Preview
81-CV-23-581
Filed in District Court
State of Minnesota
8/31/2023 12:01 PM
STATE OF MINNESOTA DISTRICT COURT
COUNTY OF WASECA THIRD JUDICIAL DISTRICT
In re the minor settlement of Grayson Osborne, a Court File No.
minor, by and through his mother and legal Judge:
guardian, Melissa Osborne, Case Type: Minor Settlement
Petitioner. PETITION FOR APPROVAL OF
MINOR SETTLEMENT
Pursuant to Rule 145 of the Minnesota Rules of General Practice, Petitioner Melissa
Osborne (“Petitioner”), mother and legal guardian for the minor, Grayson Osborne, makes this
Petition to approve the settlement of a claim on the minor’s behalf. Petitioner requests that the
Court authorize and approve Petitioner entering into the settlement described herein. Petitioner
further states as follows:
1. She is the mother and legal guardian of minor Grayson James Osborne (the
“Minor”), who was born on March 11, 2015, and currently resides in Waseca, Minnesota.
2. On July 4, 2022, the Minor was lawfully at the home of Brandon Smith and
Madison Arkadie (collectively the “Dog Owners”) when he was bitten by their dog, resulting in
injuries to the Minor’s eye and cheeks.
3. As a result of the dog bite, the Minor received treatment at the Mayo Clinic and
Mankato Clinic. His treatment consisted primarily of an eye lid repair surgery and follow-up care.
True and correct excerpts from the Minor’s medical records from these facilities are attached as
Exhibit A.
4. The full billed amount of medical expenses arising from the Minor’s injuries totaled
$17,053.44.
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Doc ID: ec3e724d49e0053c346bf6b3bb2badd93e4ab7a7
81-CV-23-581
Filed in District Court
State of Minnesota
8/31/2023 12:01 PM
5. At the time of the incident, the Dog Owners had in effect a liability insurance policy
issued by Austin Mutual Insurance Company (“Austin Mutual”) that provided liability coverage
with a limit of $300,000.00.
6. Austin Mutual’s policy also included a $5,000.00 medical payments provision, all
of which was paid to satisfy a portion of the Minor’s medical expenses resulting from the July 4,
2022, dog bite incident.
7. Petitioner retained the law firm, Pritzker Hageman, P.A., to pursue claims against
the Dog Owners arising from the dog bite incident in exchange for attorney’s fees in the amount
of one-third (1/3) of the total recovery, plus costs.
8. Pritzker Hageman, P.A., is a Minneapolis-based law firm. Attorney Raymond
Trueblood-Konz has extensive experience handling dog bite claims and was primarily responsible
for the Minor’s case.
9. On Petitioner’s behalf, Pritzker Hageman, P.A., investigated the incident, requested
and reviewed medical records, sent a demand package, and negotiated with the liability insurance
carrier.
10. Pritzker Hageman, P.A., has negotiated a proposed settlement of the Minor’s claims
with Austin Mutual, in which Austin Mutual will contribute $80,000.00 from its liability policy to
settle the Minor’s claims against the Dog Owners.
11. The Minor’s medical expenses were covered by CenterPoint Energy, Inc. Group
Welfare Benefits Plan (the “CenterPoint Plan”), which is an ERISA medical benefits plan. The
CenterPoint Plan retained Blue Cross Blue Shield of Texas (“BCBS”) to pursue a claim to be
reimbursed by the Dog Owner and/or Austin Mutual. BCBS asserted a reimbursement claim in the
amount of $10,986.09 on behalf of the CenterPoint Plan. Pritzker Hageman, P.A., negotiated a
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Doc ID: ec3e724d49e0053c346bf6b3bb2badd93e4ab7a7
81-CV-23-581
Filed in District Court
State of Minnesota
8/31/2023 12:01 PM
reduction of this reimbursement claim. BCBS and the CenterPoint Plan have agreed to accept
$5,000.00 to resolve the CenterPoint Plan’s subrogation/reimbursement claim in this matter.
12. Pritzker Hageman, P.A. is entitled to $26,666.67 under their retainer agreement
with Petitioner.
13. Pritzker Hageman, P.A. incurred $1,750.00 in expenses for a narrative report from
the Minor’s treating physician, Dr. Penelope Swanson addressing, inter alia, the Minor’s future
prognosis. As a result, the total due to Pritzker Hageman, P.A., is $28,416.67.
