Court Opinion

ID: 9752861
Source: CourtListenerOpinion
Date Created: 2023-08-28 18:40:09.301391+00
Date Added: 2024-06-11T07:27:24.044810
License: Public Domain

COLLINS, Justice,
dissenting.
I respectfully dissent.
We review directly the decision of the District Court, here sitting as the Small Claims Court. Cf. City of Portland v. Gemini Concerts, Inc., 481 A.2d 180, 181 (Me.1984). Because I cannot conclude on this record that the District Court misapplied the law,1 I would vacate the Superior Court’s decision and reinstate the judgment in favor of the Rays.
The Small Claims Court was obligated to construe the terms of the insurance policy as a matter of law, and to construe any ambiguities strictly against the insurer. See Baybutt Constr. Co. v. Commercial Union Ins. Co., 455 A.2d 914, 921 (Me.1983). Here, although the policy limited coverage to services provided by physicians,2 it also states that it covers “medically necessary hospital admissions, healthcare services, supplies, and equipment.” (Emphasis added.)
At the hearing before the Small Claims Court, the Rays produced a letter from a physician stating that acupuncture “should be considered a prescribed therapy” for Mrs. Ray and that it had produced “very good results.” The court reasonably could have inferred from this evidence that the acupuncture was a medically necessary health care service.
Because the term “healthcare service” is not further defined in the policy, I agree with the Small Claims Court that an ambi*1112guity existed that was properly construed against the insurer and in favor of coverage for the acupuncture treatments.

. Although the Superior Court stated that the District Court’s ruling was "clearly erroneous as a matter of law,” I presume that it properly reviewed the District Court’s conclusions of law for legal error, and that it did not intend to set aside the District Court’s findings of fact, which were adequately supported by the evidence. See Commissioner of Human Services v. Levesque, 528 A.2d 456, 458 (Me.1987) (on appeal, court reviews findings of fact for clear error, i.e. to determine whether they are supported by competent evidence in the record, and conclusions of law for legal error).

. The policy also excludes “experimental” treatments. Because the testimony showed that BAMICO routinely provides coverage for acupuncture under other policies, BAMICO’s attempt to characterize acupuncture as "experimental” was apparently a makeweight argument.