2012 District Court Proceedings
- Order (File Stamped September 25, 2012 – Posted October 10,2012)
Supreme Court Appeals
- Fortune (File Stamped July 28, 2011 – Posted August 2, 2011)
- Pallister, Budd, Normandeau (File Stamped July 27, 2011 – Posted August 2, 2012)
- Supreme Court Opinion (File Stamped September 5, 2012 – Posted October 10, 2012)
- Supreme Court Synopsis of Opinion (File Stamped September 5, 2012 – Posted October 10, 2012)
- Supreme Court Synopsis for Dissent (File Stamped September 5, 2012 – Posted October 10, 2012)
Final Order Announcement
- Final Order and Judgment (File stamped June 29, 2011 – Posted June 29, 2011)
- Findings of Fact and Conclusions of Law (File stamped June 28, 2011 – Posted June 29, 2011)
Explanation of Class Action Litigation
Important information for all persons who were insured by Blue Cross and Blue Shield of Montana, Inc. (BCBSMT) or the Montana Comprehensive Health Association (MCHA) after December 29, 2000 through December 31, 2008, and were injured in an automobile or premises accident.
Background: Health insurance policies issued by BCBSMT and the MCHA must be approved by the Montana Department of Insurance (DOI) prior to their use. Since 1987, approved BCBSMT health policies contained provisions that excluded health insurance coverage for health care expenses arising out of automobile or premises-related injuries when such expenses were also covered by other insurance. In 2000, the DOI also approved identical provisions for use in MCHA health policies. BCBSMT reached an agreement with the DOI in 2002, again approving the exclusion of health insurance coverage for health care expenses that were already covered by other insurance. In 2006, the DOI refused to approve BCBSMT’s proposed 2007 policy forms which contained the same exclusions that had been previously approved. The DOI did not disapprove or withdraw approval of BCBSMT’s previously approved plans or MCHA’s policy exclusions. The Montana Supreme Court ruled that the DOI’s refusal to approve BCBSMT’s proposed 2007 policy forms was lawful. Prior to the Supreme Court’s decision, three class action lawsuits were filed against BCBSMT and two against the MCHA alleging that the exclusions in BCBSMT and MCHA policies relative to auto or premises accident injuries prior to the DOI’s disapproval or the Court’s ruling were unlawfully applied.
BCBSMT and the MCHA have provisionally settled one of the lawsuits by agreeing to preliminary class certification and payment of specific time-based reimbursement percentages or health insurance premium credits to eligible members of the “class.” (See “Are you a Class Member” below.) The settlement and class certification must be approved by the court. If the court enters a final judgment approving the settlement and class certification and authorizing payments or premium credits, eligible BCBSMT and MCHA members will receive the appropriate time-based payments or premium credits. BCBSMT and the MCHA believe that in most instances the settlement payment or premium credit will provide the BCBSMT or MCHA member with a double-recovery of their associated medical expenses. BCBSMT and MCHA members who receive a settlement payment or premium credit should consult with Class Counsel, Robert McCarthy or their own attorney to determine whether they are required to pay back any money they may have received from other insurance that covered their claims or whether the payment will affect eligibility for income-based entitlement programs.
BCBSMT and the MCHA are currently complying with a procedural order to provide notice to known and unknown Class Members (see “Are you a Class Member” below) regarding their possible eligibility to receive a settlement payment or insurance premium credit if the court issues final approval of the agreed settlement.
If the court issues a final judgment approving the Settlement Agreement, BCBSMT and the MCHA will provide payment or premium credit to known eligible Class Members as quickly as possible as outlined in the Settlement Agreement. If the court issues a final judgment approving the Settlement Agreement, unknown Class Members will need to file a Proof of Claim in order for an eligibility determination to be made.
For more information, contact Class Counsel:
Robert G. McCarthy
McCarthy Law, P.C.
3738 Harrison Avenue
Are You a Class Member?
If you or your health care provider filed a claim with BCBSMT or the MCHA from December 29, 2000 through December 31, 2008, arising from an auto- or a premises-related injury, you may be a Class Member. If you or your health care provider did not file a claim but you were injured in an auto- or premises-related accident during that time frame, you may want to learn more by contacting Robert McCarthy, Class Counsel.
Known Class Member
If you are a known Class Member, you should have received by mail a copy of the Notice of Pendency of Class Action and Proposed Settlement from BCBSMT. If you did not receive this document, contact Robert McCarthy, Class Counsel.
Unknown Class Member
If you feel you are a Class Member and you did not receive a copy of the Notice of Pendency of Class Action and Proposed Settlement from BCBSMT, contact Robert McCarthy, Class Counsel.