14. After deducting attorneys’ fees and expenses and satisfaction of the CenterPoint
Plan’s reimbursement claim described above, there remains $46,583.33 for the benefit of the
Minor.
15. The proposed settlement would release all claims against the Dog Owners and
Austin Mutual.
16. By way of Settlement, Austin Mutual has offered to fund the settlement of this
matter as follows:
a. $33,416.67 by Austin Mutual to Pritzker Hageman, P.A., for payment of both
firms’ fees and costs, and for reimbursement of the CenterPoint Plan’s
reimbursement claim; and
b. $46,583.33 by Austin Mutual to Pacific Life and Annuity Services, Inc. (the
“Assignee”) to fund future periodic payments for the Minor, as follows:
$2,500.00 guaranteed lump sum payment on March 11, 2033;
$2,500.00 guaranteed lump sum payment on March 11, 2034;
$2,500.00 guaranteed lump sum payment on March 11, 2035;
$2,500.00 guaranteed lump sum payment on March 11, 2036;
$2,500.00 guaranteed lump sum payment on March 11, 2037;
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Doc ID: ec3e724d49e0053c346bf6b3bb2badd93e4ab7a7
81-CV-23-581
Filed in District Court
State of Minnesota
8/31/2023 12:01 PM
$2,500.00 guaranteed lump sum payment on March 11, 2038; and
$76,352.15 guaranteed lump sum payment on March 11, 2039.
17. Any payments to be made after the death of the Minor shall be made to the Estate
of Grayson Osborne or to such person or entity as shall be designated in writing by the Minor upon
reaching the age of majority.
18. The obligation to make the periodic payments described herein will be assigned by
Austin Mutual under the meaning of IRC Sec. 130 to the Assignee and funded by an annuity
contract issued by Pacific Life Insurance Company (the “Annuity Issuer”).
19. Petitioner believes this compromised settlement is fair and reasonable and in the
best interest of the Minor. Accordingly, Petitioner petitions the Court for approval of the proposed
settlement as a full, final, and complete settlement of all of the Minor’s claims against the Dog
Owners and Austin Mutual arising from the July 4, 2022, dog bite incident.
WHEREFORE, Petitioner prays for an order of the Court approving the compromise and
settlement described herein and authorizing Petitioner Melissa Osborne, on behalf of the Minor,
to execute all necessary documents to effectuate the settlement, to authorize distribution as
requested herein, and for such other order as the Court may deem reasonable and proper.
Respectfully Submitted by Petitioner:
08 / 26 / 2023
Dated: __________________ ________________________________
Melissa Osborne, mother and legal guardian of
Grayson Osborne, a minor
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Doc ID: ec3e724d49e0053c346bf6b3bb2badd93e4ab7a7
81-CV-23-581
Filed in District Court
State of Minnesota
8/31/2023 12:01 PM
VERIFICATION
STATE OF MINNESOTA )
)ss.
COUNTY OF WASECA )
I, Melissa Osborne, having been duly sworn on oath, depose and say that I am the Petitioner in the
above-captioned proceeding for Grayson Osborne, a minor. I have read and understand the
forgoing Petition for Approval of Minor Settlement and that the same is true and correct to the best
of my own knowledge.
Pursuant to Minn. Stat. §358.116, I declare under penalty of perjury that everything I have stated
in this document is true and correct.
________________________
Melissa Osborne
ENDORSEMENT AND DISCLOSURE
The undersigned hereby states that he is the attorney for the Petitioner pursuant to a retainer
agreement with Petitioner and has not, in fact, been retained and is not to be compensated directly
or indirectly by a person whose interests are adverse to the above-named minor. The undersigned
hereby acknowledges that sanctions may be awarded pursuant to Minn. Stat. § 549.211.
26 day of August, 2023.
Dated this _____
PRITZKER HAGEMAN, P.A.
