§ 33-18-251 — Time-Limited Demands -- Requirements -- Insurer's Fair And Reasonable Opportunity To Investigate And Evaluate Claims

Montana § 33-18-251

• Jurisdiction: Montana
• Title 33: INSURANCE AND INSURANCE COMPANIES
• Ch. 18: UNFAIR TRADE PRACTICES
• Part 2: Insurer's Relations With Insured and Claimant

Text

33-18-251 . Time-limited demands -- requirements -- insurer's fair and reasonable opportunity to investigate and evaluate claims. (1) A time-limited demand from a claimant to an insurer offering to settle any claim must:
(a) reference this section;
(b) be in writing and labeled "time sensitive" at the top of the first page of the writing setting forth the required material terms of the offer to settle set forth in subsection (1)(d);
(c) be sent certified mail, return-receipt requested, to the insurer of the allegedly responsible party; and
(d) contain the following material terms:
(i) the name of the allegedly responsible party;
(ii) the time period within which the offer to settle shall remain open for acceptance by the allegedly responsible party's insurer, which may not be less than 60 days or the first business day following the 60th day when that day falls on a weekend or holiday;
(iii) the amount of the monetary payment requested to settle the claim, together with a description of any other form of consideration sought to settle the claim;
(iv) the date and location of the damage, loss, professional negligence, or breach of fiduciary duty;
(v) a reasonable description of the nature and extent of all known injuries, damages, and losses sustained by the claimant;
(vi) the party or parties to be released if the insurer accepts the time-limited demand;
(vii) a description of the claim or claims to be released if the time-limited demand is accepted; and
(viii) disclosure of eligibility, or information sufficient to verify eligibility, for medicare, medicaid, any other federal or state benefit program, and any other known liens or assignments granted by the claimant that apply to any of the damages claimed.
(2) The time period within which an insurer may accept a time-limited demand commences on the date the insurer actually receives the time-limited demand through certified mail.
(3) (a) A time-limited demand made pursuant to this section must be accompanied and supported by the following:
(i) all available and supporting documents, records, and information sufficient to allow the insurer a fair and reasonable opportunity to investigate and evaluate the nature and extent of the alleged responsible party's liability and the nature and extent of the claimant's injuries, damages, and losses;
(ii) medical records, invoices, and billing statements from all health care providers, if any, who provided treatment to or evaluated the claimant or decedent for:
(A) injuries suffered in connection with the claim from the date of injury until the date of the time-limited demand, including but not limited to emotional distress; and
(B) injuries, damages, losses, ailments, diseases, or other medical conditions occurring or existing prior to the date of injury that relate or may relate in any manner to any of the claimant's claims that are the subject of the written time-limited demand.
(b) If the claimant asserts a claim for loss of wages, earnings, compensation, or profits, however denominated, the claimant shall provide records from employers or other relevant sources or tax records to document the claimed loss.
(4) On receipt of a time-limited demand, the insurer has the right to provide a proposed settlement agreement or release, or both, or seek clarification or additional information regarding terms, liens, subrogation claims, alleged damages, standing to release claims, medical bills, medical records, preexisting medical conditions, and other relevant facts. The claimant has the duty to provide any missing or needed documents, records, and information reasonably requested by the insurer. A request for clarification or for additional documents, records, or information, or to propose a settlement agreement or release, or both, may not be deemed a counteroffer or rejection of the time-limited demand to settle. On a request or proposal, any time limit imposed within the time-limited demand is extended a minimum of either 30 days, or by the number of days from and including the date of the request to the date of receipt of the information responding to the requestor, whether the terms of a settlement agreement, a release, or both, are accepted or rejected.
(5) If, during the time period within which a time-limited demand may be accepted, it is determined that a lien attaches to any settlement payment to be paid by the allegedly responsible party's insurer, including but not limited to any actual or potential medicare or medicaid lien, the claimant has a duty to cooperate with the insurer to ensure satisfaction of any valid lien interest medicare, medicaid, or other lienholder may have in the settlement payment. In addition, any time limit imposed within the time-limited demand must be stayed from date the valid lien is identified until the date on which the claimant, allegedly responsible party, and the insurer agree to address and resolve satisfaction of the valid lien.
(6) If an insurer with the right to settle on behalf of an insured receives a time-limited demand, the insurer may accept the time-limited demand by providing written acceptance of the material terms outlined in subsection (1) that is delivered or postmarked to the claimant within the time period set in the time-limited demand. The person or entity providing payment to satisfy the material terms may elect to provide payment by any one or more of the following means:
(a) cash;
(b) money order;
(c) wire transfer;
(d) a cashier's check issued by a bank or other financial institution;
(e) a draft or bank check issued by an insurer; or
(f) electronic funds transfer or other method of electronic payment.
(7) In any civil action commenced by or on behalf of a claimant, or by a claimant as an assignee of the allegedly responsible party, or by the allegedly responsible party for the benefit of the claimant:
(a) a time-limited demand that does not strictly comply with the terms of this section may not be considered as a reasonable opportunity to settle for the insurer and may not be admissible in any civil action alleging extracontractual damages against the allegedly responsible party's liability insurer; and
(b) an insurer is not liable for any extracontractual damages arising from or related to any injuries, damages, or losses suffered by a claimant that are not identified in the time-limited demand and supported by the documents, records, and information set forth in subsection (3).
(8) If an insurer receives a time-limited demand from a claimant that the insurer knows or reasonably believes is not represented by an attorney, and the insurer determines that the time-limited demand does not strictly comply with the requirements set forth in subsections (1) and (3), the insurer is obligated to notify the claimant of the requirements within 10 business days of receiving the time-limited demand from the claimant. On delivery of the notice to the claimant, any time limit imposed within the time-limited demand is extended a minimum of either 30 days, or by the number of days from and including the date on which the claimant presents a time-limited demand to the insurer that strictly complies with the requirements in subsections (4) and (5). If an insurer becomes obligated under this section to notify a claimant and fails to deliver the notice to the claimant, subsection (7) may not apply in any civil action alleging extracontractual damages against the insurer.
(9) For purposes of this section, the following definitions apply:
(a) "Allegedly responsible party" means any person or entity:
(i) claimed or alleged to have caused or contributed to cause property damage, personal injury, bodily injury, wrongful death, professional negligence or liability, or breach of any fiduciary duty; or
(ii) claimed or alleged to have committed, engaged in, or be liable for professional negligence or breach of fiduciary duty.
(b) "Claimant" means:
(i) any injured party delivering a time-limited demand to an insurer, including but not necessarily limited to the injured party's attorney or any other authorized representative acting for or on behalf of the injured party;
(ii) any insured under an insurance policy pursuing a claim or cause of action arising from or related in any manner to the insurance policy issued by the insurer and delivering a time-limited demand to the insurer, including but not necessarily limited to the insured's attorney or any other authorized representative acting for or on behalf of the insured; or
(iii) any assignee of an injured party or insured delivering a time-limited demand to the insurer, including but not necessarily limited to the assignee's attorney or any other authorized representative acting for or on behalf of the assignee.
(c) "Extracontractual damages" means any amount of damages caused by the allegedly responsible party that exceeds the total available policy limit of liability for all policies of liability insurance that an insurer has issued to an allegedly responsible party and which policies of liability insurance are applicable to a claim for property damage, personal injury, bodily injury, wrongful death, professional negligence or liability, or breach of any fiduciary duty.
(d) "Insurer" means any insurer referred to or defined under 33-1-201 who has issued an insurance contract to an allegedly responsible party.
(e) "Time-limited demand" means any offer to settle any claim for personal injury, property damage, bodily injury, wrongful death, professional negligence or liability, or breach of any fiduciary duty, in which the offer to settle:
(i) is made by or on behalf of a claimant or is made based on or arising out of any rights of a claimant;
(ii) is delivered in writing to an allegedly responsible party's insurer for purposes of offering to settle a claim against the allegedly responsible party within any insurance policy limit of liability; and
(iii) states by its terms that it can only be accepted within a specified period of time.

Legislative History

En. Sec. 1, Ch. 352, L. 2023.