Moreau v. Transportation Ins.
2018 MT 1
| Mont. | 2018Background
- Edwin Moreau worked at W.R. Grace’s Libby mine and died in 2009 of an asbestos-related occupational disease; his wife Christita Moreau is personal representative of his estate.
- W.R. Grace had created and funded the Libby Medical Plan (LMP) to pay asbestos-related medical expenses; LMP paid $95,846 of Edwin’s bills and did not seek reimbursement.
- Transportation Insurance Company (Transportation), Grace’s workers’ compensation insurer, initially denied liability, later accepted the workers’ compensation claim and reimbursed most providers and the estate but LMP refused Transportation’s offered reimbursement.
- Moreau sought a WCC order requiring Transportation to pay the $95,846 to the Estate, the LMP Trust (successor), or a charity; the WCC concluded the Estate had received the medical services and that paying the monetary value would be a double recovery.
- The WCC granted summary judgment to Transportation, holding it had fulfilled its obligations under § 39‑71‑704, MCA, and that the court lacked jurisdiction to adjudicate rights of non-parties (the LMP Trust). The Montana Supreme Court affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether WCC should order Transportation to pay $95,846 (value of medical services paid by LMP) to Estate or LMP Trust | Moreau: Estate is not made whole unless paid the $95,846; Transportation must pay that sum | Transportation: It furnished required medical services; paying cash for services already provided would be double recovery and is not required by statute | Court: Transportation satisfied statutory obligation; monetary payment for services already provided is not required; summary judgment for Transportation affirmed |
| Whether WCC could resolve rights of the LMP Trust without it being a party | Moreau: Implicit that LMP Trust’s rights can be adjudicated here; attorneys had represented LMP Trust for recovery | Transportation: WCC lacks jurisdiction to adjudicate rights of non-parties | Court: No justiciable controversy with the non-party LMP Trust; WCC lacked legal basis to determine rights of non-parties |
| Applicability of "made-whole" principle to workers’ compensation benefits here | Moreau: Made-whole principle requires insurer pay until Estate fully compensated | Transportation: Made-whole doctrine applies to subrogation against tort recoveries, not to statutory workers’ compensation benefits already provided | Court: Made-whole doctrine inapplicable; pertains to third-party tort recoveries/subrogation, not benefits already furnished under workers’ compensation statutes |
| Precedent Shepard controlling | Moreau: Attempted to distinguish Shepard | Transportation: Shepard controls and bars monetary recovery for services already provided | Court: Shepard remains good law and is factually analogous; supports denying monetary recovery |
Key Cases Cited
- Shepard v. Midland Foods, Inc., 710 P.2d 1355 (Mont. 1985) (workers’ compensation insurer not required to repay value of medical expenses already provided; WCC lacks jurisdiction to adjudicate rights of nonparties absent joinder)
- Oberson v. Federated Mut. Ins. Co., 126 P.3d 459 (Mont. 2005) (made-whole rule applies in context of insurer subrogation against third-party tort recoveries)
- Zacher v. Am. Ins. Co., 794 P.2d 335 (Mont. 1990) (discussing priority and subrogation principles in worker recovery vs. insurer rights)
- Marbut v. Sec. of State, 752 P.2d 148 (Mont. 1988) (justiciability requires an actual controversy to permit adjudication)