Attorney Fees: Medical benefits

Dildine v. Liberty Northwest Ins. Corp., 2009 MT 87 The Montana Supreme Court concluded that the WCC correctly found that a claimant’s attorney’s efforts went beyond merely initiating a process or filling out claims forms where the attorney’s efforts included: corresponding with the insurance company’s claim adjuster and providing the adjuster with necessary information and documents: filing a petition for hearing with the Workers’ Compensation Court when the insurance company denied the claimant’s claim; and corresponding with the insurer regarding the applicability of a Lockhart lien.  The Supreme Court affirmed the WCC’s conclusion that the attorney was entitled to his attorney fee.
Arneson v. Travelers Property Casualty [02/28/06] 2006 MTWC 7 Where the language of the Attorney Retainer Agreement precludes the inclusion of medial benefits in the fee calculation unless the insurer denies all liability, or denies payment and the attorney obtains such benefit for the claimant, a delay in the payment of the medical bills is not sufficient to establish the entitlement to attorney fees.
Bustell v. AIG Claims Service, Inc. [05/03/05] 2005 MTWCC 23 Attorney fees awarded against an insurer must be credited pro rata against fees due the claimant’s attorney both from the claimant and from medical providers subject to Lockhart liens. The amount of the credit must be determined by dividing the amount of the attorney fee award by the claimant’s estimated lifetime benefits. The resulting percentage is the percentage by which the Lockhart lien must be reduced and also the percentage by which the fees owed by the claimant with regard to non-medical benefits must be reduced.
Doubek v. CNA Ins. Co. [11/10/04] 2004 MTWCC 76 An insurer acts unreasonably and is liable for attorney fees pursuant to 39-71-612, MCA (1989), with respect to denied medical benefits where the treating physician finds a causal relationship between the medical condition treated and the industrial injury or occupational disease and where the physician expressing a contrary opinion was hired by the insurer, was provided with only selected records regarding the claimant's treatment, is less qualified than the treating physician, and relies on a medical test of questionable quality and value.
Beaulieu v. Human Dynamics Corp. [9/22/04] 2004 MTWCC 65 Where an insurer, without notice or explanation, cuts off payment for prescription headache medications it has paid for several years, it is liable not only for the continued payment for the medications but for attorney fees pursuant to section 39-71-612, MCA (1987-2001).
MCCF v. Liberty NW and Rusco [7/30/03] 2003 MTWCC 54 Medical benefits are not disputed for purposes of an award of attorney fees under Lockhart v. Hampshire Ins. Co., 1999 MT 205, 25, 295 Mont. 467, 984 P.2d 744, where the claimant initially failed to submit his claim to the second insurer in a Belton situation (Belton v. Carlson Transport, 202 Mont. 384, 658 P.2d 405 (1983)), and where once submitted the insurer requested additional information so it could properly evaluate his claim.
MCCF v. Liberty NW and Rusco [7/30/03] 2003 MTWCC 54 Pursuant to Lockhart v. Hampshire Ins. Co., 1999 MT 205, 25, 295 Mont. 467, 984 P.2d 744, a claimant's attorney who secures disputed medical benefits on behalf of the claimant is entitled to a lien for attorney fees with respect to such benefits. However, the medical benefits must in fact be disputed and must in fact be obtained through the attorney's efforts.

Bustell v.AIG Claims Service, Inc. and Ins. Co. of PA [8/18/03] 2003 MTWCC 50 The Lockhart attorney fee lien applies to all medical benefits secured through the efforts of the claimant's attorney. Lockhart v. New Hampshire Ins. Co., 1999 MT 205, 295 Mont. 467, 984 P.2d 744. Where the insurer has denied all liability and the Court finds the claim compensable, those efforts encompass both past and future medical benefits, therefore the lien applies to all medical benefits, past and future.