Administrative Rules of Montana
Department 24 - LABOR AND INDUSTRY
Chapter 24.29 - WORKERS' COMPENSATION AND OCCUPATIONAL DISEASE
Subchapter 24.29.26 - Subsequent Injury Fund Rules
Rule 24.29.2614 - REIMBURSEMENT PROCESS

(1) An insurer seeking reimbursement shall send proof of 104 weeks of insurer payments for medical and indemnity benefits to the department. Documents must include:

(2) After an insurer's right to SIF reimbursement has been established, the insurer shall request SIF reimbursement in writing at six-month intervals. Requests for reimbursement for benefits paid more than 18 months prior to the request will be denied.

(3) Each reimbursement request must state the amount of reimbursement claimed for medical and indemnity payments and include documentation required by the department. When an insurer voluntarily agrees to provide reserve data as coordinated with the department, the department recognizes that individual reserve information is recognized to be proprietary information not subject to disclosure. Aggregated claim reserve information for all case reserves reported to the department may be disclosed.

(4) The insurer shall notify the department at the outset of settlement negotiations involving an injured individual who is SIF-certified. The insurer waives the right to SIF reimbursement for the settlement by failing to notify the department at the outset of settlement negotiations.

Attorney fees must be itemized separately from medical and/or indemnity benefits when a settlement is submitted for department approval.

(5) Disputes arising over payment or reimbursement between the department and the insurer may be resolved by the contested case hearing process, pursuant to [ARM 24.29.230], at the written request of either party.