MONTANA SUPREME COURT DECISIONS

American Zurich Ins. Co. v. District Court (Todd) [03/13/12] 2012 MT 61 Generally, the attorney-client privilege extends only to communications between an attorney and a client, though it may extend to another party involved in a joint effort with respect to a common legal interest.  The privilege does not extend to correspondence issued by an insurer’s attorney to the insurer’s adjuster, when the adjuster shares that letter with the employer.  The employer is not a co-litigant, it has no liability in a workers’ compensation claim, it is not a party to the action, and it has no shared common interest with the insurer in the adjustment of the claim.  The adjuster has authority to act on behalf of the insurer pursuant to § 39-71-107, MCA, including the authority to waive the attorney-client privilege by sharing the attorney’s letter with the employer.

American Zurich Ins. Co. v. District Court (Todd) [03/13/12] 2012 MT 61 The adjuster has authority to act on behalf of the insurer pursuant to § 39-71-107, MCA, including the authority to waive the attorney-client privilege by sharing the attorney’s letter with the employer.

Engle v. Hartford Underwriters Ins. Co. [12/31/13] 2013 MTWCC 27 Where a claims adjuster wrote to Petitioner and informed her that Respondent was denying further medical treatment for her claim, the Court found that Respondent had denied a payment and therefore Petitioner could be awarded a penalty and attorney fees.

Thompson v. Montana State Fund [08/30/13] 2013 MTWCC 25 Where a case involved a complex factual situation implicating multiple, overlapping medical conditions and with contradicting medical opinions, it was not unreasonable for Respondent to discontinue TTD benefits after it determined Petitioner was at MMI for both her orthopedic condition and her vocal cord injury and after receiving physician-approved alternative job analyses. Whether Petitioner could in fact perform the duties of the positions constituted a legitimate factual dispute which is a reasonable basis for an insurer to deny a claim.

Dauenhauer v. Montana State Fund [07/03/12] 2012 MTWCC 22 The claims examiner was informed that one of the reasons Petitioner needed to see a physician was because the statute of repose was about to run under § 39-71-704(1)(e), MCA.  The claims examiner interpreted this as a desire to keep the 60-month time limit from running without a need for medical care and denied the request.  The denial was not unreasonable, even though Petitioner was primarily seeking follow-up care due to numbness in his extremities resulting from his neck injury.

Brown v. Hartford Ins. Co. [12/16/09] 2009 MTWCC 38 The Court found the actions of two claims adjusters to be unreasonable in adjusting Petitioner’s claim where: the first adjuster noted after reviewing medical records that Petitioner’s condition was not work-related when the medical notes explicitly stated that it was; the file sat for four months with no adjuster assigned to it; the second adjuster sat on the file for seven months without seeking clarification regarding her “confusion” about the diagnoses; and the second adjuster continued to deny liability and again failed to seek clarification after the physician again examined Petitioner and found her to be suffering from an occupational disease.