Diaz v. State
Annotate this CasePlaintiffs were covered by the State's employee healthcare benefit program established under Title 2, chapter 18, MCA ("the Plan"). Both Plaintiffs were injured in separate automobile accidents. All of the medical bills of both plaintiffs were paid by either the Plan or by third-party insurers. In both cases, medical care providers returned a claim payment to the Plan because the claim had been paid by other insurers. Plaintiffs asserted that the Plan should not have retained the payments returned by the medical providers but should have paid those amounts to Plaintiffs unless they had been made whole or fully compensated for all losses they incurred as a result of the automobile accidents. The district court concluded that the State's operation of the Plan was subject to the "made-whole" provisions Title 2, and thus, no insurer had a right to subrogation unless the insured was made whole for all losses. The Supreme Court affirmed, holding that the made-whole requirement of Mont. Code Ann. 2-18-902(4) applied to the Plan insofar as it had withheld payments or had retained payments returned by a healthcare provider because the medical expenses had been paid by a third party.
Some case metadata and case summaries were written with the help of AI, which can produce inaccuracies. You should read the full case before relying on it for legal research purposes.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.