
    United States, 
    912 P.2d 871
    , 874 (Okla. 1996). For example, a standardized form
    offered on a take-it-or-leave-it basis may be invalid if there was great disparity of
    bargaining power, no opportunity for negotiation, and the services could not
    reasonably be obtained elsewhere. 
    Schlobohm, 326 N.W.2d at 924
    .18
    S.M.A.R.T. Sports Med. Clinic, P.C., 
    996 P.2d 1132
    , 1136 (Wyo. 2000) (four factors: the existence of a
    duty to the public; the nature of the service performed; whether the agreement was fairly entered into;
    clear and unambiguous language).
    18
    See also Hyatt v. Mini Storage on the Green, 
    763 S.E.2d 166
    , 171 (N.C. Ct. App. 2014)
    (quoting Hall v. Sinclair Ref. Co., 
    89 S.E.2d 396
    , 398 (N.C. 1955)) (defining disparity in bargaining
    power sufficient to invalidate an exculpatory agreement as bargaining power unequal to the extent that the
    releasing party must either accept the agreement or forgo a service important to him that is, for all
    practical purposes, not obtainable elsewhere); Crowell v. Hous. Auth. of Dallas, 
    495 S.W.2d 887
    , 889
    (Tex. 1973) (concluding that if one party is at such a disadvantage in bargaining power that he is
    practically compelled to sign the release, it will be unenforceable).
    - 16 -
    Clarity of language. The language of an exculpatory agreement must clearly
    and unequivocally state a party’s intent to be relieved from liability, and the
    wording must be “so clear and understandable that an ordinary and knowledgeable
    person will know what he or she is contracting away.” 
    Sanislo, 157 So. 3d at 260
    –
    61.19 The language must also alert the party agreeing to the exculpatory provision
    that the provision concerns a substantial right. 
    Sirek, 800 P.2d at 1295
    . The
    language in the agreement should not be so broad as to relieve the exculpated party
    from liability for any injury for any reason. 
    Burks, 958 S.W.2d at 777
    (holding
    exculpatory provision relieving the defendant “from any and all liability . . .
    relating to participation in these events” unenforceable as overly broad and
    ambiguous); Roberts v. T.H.E. Ins. Co., 
    879 N.W.2d 492
    , 503 (Wis. 2016) (citing
    Richards v. Richards, 
    513 N.W.2d 118
    , 121 (Wis. 1994)).20 Ambiguous language
    will be construed against the party that drafted the agreement. 
    Burks, 958 S.W.2d at 777
    .
    Public policy and the public interest. The third factor, public policy and the
    public interest, is the most difficult to articulate. Public policy has been defined as
    “‘that principle of law under which freedom of contract or private dealings is
    restricted by law for the good of the community.’” 
    Roberts, 879 N.W.2d at 501
    –02
    (quoting Atkins v. Swimwest Family Fitness Ctr., 
    691 N.W.2d 334
    , 339 (Wis.
    2005)). A private contract violates public policy if it conflicts with the constitution,
    statutes, or judicial decisions of this state or tends to be harmful to the public good,
    public interest, or public welfare. Spiegel v. Thomas, Mann & Smith, P.C., 
    811 S.W.2d 528
    , 530 (Tenn. 1991). As this Court explained in Crawford, without a
    declaration in the constitution or the statutes of Tennessee, a judicial declaration of
    public policy is within the province of the 
    courts. 839 S.W.2d at 759
    . Public policy
    is also determined by societal expectations that are flexible and change over time.
    See 
    Wolf, 644 A.2d at 527
    –28 (“The ultimate determination of what constitutes the
    19
    See also Turnbough v. Ladner, 
    754 So. 2d 467
    , 469 (Miss. 1999) (stating that the intention to
    release one party from liability for negligence must be expressed in “clear and unmistakable language”
    and “should express as clearly and precisely as possible the extent to which a party intends to be absolved
    from liability”).
