Gilder v. Auto-Owners Insurance Co.

659 N.W.2d 804, 2003 Minn. App. LEXIS 431, 2003 WL 1875484
CourtCourt of Appeals of Minnesota
DecidedApril 15, 2003
DocketC4-02-1466
StatusPublished
Cited by10 cases

This text of 659 N.W.2d 804 (Gilder v. Auto-Owners Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gilder v. Auto-Owners Insurance Co., 659 N.W.2d 804, 2003 Minn. App. LEXIS 431, 2003 WL 1875484 (Mich. Ct. App. 2003).

Opinion

OPINION

PETERSON, Judge.

In this appeal from a judgment confirming a no-fault arbitrator’s award that awarded respondent insured reimbursement for the cost of a mattress and a box spring, appellant insurer argues that (1) the arbitrator did not have authority to determine whether the no-fault act requires that respondent be reimbursed for the cost of a mattress and box spring, and (2) a mattress and a box spring are not a service or a prosthetic device for which respondent shall be reimbursed under Minn.Stat. § 65B.44, subd. 2(a)(1) (2002). We reverse and vacate the arbitration award.

FACTS

In June 2000, respondent Jennifer Gilder suffered disc injuries and soft tissue damage as a result of a motor-vehicle accident. Following an examination, respondent’s chiropractor prescribed a quality firm mattress, and respondent purchased a mattress and box spring for $2,701.22. Respondent submitted a claim for this amount to her no-fault insurer, appellant Auto-Owners Insurance Company, and appellant denied the claim. Respondent then filed a petition for no-fault arbitration seeking reimbursement for the amount spent to purchase the mattress and box spring.

Appellant moved to stay the arbitration on the grounds that whether the cost of the mattress and a box spring should be reimbursed as a medical expense benefit under Minn.Stat. § 65B.44, subd. 2 (2002), is a legal issue outside the scope of arbitration. The district court denied appellant’s motion, and appellant appealed to this court, which dismissed the appeal.

The arbitration proceeded based on a stipulation by the parties that respondent would testify that the mattress and box spring benefited her recovery and gave her relief from her symptoms following the motor-vehicle accident in June 2000. The parties also stipulated that appellant had no evidence tending to contradict or refute respondent’s testimony, and the parties provided written submissions that included medical records and other documents.

The arbitrator found that respondent’s chiropractor had prescribed a quality firm mattress, and respondent spent $2,701.22 to purchase a mattress and box spring under the prescription. The arbitrator also found that the mattress and box spring benefit respondent’s recovery and provide relief from her symptoms and that the mattress and box spring are reasonably and medically necessary. Based on these findings, the arbitrator concluded that under Minn.Stat. § 65B.44, respondent was entitled to reimbursement for the mattress and box spring and awarded respondent $2,701.22.

Appellant brought a motion to vacate the arbitrator’s award in district court, arguing that because determining whether the cost of a mattress and box spring is an expense entitled to reimbursement under *806 the no-fault act requires interpretation and construction' of a statute, and arbitrators are limited to deciding factual issues, the arbitrator exceeded his authority by deciding a legal issue. The district court denied the motion to vacate. Pursuant to a stipulation, the parties requested that the district court modify its order denying the motion to vacate to include a confirmation of the arbitrator’s award, and the district court issued an order stating that its earlier order confirms the arbitrator’s award.

ISSUES

1. Did the arbitrator have authority to determine whether respondent is entitled to reimbursement for the cost of the mattress and box spring under Minn.Stat. § 65B.44, subd. 2(a)(1)? .

2. Is the cost of the mattress and box spring an expense for which respondent shall be reimbursed under Minn.Stat. § 65B.44, subd. 2(a)(1)?

ANALYSIS

Minn.Stat. § 65B.44, subd. 2(a) (2002), provides:

Medical expense benefits shall reimburse all reasonable expenses for necessary:
(1) medical, surgical, x-ray, optical, dental, chiropractic, and rehabilitative services, including prosthetic devices.

The arbitrator determined that respondent’s expenditure for the box spring and mattress should be reimbursed under Minn.Stat. § 65B.44. Appellant argues that determining whether the expenditure should be reimbursed requires an interpretation and construction of the statute, which is a legal issue, and therefore, the arbitrator did not have authority to decide the issue because arbitrators are limited to deciding fact'issues.

In Weaver v. State Farm Ins. Co., 609 N.W.2d 878 (Minn.2000), the supreme court recently explained a no-fault arbitrator’s jurisdiction to award, suspend, or deny no-fault benefits in the context of an insured that refused to attend an independent medical examination because of nonpayment of a disputed claim. The supreme court stated:

We begin by acknowledging that no-fault arbitrators are limited to deciding questions of fact, leaving the interpretation of law to the courts. See Johnson v. American Family Mut. Ins. Co., 426 N.W.2d 419, 421 (Minn.1988). Arbitration regarding automobile reparations therefore departs from the generally accepted principle that “arbitrators are the final judges of both law and fact.” Id. (citing State, by Sundquist v. Minnesota Teamsters Pub. and Law Enforcement Employees Union Local No. 320, 316 N.W.2d 542, 544 (Minn.1982)). The limitation on the final authority of arbitrators is based on the perceived need for consistency in interpretation of the No-Fault Act. See id. at 421.
Nonetheless, we have adopted rules authorizing arbitrators in no-fault cases where the claim is for less than $10,000 to “grant any remedy or relief deemed just and equitable.” Rule 32, Rules of Procedure for No-Fault Arbitration; see also Minn.Stat. § 65B.525 (1998) (mandating binding arbitration for claims under $10,000). To grant relief, arbitrators must apply the law to the facts they have found. See, e.g., Great West Cas. Co. v. State Farm Mut. Auto. Ins. Co., 590 N.W.2d 675, 677 n. 1 (Minn.App.1999). That is, as a general proposition, the arbitrator has jurisdiction to award, suspend or deny benefits. To achieve the consistency desired in interpreting the no-fault act, this court and the district .court review de novo the arbitrator’s legal determinations necessary to *807 granting relief. See, e.g., [Neal v. State Farm Mut. Ins. Co., 529 N.W.2d 330 (Minn.1995)] at 331.

Id. at 882.

The supreme court explained further that

severance of legal and factual issues between court and arbitrator would interfere with the goal of speeding the administration of justice.

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659 N.W.2d 804, 2003 Minn. App. LEXIS 431, 2003 WL 1875484, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gilder-v-auto-owners-insurance-co-minnctapp-2003.