By: s/Raymond Trueblood-Konz
______________________________
Raymond J. Trueblood-Konz
(MN # 0391236)
100 University Ave SE
Minneapolis, MN 55414
P: (612) 338-0202
F: (612) 338-0104
Email: raymond@pritzkerlaw.com
Attorney for Petitioner
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Doc ID: ec3e724d49e0053c346bf6b3bb2badd93e4ab7a7
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81-CV-23-581 Filed in District Court State of Minnesota 8/31/2023 12:01 PM STATE OF MINNESOTA DISTRICT COURT COUNTY OF WASECA THIRD JUDICIAL DISTRICT In re the minor settlement of Grayson Osborne, a Court File No. minor, by and through his mother and legal Judge: guardian, Melissa Osborne, Case Type: Minor Settlement Petitioner. PETITION FOR APPROVAL OF MINOR SETTLEMENT Pursuant to Rule 145 of the Minnesota Rules of General Practice, Petitioner Melissa Osborne (“Petitioner”), mother and legal guardian for the minor, Grayson Osborne, makes this Petition to approve the settlement of a claim on the minor’s behalf. Petitioner requests that the Court authorize and approve Petitioner entering into the settlement described herein. Petitioner further states as follows: 1. She is the mother and legal guardian of minor Grayson James Osborne (the “Minor”), who was born on March 11, 2015, and currently resides in Waseca, Minnesota. 2. On July 4, 2022, the Minor was lawfully at the home of Brandon Smith and Madison Arkadie (collectively the “Dog Owners”) when he was bitten by their dog, resulting in injuries to the Minor’s eye and cheeks. 3. As a result of the dog bite, the Minor received treatment at the Mayo Clinic and Mankato Clinic. His treatment consisted primarily of an eye lid repair surgery and follow-up care. True and correct excerpts from the Minor’s medical records from these facilities are attached as Exhibit A. 4. The full billed amount of medical expenses arising from the Minor’s injuries totaled $17,053.44. 1 Doc ID: ec3e724d49e0053c346bf6b3bb2badd93e4ab7a7 81-CV-23-581 Filed in District Court State of Minnesota 8/31/2023 12:01 PM 5. At the time of the incident, the Dog Owners had in effect a liability insurance policy issued by Austin Mutual Insurance Company (“Austin Mutual”) that provided liability coverage with a limit of $300,000.00. 6. Austin Mutual’s policy also included a $5,000.00 medical payments provision, all of which was paid to satisfy a portion of the Minor’s medical expenses resulting from the July 4, 2022, dog bite incident. 7. Petitioner retained the law firm, Pritzker Hageman, P.A., to pursue claims against the Dog Owners arising from the dog bite incident in exchange for attorney’s fees in the amount of one-third (1/3) of the total recovery, plus costs. 8. Pritzker Hageman, P.A., is a Minneapolis-based law firm. Attorney Raymond Trueblood-Konz has extensive experience handling dog bite claims and was primarily responsible for the Minor’s case. 9. On Petitioner’s behalf, Pritzker Hageman, P.A., investigated the incident, requested and reviewed medical records, sent a demand package, and negotiated with the liability insurance carrier. 10. Pritzker Hageman, P.A., has negotiated a proposed settlement of the Minor’s claims with Austin Mutual, in which Austin Mutual will contribute $80,000.00 from its liability policy to settle the Minor’s claims against the Dog Owners. 11. The Minor’s medical expenses were covered by CenterPoint Energy, Inc. Group Welfare Benefits Plan (the “CenterPoint Plan”), which is an ERISA medical benefits plan. The CenterPoint Plan retained Blue Cross Blue Shield of Texas (“BCBS”) to pursue a claim to be reimbursed by the Dog Owner and/or Austin Mutual. BCBS asserted a reimbursement claim in the amount of $10,986.09 on behalf of the CenterPoint Plan. Pritzker Hageman, P.A., negotiated a 2 Doc ID: ec3e724d49e0053c346bf6b3bb2badd93e4ab7a7 81-CV-23-581 Filed in District Court State of Minnesota 8/31/2023 12:01 PM reduction of this reimbursement claim. BCBS and the CenterPoint Plan have agreed to accept $5,000.00 to resolve the CenterPoint Plan’s subrogation/reimbursement claim in this matter. 12. Pritzker Hageman, P.A. is entitled to $26,666.67 under their retainer agreement with Petitioner. 