    20
    See also 
    Turnbough, 754 So. 2d at 469
    (“We do not sanction broad, general, ‘waiver of
    negligence’ provisions, and strictly construe them against the party asserting them as a defense.”);
    Richards v. Richards, 
    513 N.W.2d 118
    , 122 (Wis. 1994) (finding that the overly broad language of the
    release “raised questions about its meaning and demonstrate[d] its one-sidedness” as unreasonably
    favorable to the released party). But see Huber v. Hovey, 
    501 N.W.2d 53
    , 54–55 (Iowa 1993) (upholding
    broad release from “any and all” loss, damage, or claim whether caused by negligence or otherwise).
    - 17 -
    public interest must be made considering the totality of the circumstances of any
    given case against the backdrop of current societal expectations.”).
    Whether the public interest is affected may be determined by considering
    whether a party to the transaction has a public service obligation, such as a public
    utility, common carrier, or innkeeper. 
    Wolf, 644 A.2d at 526
    . This analysis also
    includes transactions that are not as readily defined, but are so important to the
    public good that an exculpatory clause would be contrary to society’s expectations.
    
    Id. (quoting Md.-Nat’l
    Capital Park & Planning Comm’n v. Wash. Nat’l Arena,
    
    386 A.2d 1216
    , 1228 (Md. 1978)); see also Hanks v. Powder Ridge Rest. Corp.,
    
    885 A.2d 734
    , 744 (Conn. 2005) (citations omitted) (agreeing with the Maryland
    and Vermont Supreme Courts that the public interest must be determined based on
    the totality of the circumstances and that the analysis, guided but not limited by
    Tunkl, “is informed by any other factors that may be relevant given the factual
    circumstances of the case and current societal expectations”); Williston § 19:22.
    In determining whether the service involved is a public or essential service,
    courts should consider whether it is a type of service generally considered suitable
    for public regulation. 
    Schlobohm, 326 N.W.2d at 925
    –26. And in deciding whether
    enforcement of an exculpatory provision would be against public policy, courts
    should consider whether the services involved are of great importance to the
    public, which are a practical necessity for some members of the public. Id.; see
    also Plant v. Wilbur, 
    47 S.W.3d 889
    , 893 (Ark. 2001) (upholding release signed by
    a spectator at a car race because that activity involved a narrow segment of the
    public, unlike a public utility, common carrier, or “a similar entity connected with
    the public interest”).
    IV.
    In applying this restated analysis to the facts before us, we take the strongest
    legitimate view of the evidence in favor of Mr. Copeland as the non-moving party
    for summary judgment and allow all reasonable inferences in his favor. B & B
    Enters. of Wilson Cnty., LLC v. City of Lebanon, 
    318 S.W.3d 839
    , 844–45 (Tenn.
    2010); Martin v. Norfolk S. Ry. Co., 
    271 S.W.3d 76
    , 84 (Tenn. 2008) (citing
    Staples v. CBL & Assocs., Inc., 
    15 S.W.3d 83
    , 89 (Tenn. 2000)).
    We begin with the first factor – disparity in bargaining power. Mr. Copeland
    was a seventy-seven-year-old hospital patient recovering from knee replacement
    surgery who needed to go to a follow-up appointment at his doctor’s office. Mr.
    - 18 -
    Copeland did not select, hire, or pay MedicOne. Instead, the hospital where Mr.
    Copeland was a patient arranged for his transportation with MedicOne. The
    MedicOne driver presented Mr. Copeland with a pre-printed, two-sided document
    containing two different forms – the Run Report and the Agreement – which Mr.
    Copeland had limited time to review and sign before being transported to his
    doctor’s appointment. The Agreement consisted of nine single-spaced paragraphs,
    including three paragraphs of exculpatory language. The MedicOne driver spent
    only nineteen minutes at the hospital, which began with his arrival, and included
    going to Mr. Copeland’s room, pushing Mr. Copeland in a wheelchair to the
    hospital entrance, getting him into the van, loading his walker into the back of the
    van, and having Mr. Copeland review and sign the two forms.
    The MedicOne driver presented the Agreement to Mr. Copeland on a
    take-it-or-leave-it basis with the expectation that he would sign it. The driver did
    not understand the implications of the Agreement, could not have explained it if
    asked, had no authority to alter it, and would not have transported Mr. Copeland to
    his appointment if he had not signed the document.
