No-fault auto must pay for injured bus driver’s chiropractorPosted On: Jul. 9, 2019 12:06 PM CST
A personal no-fault auto insurer must cover additional chiropractic care for a bus driver injured in an automobile accident, whose employer’s workers compensation insurer paid for the max chiropractic sessions permissible by state law, the Supreme Court of Minnesota ruled Wednesday.
Following her accident, Jennifer Rodriguez sought and received chiropractic care at one chiropractor with her employer's workers' compensation insurer agreeing to cover 12 weeks of care, as determined by state law that says “more than 12 weeks of chiropractic care is excessive, unnecessary, or inappropriate,” according to documents in Jennifer Rodriguez v. State Farm Mutual Automobile Insurance Co., filed in St. Paul.
Ms. Rodriguez then sought additional sessions with another chiropractor, requesting reimbursement under her personal automobile insurance policy with State Farm Mutual, which denied coverage stating that the workers comp insurer had already paid the max, according to documents.
At issue was whether the treatment sought under State Farm can be included in the max under workers comp law in Minnesota, according to records chronicling several rulings that swayed back and forth: an arbitrator ruled in favor of Ms. Rodriguez, awarding her $16,883 in reimbursements for care; a district court on appeal vacated the award after State Farm filed a motion that the arbitrator had “exceeder her authority;” and the state court of appeals reversed and reinstated the award.
The state’s highest court on further appeal affirmed the award, writing that the additional care fell outside of the comp statute because it was with a separate provider: “the plain language of (state law) bars reimbursement only for the provider who has been deemed to have provided excessive, unnecessary, or inappropriate services under the Workers' Compensation Act and the workers' compensation treatment parameters.”
Because Rodriguez seeks reimbursement under the state’s No-Fault Act for services provided by a separate provider and because that provider “has never been deemed by (the workers comp insurer) to have provided excessive, unnecessary, or inappropriate services, Rodriguez is not barred by the Workers' Compensation Act from seeking reimbursement from State Farm under the No-Fault Act,” the latest ruling states.
State Farm and the attorneys involved could not immediately be reached for comment.