13. Pritzker Hageman, P.A. incurred $1,750.00 in expenses for a narrative report from the Minor’s treating physician, Dr. Penelope Swanson addressing, inter alia, the Minor’s future prognosis. As a result, the total due to Pritzker Hageman, P.A., is $28,416.67. 14. After deducting attorneys’ fees and expenses and satisfaction of the CenterPoint Plan’s reimbursement claim described above, there remains $46,583.33 for the benefit of the Minor. 15. The proposed settlement would release all claims against the Dog Owners and Austin Mutual. 16. By way of Settlement, Austin Mutual has offered to fund the settlement of this matter as follows: a. $33,416.67 by Austin Mutual to Pritzker Hageman, P.A., for payment of both firms’ fees and costs, and for reimbursement of the CenterPoint Plan’s reimbursement claim; and b. $46,583.33 by Austin Mutual to Pacific Life and Annuity Services, Inc. (the “Assignee”) to fund future periodic payments for the Minor, as follows: $2,500.00 guaranteed lump sum payment on March 11, 2033; $2,500.00 guaranteed lump sum payment on March 11, 2034; $2,500.00 guaranteed lump sum payment on March 11, 2035; $2,500.00 guaranteed lump sum payment on March 11, 2036; $2,500.00 guaranteed lump sum payment on March 11, 2037; 3 Doc ID: ec3e724d49e0053c346bf6b3bb2badd93e4ab7a7 81-CV-23-581 Filed in District Court State of Minnesota 8/31/2023 12:01 PM $2,500.00 guaranteed lump sum payment on March 11, 2038; and $76,352.15 guaranteed lump sum payment on March 11, 2039. 17. Any payments to be made after the death of the Minor shall be made to the Estate of Grayson Osborne or to such person or entity as shall be designated in writing by the Minor upon reaching the age of majority. 18. The obligation to make the periodic payments described herein will be assigned by Austin Mutual under the meaning of IRC Sec. 130 to the Assignee and funded by an annuity contract issued by Pacific Life Insurance Company (the “Annuity Issuer”). 19. Petitioner believes this compromised settlement is fair and reasonable and in the best interest of the Minor. Accordingly, Petitioner petitions the Court for approval of the proposed settlement as a full, final, and complete settlement of all of the Minor’s claims against the Dog Owners and Austin Mutual arising from the July 4, 2022, dog bite incident. WHEREFORE, Petitioner prays for an order of the Court approving the compromise and settlement described herein and authorizing Petitioner Melissa Osborne, on behalf of the Minor, to execute all necessary documents to effectuate the settlement, to authorize distribution as requested herein, and for such other order as the Court may deem reasonable and proper. Respectfully Submitted by Petitioner: 08 / 26 / 2023 Dated: __________________ ________________________________ Melissa Osborne, mother and legal guardian of Grayson Osborne, a minor 4 Doc ID: ec3e724d49e0053c346bf6b3bb2badd93e4ab7a7 81-CV-23-581 Filed in District Court State of Minnesota 8/31/2023 12:01 PM VERIFICATION STATE OF MINNESOTA ) )ss. COUNTY OF WASECA ) I, Melissa Osborne, having been duly sworn on oath, depose and say that I am the Petitioner in the above-captioned proceeding for Grayson Osborne, a minor. I have read and understand the forgoing Petition for Approval of Minor Settlement and that the same is true and correct to the best of my own knowledge. Pursuant to Minn. Stat. §358.116, I declare under penalty of perjury that everything I have stated in this document is true and correct. ________________________ Melissa Osborne ENDORSEMENT AND DISCLOSURE The undersigned hereby states that he is the attorney for the Petitioner pursuant to a retainer agreement with Petitioner and has not, in fact, been retained and is not to be compensated directly or indirectly by a person whose interests are adverse to the above-named minor. The undersigned hereby acknowledges that sanctions may be awarded pursuant to Minn. Stat. § 549.211. 26 day of August, 2023. Dated this _____ PRITZKER HAGEMAN, P.A. By: s/Raymond Trueblood-Konz ______________________________ Raymond J. Trueblood-Konz (MN # 0391236) 100 University Ave SE Minneapolis, MN 55414 P: (612) 338-0202 F: (612) 338-0104 Email: raymond@pritzkerlaw.com Attorney for Petitioner 5 Doc ID: ec3e724d49e0053c346bf6b3bb2badd93e4ab7a7