Frequently Asked Questions About Personal Injury and Workers’ Compensation

It depends. Montana law distinguishes between an industrial injury and an occupational disease. An industrial injury is defined as an incident that occurs during a single work shift. In contrast, an occupational disease occurs over more than one work shift. A claimant has different deadlines depending upon whether the injury occurred over a single work shift or more than one work shift. If you have suffered an injury that occurred during a single shift it is an industrial injury and the deadline for reporting the injury is under Section 39-71-603, MCA Under Section 39-71-603, MCA, a claimant must notify his or her employer of a workplace injury within 30 days of the incident.

Under 39-71-601, MCA, a claimant must file a written claim with either the Department of Labor and Industry, the employer, or the insurer within 12 months of the incident. This time limit is extended to 24 months if the claimant can establish lack of knowledge of disability, latent injury; or equitable estoppel.

If your injuries occurred over more than a single shift, you have suffered an occupational disease. As such, the 30-day reporting period does not apply.

Yes, your health insurance plays a vital role in your automobile insurance claim. How you pay medical bills impacts whether there will be enough money for you and your family to achieve stable financial footing following an automobile crash. Your health insurance, Medicare, or Medicaid cards must be presented to all your health care providers. For reasons explained below, your health care providers will likely object to billing anyone other than your automobile insurance carrier. However, you have only a specific amount of insurance coverage to pay your bills, and your health insurance is a necessary tool for getting your family’s financial situation on track. You must insist that your health insurance carrier accepts your health insurance, Medicare, or Medicare.

Health care providers in the United States use an incredibly complicated method for billing patients. Health care providers NEVER expect to be paid the full amount they bill. Instead, they have agreements with health insurance carriers, Medicare, and Medicaid to accept payment for a fraction of the amount they bill. In contrast, a person paying cash or using automobile insurance for payment is billed an amount sometimes two and three times higher than the amount the health care provider will accept from Medicare, Medicaid, or a health insurance carrier. If you allow a health care provider to receive money directly from your or the negligent driver’s automobile insurance policies, you are losing money that is rightfully yours to keep.

A policy limit is the most an insurance carrier is required to pay for claims made on that policy. Although an insurance company may pay less, it is under no obligation to pay more than the policy limit. It is also important to understand that, under Montana law, an insurance carrier may not require a release before paying policy limits. Most underinsured motorist policies require you to obtain permission to settle a case and sign a release.

In other words, your carrier may require you to obtain permission before filing a claim for underinsured motorist coverage. Without permission, you may have waived your right to underinsured motorist coverage. In addition to the many reasons explained in this book, you should not sign a release before consulting an attorney to understand the consequences.

Under Montana law, when liability is "reasonably clear," an insurance carrier may be required to pay all medical bills prior to settling a case. The Montana Supreme Court recognizes that an insurance carrier's refusal or delay in paying medical bills can cause significant financial hardship on families. Allowing an insurance carrier to withhold payment until a settlement is reached creates a situation where the insurance company can and will leverage a car crash victim's family’s needs to strongarm a claimant into a settlement by withholding payment for medical bills.

A car crash victim and the victim's family may have three remedies to pay for medical bills incurred as a result of a crash: 1) health insurance or other method for payment of medical bills; 2) medical pay insurance coverage (which may be stacked just like underinsured motorist coverage); and 3) the negligent motorist's insurance coverage.

How these three methods of payment and remedies work together can become complicated. Medicare and Medicaid may have a right to reimbursement while Blue Cross Blue Shield has no such requirement. A plan may fall under the federal law known as ERISA which has its own set of rules.

Someone who purchases a disability policy is 16 times more likely to qualify for benefits under the disability policy than his or her family will for a term life insurance policy. You may have heard of the AFLAC duck and AFLAC’s commercials concerning long-term disability. AFLAC is just one of many companies selling disability policies. You may even have disability coverage through your employer and not even know it. You may choose among many different types of long- and short-term disability policies to purchase.

It is important to understand that many disability policies require reimbursement. In addition to the terms of the insurance agreement for a disability policy, that insurance policy may also fall under an area of the federal law called ERISA. For all of these reasons, it is critical that any attorney you hire be fully aware of any disability policy you purchased.

An automobile insurance carrier may be required to pay lost wages in addition to medical bills when liability is "reasonably clear." The Montana Supreme Court recognizes that an insurance carrier can and will strongarm a victim and their family into a settlement by withholding payment for lost wages.

As you can imagine, insurance carriers have developed a method for attacking claims for payments of lost wages and medical bills. Insurance carriers send claimants to a "doctor of their choosing" in an attempt to cut off medical and lost wage payments. These doctors are bought and paid for by the insurance company. Many doctors are little more than tools of the insurance carrier who are in violation of their Hippocratic oath.

Although there is not a Montana Supreme Court case explaining how frequently payments for lost wages should be made, an insurance carrier usually pays compensation for lost wages at a rate of frequency that the injured claimant typically receives compensation. If you are paid on a monthly basis in your job, you will likely be paid on a monthly basis for your lost wage claim. If you're paid on a weekly or bi-weekly basis, the insurance carrier will typically pay your lost wages over that period of time.