Benefits: Medical Benefits: Sixty (60) Month Limitation

Wiard v. Liberty Northwest Ins. Corp., 2003 MT 295 Supreme Court upheld WCC’s grant of partial summary judgment on insurer’s entitlement to rely on section 39-71-704(1)(d), MCA, provision that an insurer’s liability for further medical benefits terminates if medical benefits are not used for 60 or more months.
Wiard v. Liberty Northwest Ins. Corp. [7/20/01] 2001 MTWCC 31A Maximum medical healing is immaterial to the rule providing for termination of medical benefits if not used for 60 continuous months.
Wiard v. Liberty Northwest Ins. Corp. [7/20/01] 2001 MTWCC 31A Bony fusion of cervical vertebrae does not constitute a prosthesis under section 39-71-704(1)(d), MCA (1991).
Wiard v. Liberty Northwest Ins. Corp. [7/20/01] 2001 MTWCC 31A Prosthetic exception to the rule providing that medical benefits terminate if not used for 60 continuous months applies only to the replacement or repair of a preexisting prosthesis.
Wiard v. Liberty Northwest Ins. Corp. [7/20/01] 2001 MTWCC 31A Failure of insurer or adjuster to tell claimant that failure to use medical benefits for 60 months would result in termination of medical benefits was not a representation. There was no duty by the insurer to advise claimant of the 60-month limitation and no reliance on such omission. The 60-month limitation does not preclude claimant from seeking medical care during that time. Only purpose of requiring notice of requirement would be to allow a claimant to seek unnecessary care merely to toll the period, which would be tantamount to fraud.
Wiard v. Liberty NW [6/08/01] 2001 MTWCC 31 Under 1991 law - § 39-71-704 (1)(d) - an insurer's liability for further medical benefits terminates if medical benefits are not used for 60 or more months.