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Guedesse v. Liberty Mutual Fire Insurance Co.

Court of Workers Compensation of Montana

March 12, 1997

STAN GUEDESSE Petitioner
v.
LIBERTY MUTUAL FIRE INSURANCE COMPANY Respondent/Insurer for GENERAL MILLS, INCORPORATED Employer.

          Submitted: March 6, 1997

          ORDER DENYING MOTION FOR PARTIAL SUMMARY JUDGMENT

          MIKE MCCARTER JUDGE.

         Summary: Claimant, who seeks temporary total, permanent partial, and medical benefits, moves for summary judgment on ground that insurer's failure to accept or deny his claim within 30 days constitutes automatic acceptance under the Workers' Compensation Act, pursuant to Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995). Insurer had accepted the claim under the Occupational Disease Act.

         Held: Where the claim form signed by claimant did not state any specific event or any specific time or place for an alleged injury, it fails to identify an industrial accident or injury within the meaning of the Workers' Compensation Act. Haag comes into play only if the insurer has received a valid claim for injury, containing sufficient information to inform the employer and insurer of the nature and basis of the claim. As the insurer argues, the claim submitted in this case, at best, suggests claimant is suffering from an occupational disease, and the insurer accepted the claim as such.

         Topics:

Constitutions, Statutes, Regulations and Rules: Montana Code Annotated: Section 39-71-119, MCA (1993). Where the claim form signed by claimant did not state any specific event or any specific time or place for an alleged injury, it fails to identify an industrial accident or injury within the meaning of the Workers' Compensation Act.
Constitutions, Statutes, Regulations and Rules: Montana Code Annotated: Section 39-71-606, MCA (1993). Where the claim form signed by claimant did not state any specific event or any specific time or place for an alleged injury, it fails to identify an industrial accident or injury within the meaning of the Workers' Compensation Act. The "automatic acceptance" rule of Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995) comes into play only if the insurer has received a valid claim for injury, containing sufficient information to inform the employer and insurer of the nature and basis of the claim. As the insurer argues, the claim submitted in this case, at best, suggests claimant is suffering from an occupational disease, and the insurer accepted the claim as such.
Cases Discussed: Workers' Compensation Court Cases: Haag v. MSGIA. Where the claim form signed by claimant did not state any specific event or any specific time or place for an alleged injury, it fails to identify an industrial accident or injury within the meaning of the Workers' Compensation Act. The "automatic acceptance" rule of Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995) comes into play only if the insurer has received a valid claim for injury, containing sufficient information to inform the employer and insurer of the nature and basis of the claim. As the insurer argues, the claim submitted in this case, at best, suggests claimant is suffering from an occupational disease, and the insurer accepted the claim as such.
Claims: Acceptance. Where the claim form signed by claimant did not state any specific event or any specific time or place for an alleged injury, it fails to identify an industrial accident or injury within the meaning of the Workers' Compensation Act. The "automatic acceptance" rule of Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995) comes into play only if the insurer has received a valid claim for injury, containing sufficient information to inform the employer and insurer of the nature and basis of the claim. As the insurer argues, the claim submitted in this case, at best, suggests claimant is suffering from an occupational disease, and the insurer accepted the claim as such.
Claims: Filing. Where the claim form signed by claimant did not state any specific event or any specific time or place for an alleged injury, it fails to identify an industrial accident or injury within the meaning of the Workers' Compensation Act. The "automatic acceptance" rule of Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995) comes into play only if the insurer has received a valid claim for injury, containing sufficient information to inform the employer and insurer of the nature and basis of the claim. As the insurer argues, the claim submitted in this case, at best, suggests claimant is suffering from an occupational disease, and the insurer accepted the claim as such.
Claims: Sufficiency. Where the claim form signed by claimant did not state any specific event or any specific time or place for an alleged injury, it fails to identify an industrial accident or injury within the meaning of the Workers' Compensation Act. The "automatic acceptance" rule of Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995) comes into play only if the insurer has received a valid claim for injury, containing sufficient information to inform the employer and insurer of the nature and basis of the claim. As the insurer argues, the claim submitted in this case, at best, suggests claimant is suffering from an occupational disease, and the insurer accepted the claim as such.

         Petitioner in this matter seeks temporary total, permanent partial and medical benefits on account of an alleged industrial injury occurring on May 20, 1995. He now moves for partial summary judgment respecting liability for the claim. He argues that the insurer is liable as a matter of law because it failed to accept his written claim for compensation within 30 days, as required by section 39-71-606, MCA (1993).[1]

         Undisputed Facts

         The following undisputed facts are taken from the parties' pleadings, their briefs and an Affidavit of Deborah Fotopoulos (Affidavit).

         Petitioner, Stan Guedesse (claimant), alleges that he injured his low back on May 20, 1995, while working for General Mills, Inc. (General Mills). (Petition para. 1.) At the time of the alleged industrial accident, respondent, Liberty Mutual Fire ...


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