Petition_for

ARM 24.5.301 - PETITION FOR TRIAL

Morse v. Liberty Northwest Ins. Corp. [05/03/12] 2012 MTWCC 16 The Court held that although the insurer characterized its relationship with its insured as a “complete disconnect,” ARM 24.5.301(4) states that it should not be construed as relieving any employer from its duty to cooperate and assist its insurer; this Court previously rejected an insurer’s argument that it did not have access to its insured’s files to answer discovery; and § 39-71-2203(1)(a), MCA, imputes an employer’s knowledge to the insurer. By accepting the responsibility for injury reporting and claims filing, Petitioner’s employer stood in the place of Respondent insurer in dealing with injured workers and acted as Respondent’s agent.

Cissell v. Employers Compensation Ins. Co. [04/18/12] 2012 MTWCC 12 There is an agency relationship between the insurer and the TPA, and any rights and liabilities within the authority of the TPA accrue to the insurer as the principal, including those John Does named by Petitioner who worked on her claim. Since the insurer is already properly named as a respondent, there is no reason to name such entities or persons as parties in addition to the insurer. Petitioner shall file an amended petition to reflect the insurer as the only respondent.

Cissell v. Employers Compensation Ins. Co. [04/18/12] 2012 MTWCC 12 The Petitioner named Brentwood Services as a Respondent. Brentwood adjusted Petitioner’s claim on behalf of the insurer as a third-party administrator (TPA). As this Court has previously held, a TPA will not be named in the caption of a workers’ compensation case as a matter of course, absent a compelling reason for doing so.

Flynn and Miller v. Montana State Fund [07/14/10] 2010 MTWCC 26 ARM 24.5.301(3) requires any penalty or attorney fee claims to be joined and pleaded in the petition. Here, Petitioners asserted that they could not have claimed attorney fees and a penalty sooner because the insurers’ allegedly unreasonable actions only arose recently in the course of the litigation. Because Petitioners’ motion was filed in accordance with Court deadlines and because Respondents provided no basis for denying the requested amendment, the Court granted Petitioners’ motion to amend their petition.

Charlson v. Montana State Fund [07/01/10] 2010 MTWCC 23 Respondent attempted to subvert the procedure specified in ARM 24.5.301(3) by moving to dismiss Petitioner’s claim for attorney fees and penalty, alleging that no evidence indicated that Respondent acted unreasonably in the adjustment of Petitioner’s claim. Respondent suggested that if Petitioner learned through discovery that Respondent unreasonably denied his claim, Petitioner could amend his petition to reinstate the claims. The Court denied Respondent’s motion, noting that both the parties and the Court are better served by following the procedure established by the Court’s rules and scheduling order.

Ivie v. MUS Self Funded Workers' Compensation Program [06/09/10] 2010 MTWCC 15 Although ARM 24.5.301 does not prohibit naming a third-party claims administrator as a party in a workers’ compensation benefit dispute, it does not necessarily follow that the Court should allow parties other than the insurer to be named in the caption absent a compelling reason for doing so. The Court will not exercise jurisdiction over a party that is not necessary to the resolution of a dispute simply because it can.

Ivie v. MUS Self Funded Workers' Compensation Program [06/09/10] 2010 MTWCC 15 Although the claimant argued that a third-party claims administrator was a proper party to his suit because he has a claim against the administrator for benefits, attorney fees, and a penalty, the WCA establishes that liability for these things lies with the insurer and not the third-party administrator. Therefore, the claimant’s dispute lies with the insurer and there is no dispute with the administrator to adjudicate.

Baker v. Transportation Ins. Co. [02/01/07] 2007 MTWCC 6 It would make little sense for this Court to require Petitioner to attempt to resolve a dispute concerning medical benefits when the entire claim was denied based on an ostensible running of the statute of limitations. It would have been futile for Petitioner to attempt any further piecemeal resolution of the claim after the claim was denied in its entirety based on a statute of limitations. Courts do not require exhaustion of administrative remedies when doing so would be futile. Mountain Water Co. v. Montana Dept. of Pub. Serv. Regulation, 2005 MT 84, 326 Mont. 416, 420, 110 P.3d 20, 22.