Moreau v. Transportation Insurance Co., 2015 MT 5 (Jan. 6, 2015) (McGrath, C.J.) (5-0, rev’d)
Issue: Whether a workers’ compensation claimant’s estate had standing to seek reimbursement of his medical expenses from the insurance carrier.
Short Answer: Yes.
Reversed and remanded
Facts: Edwin Moreau worked at the W.R. Grace mine from 1963-1992. He died of asbestos-related lung cancer in 2009. In 2010, his wife Cristita, the PR of the estate, filed for occupational disease benefits with Grace’s work comp carrier, Transportation Insurance. After initially denying the claim, Transportation accepted liability for Edwin’s medical expenses. Moreau and Transportation entered a settlement agreement under which Transportation reimbursed Medicaid, other providers, and Moreau for medical expenses paid on Edwin’s behalf.
The Libby Medical Plan, established and funded by W.R. Grace, paid about $95,000 of Edwin’s medical expenses. The Plan and Grace refused reimbursement from Transportation. Moreau demanded that the money should be paid either to Edwin’s estate or to a charity chosen by the estate. Transportation refused, and Moreau petitioned the Work Comp Court.
Procedural Posture & Holding: The Workers’ Compensation Court reasoned that any further recovery would be double payment, and concluded Moreau lacked standing. Moreau appeals, and the Supreme Court reverses.
Reasoning: The Workers’ Compensation Court is a court of limited statutory jurisdiction. MCA § 39-71-2905. Under the plain terms of the statute, the court has jurisdiction when a claimant has a dispute concerning benefits. Entitlement to payment for medical expenses is a benefit under the work comp statutes. The Workers’ Compensation Act is binding on the employee and the employee’s personal representative. Edwin’s estate had standing and was entitled to have its petition determined on the merits.