Prev Next


(1) All insurers shall maintain their respective claim files. Upon request by the department, insurers shall provide to the department, in whole or part according to the request, a copy of the claim file, other than documents protected by the attorney-client privilege or attorney work-product doctrine. The copies must be provided at no cost to the department. If information is maintained by computer, "hard copy" information must be available upon request. Insurers shall submit requested copies of file information within 30 days of the department's request.

(2) All insurers shall retain complete copies of the claim file for the life of the claim or as long as liability or potential liability exists for the claim. The department is not responsible for maintaining a duplicate of any document pertaining to a claim.

(3) Claim files must include, but need not be limited to, all of the following which exist in relation to the claim:

(a) first report of injury and occupational disease, Montana form ERD-991 or department-approved equivalent;

(b) medical bills, or an electronic data record thereof;

(c) benefit rate calculations, if applicable;

(d) correspondence relating to the claim;

(e) medical reports;

(f) vocational rehabilitation reports;

(g) payment record; and

(h) official orders, whether those orders are from the department or a court.

(4) For the purposes of this rule, an insurer may maintain claim file documents either as an "original" or as a "duplicate", as those terms are used in the Montana Rules of Evidence. However, nothing in this rule affects the legal standards concerning the admissibility of an original versus a duplicate.

History: 39-71-203, MCA; IMP, 39-71-225, MCA; NEW, 1994 MAR p. 2630, Eff. 10/1/94; AMD, 2003 MAR p. 2297, Eff. 10/17/03.

Home  |   Search  |   About Us  |   Contact Us  |   Help  |   Disclaimer  |   Privacy & Security