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Estrada v. State Compensation Insurance Fund

Court of Workers Compensation of Montana

January 14, 1997

ANTONIO J. ESTRADA Petitioner
v.
STATE COMPENSATION INSURANCE FUND Respondent/Insurer for OXYGEN LTD. Employer.

          Submitted: November 4, 1996

          PARTIAL SUMMARY JUDGMEN

          Mike McCarter JUDGE

         Summary: Claimant and insurer submitted on stipulated facts the issue whether claimant filed a timely claim for compensation within section 39-71-601, MCA (1993). Claimant, an Oregon resident employed by an Oregon corporation, was injured in an automobile accident in Montana. He submitted a claim to his employer, and for Oregon workers' compensation benefits, within a year following the accident, but did not submit a claim to a Montana insurer until more than one year following the accident. State Fund's motion to dismiss, treated as a motion for summary judgment due to stipulated facts, argued claimant had to submit the claim to a Montana insurer within one year.

         Held: Section 39-71-601, MCA (1993) provides that within one year of an industrial accident the claimant must submit a signed claim "to the employer, the insurer, or the department." By using the word "or," the statute permits the claimant to submit a timely claim to any of the entities listed. Where the employer received a claim within one year, the insurer's argument for dismissal because no claim was submitted to it within a year has no merit.

         Topics:

Constitutions, Statutes, Regulations and Rules: Montana Code Annotated: Section 39-71-601, MCA (1993). Claimant, an Oregon resident employed by an Oregon corporation, was injured in an automobile accident in Montana. Insurer moved to dismiss where claimant submitted a claim to his employer, and for Oregon workers' compensation benefits, within a year following the accident, but did not submit a claim to a Montana insurer until more than one year following the accident. Motion denied because section 39-71-601, MCA (1993) provides that within one year of an industrial accident the claimant must submit a signed claim "to the employer, the insurer, or the department." By using the word "or," the statute permits the claimant to submit a timely claim to any of the entities listed.
Cases Discussed: Workers' Compensation Court Cases: Haag v. MSGIA. Under Haag v. Montana School Group Insurance 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.
Claims: Acceptance. Under Haag v. Montana School Group Insurance 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.
Limitations Periods: Claim Filing: Generally. Claimant, an Oregon resident employed by an Oregon corporation, was injured in an automobile accident in Montana. Insurer moved to dismiss where claimant submitted a claim to his employer, and for Oregon workers' compensation benefits, within a year following the accident, but did not submit a claim to a Montana insurer until more than one year following the accident. Motion denied because section 39-71-601, MCA (1993) provides that within one year of an industrial accident the claimant must submit a signed claim "to the employer, the insurer, or the department." By using the word "or," the statute permits the claimant to submit a timely claim to any of the entities listed.

         The petitioner in this case, Antonio J. Estrada (claimant), alleges that he suffered an industrial accident in the course and scope of his employment with Oxygen Ltd., which is insured within the State of Montana by the State Compensation Insurance Fund (State Fund). In its response the State Fund denies that claimant suffered an industrial industry and affirmatively alleges (1) that it does not insure Oxygen Ltd. and (2) that if claimant was injured in an industrial accident it was not a Montana accident. (Response to Petition for Hearing at 2.)

         As an additional affirmative defense, stated as a motion to dismiss, the State Fund alleges that claimant failed to submit a claim for compensation within the one-year period prescribed by section 39-71-601, MCA (1993). (Id.) The parties have agreed to submit this issue to the Court on an Agreed Statement of Facts and Issue filed on October 17, 1996. Counsel have briefed the issue and the matter is now ready for decision.

         Issue presented: The sole issue presently before the Court is whether the claimant filed a timely claim for compensation complying with section 39-71-601, MCA (1993).

         AGREED ...


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