    Mr. Copeland had a practical necessity to get to his medical appointment. He
    had the difficult choice of signing the Agreement or delaying or forgoing his
    medical care that day. Mr. Copeland’s situation was analogous to the difficult
    choice presented to the plaintiff in Wofford v. M.J. Edwards & Sons Funeral
    Home, Inc., 
    490 S.W.3d 800
    (Tenn. Ct. App. 2015). There, a funeral home
    presented the plaintiff with a contract for funeral services after her father’s body
    had been embalmed. Relying on Buraczynski v. Eyring, 
    919 S.W.2d 314
    (Tenn.
    1996), the Wofford court ruled that the arbitration clause in the contract was
    unenforceable because it was a contract of adhesion, offered on a take-it-or-leave-it
    basis, and the plaintiff’s failure to sign the agreement would have interrupted the
    rendition of services and caused delay, resulting in a “difficult 
    choice.” 490 S.W.3d at 824
    . Recognizing that the Buraczynski analysis rests on the critical
    finding of a unique relationship built on trust (such as the doctor-patient
    relationship in Buraczynski), the Wofford court found that the plaintiff had no
    realistic choice other than to sign the contract, and that asking her to stop the
    funeral services at that point would be like asking her “to swap horses midstream.”
    
    Id. at 816.
    Mr. Copeland may not have had a preexisting relationship with
    MedicOne that was “unique and built on trust,” but he did have a hospital-patient
    relationship with HealthSouth, the entity that had arranged for his transportation by
    MedicOne. Mr. Copeland also faced the same kind of difficult choice – refusing to
    sign the Agreement, offered on a take-it-or-leave-it basis that would have
    - 19 -
    potentially interrupted and caused a delay in his medical care by requiring him to
    reschedule his appointment or, as the Court of Appeals suggested, calling a taxi. In
    our view, asking Mr. Copeland to make such a choice would be like asking him to
    “swap horses in midstream.” 
    Id. There is
    ample evidence in the record of relative
    disparity in the parties’ bargaining power.
    We now turn to the second factor – the clarity of the Agreement’s
    exculpatory language. Much of the exculpatory language appears in bold print and
    all capital letters. Even so, although portions of paragraphs three and four purport
    to limit the exculpatory language in those paragraphs to simple negligence by
    expressly excluding gross negligence and willful misconduct, this limiting
    language begins by stating, “WITHOUT LIMITATION OF THE FOREGOING
    . . . .” The “foregoing” in paragraph three reads:
    Client does hereby release and forever discharge MedicOne . . . from
    any and all claims, suits, rights, interests, demands, actions, causes of
    action, liabilities, accident, injury (including death), costs, fees,
    expenses and any and all other damages or losses of any kind
    whatsoever, whether to person or property . . . arising out of,
    incidental to, associated with, or in any way related to any
    transportation services provided to Client by MedicOne.
    Similarly, the “foregoing” in paragraph four reads:
    CLIENT WILL INDEMNIFY, DEFEND AND HOLD HARMLESS
    MEDICONE RELATED PARTIES FROM AND AGAINST ANY
    AND ALL CLAIMS ASSERTED BY CLIENT, ANY PERSON OR
    ENTITY RELATED TO CLIENT OR ASSERTING A CLAIM BY
    OR THROUGH CLIENT, OR ANY OTHER THIRD PARTIES OR
    ENTITIES WHICH, IN ANY WAY, ARISE OUT OF, ARE
    INCIDENTAL TO, ASSOCIATED WITH, OR IN ANY WAY
    RELATED TO ANY TRANSPORTATION SERVICES PROVIDED
    TO CLIENT BY MEDICONE.
    Paragraph six contains no limitation for claims of gross negligence or willful
    misconduct, but purports to release MedicOne from “any liability, damage or
    expense arising out of any claim in any way associated with or relating to any
    transportation services provided to Client by MedicOne.”
    - 20 -
    Courts in many jurisdictions, including Tennessee, have found such
    unlimited language to be so overly broad as to render the provisions unenforceable.
