Title: DAVIS v JONES
Citation: N/A
Docket Number: 82-387
State: Montana
Issuer: Montana Supreme Court
Date: April 13, 1983

N O . 8 2 - 3 8 7 I N T H E S U P R E M E C O U R T O F T H E S T A T E O F MONTANA 1 9 8 3 JOHN A . D A V I S ( F A T A L ) V I V I A N M A R I E D A V I S , C l a i m a n t s a n d R e s p o n d e n t s , G E O R G E W. J O N E S , E m p l o y e r a n d M O U N T A I N W E S T FARM B U R E A U MUTUAL I N S U R A N C E COMPANY, D e f e n d a n t s and A p p e l l a n t s . A p p e a l f r o m : W o r k e r s ' C o m p e n s a t i o n C o u r t H o n o r a b l e ~ i m R e a r d o n , J u d g e p r e s i d i n g . C o u n s e l of R e c o r d : F o r A p p e l l a n t s : U t i c k , G r o s f i e l d & U d a , H e l e n a , M o n t a n a F o r R e s p o n d e n t s : Joseph C . E n g e l 111, B u t t e , M o n t a n a S u b m i t t e d o n b r i e f s : F e b r u a r y 3 , 1 9 8 3 D e c i d e d : A p r i l 1 4 , 1 9 8 3 F i l e d : AP K . i $ , 9 8 3 M r . J u s t i c e L . C. Gulbrandson d e l i v e r e d t h e Opinion of t h e C o u r t . The i n s u r e r a p p e a l s from an o r d e r i s s u e d by t h e Workers' Compensation Court g r a n t i n g c l a i m a n t a waiver of the twelve-month f i l i n g requirement i n s e c t i o n 39-71-601(1) MCA. On F e b r u a r y 1 5 , 1980, t h e c l a i m a n t ' s husband, a ranch hand, became unconscious w h i l e chopping a h o l e i n some ice. H i s employer, George J o n e s , suggested t h a t t h e husband go home and see a d o c t o r . The husband went to see some f r i e n d s and r e t u r n e d home a t about 9 30 p.m. t h a t evening. H e l a t e r died a t home of a h e a r t a t t a c k . On February 1 7 , 1980, t h e c l a i m a n t went to t h e employer f o r h e r husband's l a s t paycheck. The employer gave the c l a i m a n t h e r h u s b a n d ' s l a s t check p l u s a two hundred d o l l a r bonus. While they were d i s c u s s i n g p o s s i b l e i n s u r a n c e c o v e r a g e , t h e employer t o l d c l a i m a n t t h a t he had no r e s p o n s i b i l i t y because t h e husband had d i e d a t home. Claimant d i d n o t become aware of p o s s i b l e workers1 compen- s a t i o n coverage u n t i l one y e a r l a t e r , February 1 7 , 1981, w h i l e t a l k i n g w i t h h e r a t t o r n e y on a s e p a r a t e matter. On February 20, h e r a t t o r n e y s e n t a l e t t e r t o t h e Workers1 Compensation D i v i s i o n ( D i v i s i o n ) , s t a t i n g t h e f a c t s surrounding h e r husband's d e a t h and s e e k i n g a s e t t l e m e n t . On A p r i l 1, 1981, about one y e a r and s i x weeks a f t e r h e r h u s b a n d ' s d e a t h , c l a i m a n t f i l e d a claim w i t h t h e D i v i s i o n . A f t e r a h e a r i n g , t h e h e a r i n g examiner f o r t h e D i v i s i o n concluded t h a t t h e i n s u r e r and employer were e q u i t a b l y estopped from a s s e r t i n g t h e one-year f i l i n g r e q u i r e m e n t because t h e employer had denied any r e s p o n s i b i l i t y and because c l a i m a n t had d e t r i m e n t a l l y r e l i e d on h i s r e p r e s e n t a t i o n . The case was t h e n heard b e f o r e t h e D i v i s i o n which r e v e r s e d t h e h e a r i n g e x a m i n e r ' s c o n c l u s i o n , and b a r r e d c l a i m a n t from a s s e r t i n g h e r claim because of h e r f a i l u r e t o f i l e w i t h i n one y e a r . The D i v i s i o n s t a t e d t h a t t h e c l a i m a n t I s own t e s t i m o n y supported n e i t h e r e q u i t a b l e e s t o p - p e l , nor t h e c o n c l u s i o n t h a t t h e employer prevented t h e c l a i m a n t from f i l i n g i n a t i m e l y manner. The Workers ' Compensation Court r e v e r s e d t h e D i v i s i o n ' s c o n c l u s i o n . The Court looked to t h e s i x e l e m e n t s of e q u i t a b l e e s t o p p e l and concluded t h a t t h e D i v i s i o n had made an e r r o r of l a w . Claimant was t h e n g r a n t e d a waiver of t h e one-year f i l i n g r e q u i r e m e n t . The sole i s s u e on a p p e a l is whether t h e d o c t r i n e of e q u i t a b l e e s t o p p e l should be a p p l i e d to e s t o p t h e i n s u r e r and employer from a s s e r t i n g a s t a t u t e of l i m i t a t i o n s d e f e n s e . S e c t i o n 39-71-601(1), MCA, r e q u i r e s t h e f i l i n g of a w o r k e r s f compensation c l a i m w i t h i n one y e a r from t h e happening of t h e a c c i d e n t . The d o c t r i n e of e q u i t a b l e e s t o p p e l a p p l i e s where an employer or i n s u r e r has taken some p o s i t i v e a c t i o n which e i t h e r p r e v e n t s c l a i m a n t from f i l i n g a t i m e l y claim or l e a d s him reason- a b l y t o b e l i e v e he need n o t f i l e such a claim. Ricks v. Teslow C o n s o l i d a t e d ( 1 9 7 3 ) , 162 Mont. 469, 512 P.2d 1304. E q u i t a b l e e s t o p p e l is a f l e x i b l e p r i n c i p l e which should be a p p l i e d when an employer o r i n s u r e r m i s l e a d s a c l a i m a n t by f o i s t i n g o n t o t h e c l a i m a n t a m i s i n t e r p r e t a t i o n of t h e Workers Compensation A c t . Levo v. General-Shea-Morrison (1955 ) , 128 Mont . 