Last updated: 5/30/2024
Petition For Settlement (Disputed Initial Compensability)
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Description
PETITION FOR SETTLEMENT DISPUTED INITIAL COMPENSABILITY. This form is used in Montana for settling indemnity, medical, and hospital benefits on a denied workers' compensation claim. It outlines the settlement process for disputed initial compensability cases, including necessary documentation and signatures. The form requires details such as the claimant's name, insurer, employer, claim number, injury date, and settlement amount. It confirms that the claimant agrees to a lump sum settlement and releases the insurer from further liability. www.FormsWorkflow.com