Rolan v. New West Health Services, 2013 MT 220

Background

Dana Rolan was injured in a 2007 car crash; medical bills totaled ~ $120,000. New West was her health insurer; the tortfeasor’s insurer (Unitrin) paid ~ $100,000 to providers.
New West’s policy included a reimbursement/subrogation right and an exclusion for “[m]edical payments” by a liability insurer (i.e., no coverage if medical payments were received under a liability policy).
Rolan sued New West (individual and class claims) alleging breach of contract, violation of made‑whole rights, and unfair claims practices; she sought class certification under M. R. Civ. P. 23(b)(2) and (b)(3).
The District Court certified a class defined broadly to include insureds (back to Jan 26, 2002) for whom New West “avoided payment of benefits” (including when liability carriers or providers were paid) without first performing a made‑whole determination. The court relied on evidence New West employed First Recovery Group to direct liability carriers to pay providers or reimburse New West.
New West moved to narrow the class to insureds who timely filed claims for benefits (arguing non‑filers cannot be identified/manageable); the District Court denied that motion. New West appealed only the class‑definition ruling.
The Montana Supreme Court affirmed, holding the District Court did not abuse its discretion in adopting the broader class definition and denying modification; the court emphasized Diaz I precedent and the district court’s discretion under Rule 23(c)(1)(C).

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the broad class definition (including non‑filers) is too imprecise for certification	Rolan: class is sufficiently defined by Rule 23(a) and evidence shows New West’s practices (First Recovery Group) caused non‑filing; district court provided parameters for “avoiding payment.”	New West: class is vague (e.g., “avoiding payment” undefined); identifying non‑filers is factually burdensome; class must use objective criteria.	Court held the class was sufficiently precise for certification (following Diaz I reasoning) and the district court did not abuse its discretion.
Whether the District Court improperly diverged from the narrower class definition adopted by Judge Sherlock after Diaz I	Rolan: broader definition is appropriate here because evidence shows New West actively directed liability carriers/providers to handle billing, so many insureds never filed claims with New West.	New West: this case should conform to Judge Sherlock’s narrower Diaz II definition (only timely filers) to avoid conflict and manageability problems.	Court held divergence was permissible; district courts may reach different reasonable decisions on class definition and may modify class later under Rule 23(c)(1)(C).
Whether inclusion of non‑filers makes the class unmanageable and will force decertification later	Rolan: New West’s practices produce identifiable cohorts (via First Recovery Group evidence); manageability concerns premature and can be revisited.	New West: non‑filers undermine commonality, typicality, and other Rule 23 requirements and will require mini‑trials.	Court held manageability/de‑certification concerns do not mandate reversal now; the district court can adjust class as discovery proceeds.

Key Cases Cited

Diaz v. Blue Cross & Blue Shield of Mont., 267 P.3d 756 (Mont. 2011) (affirming that Rule 23(a) prerequisites can suffice to define a class for certification)
State Auditor v. Blue Cross Blue Shield of Mont., 218 P.3d 475 (Mont. 2009) (insurance exclusions allowing avoidance of payment even if insured not made whole violate Montana law)
Chipman v. N.W. Healthcare Corp., 288 P.3d 193 (Mont. 2012) (class certification reviewed for abuse of discretion)
Amgen Inc. v. Conn. Ret. Plans & Trust Funds, 133 S. Ct. 1184 (U.S. 2013) (district courts may amend class‑certification orders as case develops)
Polich v. Burlington N., Inc., 116 F.R.D. 258 (D. Mont. 1987) (discusses requirement for objectively definable class membership)