Case Discussed: Haag v. Montana Schools Group Ins. Authority,
274 Mont. 109, 906 P.2d 693 (1995)

MONTANA SUPREME COURT DECISIONS
Chaney v. U.S. Fidelity & Guaranty, 276 Mont. 513, 917 P.2d 912 (1996) Where Workers’ Compensation Court found that insurer’s failure to accept or deny a claim within thirty days constituted acceptance as a matter of law (see § 39-71-606(1), MCA, and Haag v. Montana Schools Group Ins. Auth., 274 Mont. 109 (1995)), the Court erred in failing to hold the insurer liable for claimant’s present condition. Once a claimant shows acceptance of a claim as a matter of law under Haag, and that his original injury was the same kind of injury to the same parts of his body for which he now seeks benefits, he has met his initial burden of proof. To avoid liability, the insurer must then show that claimant attained maximum medical healing and suffered another injury causing his present condition, not shown in this case.
 
 
MONTANA WORKERS' COMPENSATION COURT DECISIONS
Polk v. Planet Ins. [5/31/02] 2001 MTWCC 44A The 1993 version of the Occupational Disease Act, which allows costs only where the insurer requests a hearing before the Department or appeals a Department finding of an occupational disease, is unconstitutional since it denies claimants their right to equal protection of the laws. There is no rational basis for denying costs in occupational disease cases while allowing them in workers' compensation cases.

LaPlant v. State Compensation Insurance Fund [11/24/99] 1999 MTWCC 75 Where State Fund failed to accept or deny a 1987 claim within thirty days, under section 39-71-606, MCA (1985) and Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995), it is in the same position as though it had accepted the claim. State Fund is not, however, liable for a wide range of medical bills without proof of a causal relationship to the claimed elbow injury, nor for compensation benefits during all periods of unemployment without proof of disability and causal relationship of disability to the "accepted" claim.

Wylie v. State Fund [4/3/97] 1997 MTWCC 17 Where section 39-71-606(1), MCA, requires an insurer to accept or deny a claim "within 30 days of receipt of a claim for compensation," it is the insurer's receipt of a claim that triggers the obligation, not the employer's.
Guedesse v. Liberty Mutual Fire Insurance Company [3/12/97] 1997 MTWCC 13A Where the claim form signed by claimant did not state any specific event or any specific time or place for an alleged injury, it fails to identify an industrial accident or injury within the meaning of the Workers' Compensation Act. The "automatic acceptance" rule of Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995) comes into play only if the insurer has received a valid claim for injury, containing sufficient information to inform the employer and insurer of the nature and basis of the claim. As the insurer argues, the claim submitted in this case, at best, suggests claimant is suffering from an occupational disease, and the insurer accepted the claim as such.
Estrada v. State Fund [1/14/97] 1997 MTWCC 4 Under Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995), the insurer's duty to accept or reject a claim within 30 days arises upon the insurer's receipt of the claim. While section 39-71-601, MCA (1993) allows a claimant to submit a timely claim "to the employer, the insurer, or the department," the insurer does not risk liability under Haag unless if fails to act on a claim it has received.
Smith v. National Union Fire Ins. Co. [10/15/96] 1996 MTWCC 65 A claimant's failure to provide 30 days notice to an employer is a defense to liability. Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995)precludes the insurer from raising any defense, including this one, if the claim was not accepted or denied within 30 days as required by section 390-71-606(1), MCA (1991).
Fox v. Liberty Mutual Fire Ins. Co., [2/1/96] 1996 MTWCC 11 Haag v. MSGIA, 274 Mont. 109 (1995), which involves an insurer’s failure to accept or deny liability of an initial claim within thirty days, does not extend to subsequent “demands” made for specific benefits. Insurer’s alleged failure to respond within thirty days to “demand” for specific impairment award does not establish a right “as a matter of law” to that impairment.