The tort threshold: when a Minnesota crash claim can include pain and suffering

Minnesota closes off damages for noneconomic detriment in most motor vehicle cases unless one of five statutory gates opens. Four of them have nothing to do with a dollar figure, and the dollar figure is not the sum of the medical bills.

Minnesota traded something away when it adopted no-fault benefits. The trade is written into a single section, and the half people notice is the half that costs them: in most motor vehicle cases, damages for pain, suffering, and the rest of what the statute calls noneconomic detriment are unavailable unless a gate opens first. What is much less understood is how many gates there are, and that the number attached to one of them is not the number on the medical bills.

The gates

Minn. Stat. § 65B.51, subd. 3:

In an action described in subdivision 1, no person shall recover damages for noneconomic detriment unless:

(a) The sum of the following exceeds $4,000:

(1) reasonable medical expense benefits paid, payable or payable but for any applicable deductible, plus

(2) the value of free medical or surgical care or ordinary and necessary nursing services performed by a relative of the injured person or a member of the injured person's household, plus

(3) the amount by which the value of reimbursable medical services or products exceeds the amount of benefit paid, payable, or payable but for an applicable deductible for those services or products if the injured person was charged less than the average reasonable amount charged in this state for similar services or products, minus

(4) the amount of medical expense benefits paid, payable, or payable but for an applicable deductible for diagnostic x-rays and for a procedure or treatment for rehabilitation and not for remedial purposes or a course of rehabilitative occupational training; or

(b) the injury results in:

(1) permanent disfigurement;

(2) permanent injury;

(3) death; or

(4) disability for 60 days or more.

Five alternatives, joined by “or.” Clause (a) is one of them, not the general rule with four footnotes.

The subtraction inside clause (a)

Clause (a) is arithmetic, not a receipt total, and the fourth line is a minus sign. The statute subtracts benefits paid or payable “for diagnostic x-rays and for a procedure or treatment for rehabilitation and not for remedial purposes or a course of rehabilitative occupational training.”

That is a meaningful carve-out in exactly the kind of case where the figure is close. Imaging ordered to find out what is wrong is diagnostic. A course of treatment characterized as rehabilitative rather than remedial comes out of the sum as well. So a bill file that adds to more than $4,000 may not produce a clause (a) sum above $4,000, and the two numbers are not interchangeable.

Clause (a) also adds things that never appear on any bill. Subclause (2) counts “the value of free medical or surgical care or ordinary and necessary nursing services performed by a relative of the injured person or a member of the injured person’s household” — care given at home by family, valued rather than invoiced. Subclause (3) adds back the difference where a provider charged the injured person less than the average reasonable amount charged in Minnesota for similar services, so a discount does not shrink the threshold figure.

Paragraph (c) makes the valuation provable: “For the purposes of clause (a) evidence of the reasonable value of medical services and products shall be admissible in any action brought in this state.”

“Disability” is defined, and not the way people use the word

The final sentence of subdivision 3 supplies its own definition:

For the purposes of this subdivision disability means the inability to engage in substantially all of the injured person's usual and customary daily activities.

Nothing in that sentence refers to work, employment, wages, or a physician’s off-work note. The measure is the injured person’s ordinary daily activities — substantially all of them — over a period of 60 days or more. A person who returns to a desk and cannot do anything else they used to do is a different case from a person who misses two months of work and otherwise carries on, and the statute is written to capture the first.

The No-Fault Act uses a different definition for a different purpose elsewhere, which is one reason the two get confused. For income loss benefits, § 65B.44, subd. 3(d) defines “inability to work” as “disability which prevents the injured person from engaging in any substantial gainful occupation or employment on a regular basis, for wage or profit, for which the injured person is or may by training become reasonably qualified.” That definition governs the wage benefit. It is not the threshold definition.

What the threshold does not touch

Economic loss. Subdivision 2 keeps the door open for out-of-pocket loss the no-fault system does not cover:

A person may bring a negligence action for economic loss not paid or payable by a reparation obligor or through the assigned claims plan because of any lack of insurance coverage for the economic loss described in section 65B.44, daily or weekly dollar limitations of section 65B.44, the seven-day services exclusion of section 65B.44, the limitations of benefits contained in section 65B.44, subdivision 1, or an exclusion from coverage by sections 65B.58 to 65B.60.

Wage loss above the weekly cap in § 65B.44, subd. 3, replacement services during the first seven days excluded by subdivision 5, and medical expense above the subdivision 1 pool are all economic loss the threshold does not gate. The threshold is about noneconomic detriment specifically.

Cases that are not motor vehicle negligence cases. Subdivision 3 applies to “an action described in subdivision 1,” and subdivision 1 describes a negligence action arising out of the operation, ownership, maintenance, or use of a motor vehicle with respect to which security has been provided under §§ 65B.41 to 65B.71. Subdivision 5 states the limit of the section directly: “Nothing in this section shall impair or limit tort liability or limit the damages recoverable from any person for negligent acts or omissions other than those committed in the operation, ownership, maintenance, or use of a motor vehicle.”

Vehicle defect claims. Subdivision 4 preserves the liability of a person in the business of manufacturing, distributing, retailing, repairing, servicing, or maintaining motor vehicles arising from a defect caused or not corrected by an act or omission in the course of that business.

Motorcycles. Section 65B.46, subd. 3 provides that “injuries suffered by a person while on, mounting or alighting from a motorcycle do not arise out of the maintenance or use of a motor vehicle although a motor vehicle is involved in the accident causing the injury,” while subdivision 1 gives a right to basic economic loss benefits to a person struck as a pedestrian by a motorcycle. Those two provisions do different work and the interaction is fact-dependent.

The deduction that operates on the other side of the same section

Subdivision 1 is the companion rule, and it applies whether or not the threshold is met:

With respect to a cause of action in negligence accruing as a result of injury arising out of the operation, ownership, maintenance or use of a motor vehicle with respect to which security has been provided as required by sections 65B.41 to 65B.71, the court shall deduct from any recovery the value of basic or optional economic loss benefits paid or payable, or which would be payable but for any applicable deductible. In any case where the claimant is found to be at fault under section 604.01, the deduction for basic economic loss benefits must be made before the claimant's damages are reduced under section 604.01, subdivision 1.

Two things follow. Basic economic loss benefits are not recovered twice — they come off the top, including benefits that “would be payable but for any applicable deductible,” so declining to submit a bill to the no-fault insurer does not convert it into a recoverable item. And the sequence is fixed: the deduction happens before the comparative fault reduction, not after. Section 548.251, subd. 3(c) imposes the same order for collateral source reductions.

What this page is not

It sets out the gates the statute defines and the way the clause (a) sum is built. It does not evaluate whether any injury is permanent, whether any period of impairment reaches 60 days, or whether any bill file clears the figure — all of which are evidentiary questions decided on medical proof, not on a reading of the statute.