    See 
    Burks, 958 S.W.2d at 777
    (holding release “from any and all liability claims,
    demands, actions or causes of action whatsoever, arising out of or any injury,
    illness loss or damage including death relating to participation in these events”
    unenforceable because it would “extend its exculpation to unbounded limits”);
    Fisher v. Stevens, 
    584 S.E.2d 149
    , 152–53 (S.C. Ct. App. 2003) (finding a waiver
    signed at a racetrack to be overly broad and unenforceable based on public policy
    because the waiver released from liability “any persons in any restricted area”);
    Jesse v. Lindsley, 
    233 P.3d 1
    , 7–8 (Idaho 2008) (holding exculpatory clause in a
    residential lease unenforceable because it purported to release the landlord from
    liability “for any occurrence of any nature”); Alack v. Vic Tanny Int’l of Mo., Inc.,
    
    923 S.W.2d 330
    , 337–38 (Mo. 1996) (finding exculpatory clause unenforceable
    based on its ambiguity because the clause did not specifically state that the
    customer was releasing the health club from liability for negligence and used
    words like “any” and “all” injuries and claims, which could include intentional or
    grossly negligent conduct that cannot be excluded from liability); 
    Roberts, 879 N.W.2d at 503
    (holding waiver unenforceable because it was too broad and
    all-inclusive, ambiguous about whether it covered injury while waiting in line for
    the activity, and was a standard pre-printed form with no opportunity to negotiate).
    We find the exculpatory language in the Agreement to be overly broad and
    ambiguous. Although the Agreement also contains a severability clause,21 the three
    paragraphs containing broad, all-encompassing exculpatory language combined
    with the severability paragraph do not make it clear and unmistakable what Mr.
    Copeland was giving up by signing the Agreement, especially during the limited
    time he was given to read and comprehend the document.
    21
    The severability clause appears in paragraph 5 of the Agreement:
    5. The invalidity or unenforceability of any particular provision of this
    Agreement shall not affect any other provision hereof, and in the event that any provision
    hereof is found by a proper authority to be invalid or unenforceable, this Agreement shall
    be construed in all respects as if such invalid or unenforceable provision had never
    comprised a part hereof and the remaining provisions hereof shall remain in full force and
    effect and shall not be affected by the invalid or unenforceable provision or by its
    severance here from. Furthermore, in lieu of such invalid or unenforceable provision,
    there shall be automatically hereto and as a part hereof a provision as similar in terms and
    intent to such invalid and unenforceable provision as may be possible and be legal, valid
    and enforceable.
    - 21 -
    Finally, we turn to the third factor – public policy and public interest
    implications. Mr. Copeland’s appointment with his doctor was a medical necessity.
    That practical necessity distinguishes this case from those involving purely
    voluntary or recreational activities, which generally do not affect the public interest
    or raise public policy concerns. 
    Maxwell, 404 S.W.3d at 475
    ; 
    Henderson, 174 S.W.3d at 733
    . Although public policy and the public interest are difficult concepts
    to define, some relationships require greater responsibility of one of the parties.
    
    Olson, 558 S.W.2d at 430
    . MedicOne was in a position of greater responsibility
    when it undertook to transport Mr. Copeland to and from his doctor’s office. Mr.
    Copeland had limited time to read and comprehend the overly broad and
    ambiguous Agreement and the Run Report. Under these circumstances, it is not
    reasonable to conclude that Mr. Copeland could have just called a taxi or
    rescheduled his appointment. Our public policy protects patients and clients of
    professionals, residential tenants, employees, bank customers, and homebuyers
    from exculpatory provisions. It only makes sense that our public policy should also
    protect a hospital patient under the circumstances faced by Mr. Copeland when he
    signed the Agreement. Based on the circumstances of the parties, including
    contemporary societal expectations, we conclude that enforcement of the
    Agreement against a member of the public in Mr. Copeland’s position would be
    contrary to the public interest.
    V.
    In sum, after considering the totality of the circumstances and weighing the
    inequality in the relative bargaining power of the parties, the lack of clarity of the
    exculpatory language, and the public policy and public interest implications, we
    hold that, as a matter of law, the exculpatory provisions in the Agreement signed
    by Mr. Copeland are unenforceable and do not bar his claim against MedicOne.
    We vacate the judgment of the trial court, reverse the judgment of the Court of
    Appeals, and remand to the trial court for further proceedings consistent with this
    opinion. We tax the costs of this appeal to MedicOne Medical Response Delta
    Region, Inc., for which execution may issue if necessary.
    _________________________________
    SHARON G. LEE, JUSTICE
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