570, 280 P.2d S i x e s s e n t i a l e l e m e n t s make up t h e d o c t r i n e of e q u i t a b l e e s t o p p e l : " G e n e r a l l y s p e a k i n g , t h e f o l l o w i n g are t h e e s s e n t i a l e l e m e n t s which must e n t e r i n t o and form a p a r t of an e q u i t a b l e e s t o p p e l i n a l l of i t s a p p l i c a t i o n s : '1. There must be conduct -- acts, l a n g u a g e , o r s i l e n c e -- amounting to a r e p r e s e n t a t i o n or a concealment of m a t e r i a l f a c t s . 2. These f a c t s must be known to t h e p a r t y estopped a t t h e t i m e of h i s s a i d con- d u c t , o r a t least t h e c i r c u m s t a n c e s must be s u c h t h a t knowledge of them is n e c e s s a r i l y imputed to him. 3. The t r u t h concerning t h e s e f a c t s must be unknown t o t h e o t h e r p a r t y c l a i m i n g t h e b e n e f i t of t h e e s t o p p e l , a t t h e t i m e when it was a c t e d upon by him. 4. The conduct must be done w i t h the i n t e n t i o n , or a t l e a s t w i t h t h e e x p e c t a t i o n , t h a t it w i l l be a c t e d upon by t h e o t h e r p a r t y , or under such c i r c u m s t a n c e s t h a t it is b o t h n a t u r a l and p r o b a b l e t h a t it w i l l be so a c t e d upon. * * * 5. The conduct must be r e l i e d upon by t h e o t h e r p a r t y , and, t h u s r e l y i n g , he must be l e d t o act upon it. 6. H e must i n f a c t act upon it i n such a manner a s t o change h i s p o s i t i o n f o r t h e worse i n o t h e r words, he must s o a c t t h a t he would s u f f e r a l o s s i f he were compelled t o s u r r e n d e r o r f o r e g o or a l t e r what he h a s done by reason of t h e f i r s t p a r t y b e i n g p e r m i t t e d to r e p u d i a t e h i s conduct and t o a s s e r t r i g h t s i n c o n s i s t e n t w i t h it. . . 1 I I Lindblom v. Employers L i a b i l i t y Assurance Corp. ( 1930 ) , 88 Mont . 488, 494, 295 P. 1007, 1009, c i t e d w i t h a p p r o v a l i n ~ i c k s , s u p r a , - - . . - F r o s t v. Anaconda Co. ( 1 9 8 2 ) , -. Mont . -.--- , 645 P.2d 419, 39 St.Rep. 879, and Devlin v. Galusha, Higgins & Galusha ( 1 9 8 2 ) , ---- Mont . - , 655 P.2d 979, 39 St.Rep. 2378. The Workers l Compensation Court c a r e f u l l y c o n s i d e r e d and a p p l i e d each one of t h e above e l e m e n t s . The Court found t h a t the employer had m i s r e p r e s e n t e d a m a t e r i a l f a c t , i.e., t h a t t h e p l a c e of t h e husband I s d e a t h precluded h i s r e s p o n s i b i l i t y f o r payment of compensation i n s u r a n c e b e n e f i t s . Knowledge of t h e f a c t s were imputed t o t h e employer, because t h e employer was h e l d to a h i g h e r s t a n d a r d of knowledge t h a n t h e employee. See - Levo, s u p r a . The c l a i m a n t d i d n o t know t h e m i s r e p r e s e n t a t i o n was not t r u e . The s u r r o u n d i n g c i r c u m s t a n c e s were such t h a t it w a s n a t u r a l and p r o b a b l e f o r c l a i m a n t to act upon t h e misrepresen- t a t i o n . Claimant r e l i e d t o h e r d e t r i m e n t on t h e e m p l o y e r l s r e p r e s e n t a t i o n by n o t making f u r t h e r i n q u i r i e s and by f a i l i n g to f i l e h e r claim w i t h i n one y e a r . W e a g r e e w i t h t h e above c o n c l u s i o n s of t h e Workers1 Compensation C o u r t . The employer's m i s r e p r e s e n t a t i o n c r e a t e d t h e r e a s o n a b l e b e l i e f i n t h e c l a i m a n t t h a t t h e employer was not r e s p o n s i b l e f o r any i n s u r a n c e compensation b e n e f i t s . E q u i t a b l e e s t o p p e l was t h e r e f o r e p r o p e r l y used t o b a r t h e employer and i n s u r e r from a s s e r t i n g a s t a t u t e of l i m i t a t i o n s d e f e n s e . The o r d e r of t h e Workers' Compensation Court is a f f i r m e d . 1 . - J u s t ice' / I;" We concur: