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Gilder v. Auto-Owners Insurance Co.

April 15, 2003

JENNIFER GILDER, CLAIMANT, RESPONDENT,
v.
AUTO-OWNERS INSURANCE COMPANY, APPELLANT.



Stearns County District Court File No. C001776

Considered and decided by Peterson, Presiding Judge, Harten, Judge, and Huspeni, Judge.

SYLLABUS BY THE COURT

1. Under the Minnesota No-Fault Act, an arbitrator has authority to find facts and apply the law to those facts in order to award, suspend, or deny no-fault benefits. When applying the law to the facts, an arbitrator has authority to decide a legal question, but the arbitrator's legal determination is subject to de novo review by the district court.

2. The cost of a mattress and a box spring is not an expense for a service or a prosthetic device for which respondent shall be reimbursed under Minn. Stat. § 65B.44, subd. 2(a)(1) (2002).

The opinion of the court was delivered by: Peterson, Judge

Reversed and arbitration award vacated

OPINION

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. §á65B.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. §á65B.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 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 ...


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