New Hampshire Ins. Co. v. Matejovsky [08/07/15] 2015 MTWCC 15 Claimant made a prima facie case for reinstatement of benefits by demonstrating that her refusal to attend an IME exam was not unreasonable for two reasons: (1) there is a legitimate dispute over whether claimant’s reason for refusing to attend was “unreasonable”; and (2) the insurer waited until just before the exam before informing the claimant she could not videotape it.  Since IME’s are the most invasive type of discovery and implicate a person’s constitutional right to privacy, an insurer may not coerce a claimant to attend an IME by making an ultimatum to attend or lose benefits when there is a legitimate dispute over the conditions of the IME.

New Hampshire Ins. Co. v. Matejovsky [08/07/15] 2015 MTWCC 15 Where claimant testified that the insurer accepted liability for the claim and paid benefits for eight months, she satisfied the first two of the four factors this Court considers for an award of interim benefits.  Claimant satisfied the third factor when she testified that having her biweekly benefits terminated would put her family at risk of losing their vehicles and having their bills put into collection.  It is sufficient to show significant financial hardship by demonstrating that claimant will go into default or will fall behind on bills if her benefits were terminated without having to actually endure that hardship.

Hartford Fire Ins. Co. v. Hostetter [06/25/13] 2013 MTWCC 14 Appeals from Department determinations regarding interim benefits under § 39-71-610, MCA, are subject to de novo review by this Court.  This Court considers four factors in making a determination: (1) whether liability was accepted; (2) whether benefits were paid, especially for a significant time period; (3) whether the claimant has demonstrated he will suffer significant financial hardship without interim benefits; and (4) whether the claimant has tendered a strong prima facie case for reinstatement of the benefits.  To meet the fourth factor, a claimant need not prove entitlement to TTD benefits, but need only tender substantial evidence which, if believed, would entitle him to the benefits.

Montana Health Network v. Graham [12/5/02] 2002 MTWCC 61 In determining whether interim benefits under section 39-71-610, MCA, are appropriate, the Court will consider four factors. First, was liability for the claim accepted? Second, were benefits paid, especially for a significant time period? Third, has the claimant demonstrated she will suffer significant financial hardship if section 39-71-610, MCA, interim benefits are not ordered? Fourth, has the claimant tendered a strong prima facie case for reinstatement of the benefits she is seeking?