In Kanefsky v. Ford Motor Co. Gen. Ret. Plan, No. 22-cv-2259, 10548 U.S. Dist. 2023 WL 186800 (E.D. Mich. Jan. 13, 2023), the court granted a motion to dismiss a pension plan participant’s claim that the plan was equitably estopped from recouping overpaid plan benefits. Upon termination of his employment, the participant requested and
Remedies
Ninth Circuit: Medical Providers Lack ERISA Standing
By Steven A. Sutro on
The Ninth Circuit affirmed two district court decisions that concluded medical providers were not “beneficiaries” under Section 502(a) of ERISA and therefore lacked standing to bring an ERISA claim. The Court explained that, in one case, the provider had an assignment from the participants, but the assignment was invalid because the plan contained a non-assignment…
US Supreme Court to Consider ERISA’s Tracing Requirements
By Lindsey Chopin on
On March 30, the U.S. Supreme Court announced it would review Bd. of Trustees of Nat. Elevator Indus. Health Ben. Plan v. Montanile, 593 F. App’x 903 (11th Cir. 2014). As discussed here, at issue in the case is whether an ERISA fiduciary of a health benefit plan, who alleges that a beneficiary…
District Court Defines Surcharge Broadly
By Aaron Feuer on
A New York district court held that surcharge could include not only make-whole relief, but also consequential, exemplary, or punitive damages in limited circumstances where malice or fraud is involved. Plaintiff Janet D’Iorio alleged that Winebow breached its fiduciary duty by failing to provide an SPD and by making material misrepresentations about whether her commissions were included as income in determining LTD benefits.
Second Circuit: Class-Wide Reformation Is Appropriate Equitable Relief
By Aaron Feuer on
In the latest chapter of the Amara saga, the Second Circuit recently affirmed the district court’s class-wide order to reform CIGNA’s cash balance plan, as a means to remedy what the district court previously found to be CIGNA’s breach of its statutory notice obligations.
Ninth Circuit Breathes Life Into Participant’s Claim for Surcharge
By Aaron Feuer on
A panel of the Ninth Circuit withdrew its earlier opinion and has now joined other circuits in finding that the equitable remedy of surcharge is available for participants seeking recovery of personal losses as opposed to losses suffered by the plan. Gabriel v. Alaska Elec. Pension Fund, 2014 WL 7139686 (9th Cir. Dec. 16,…
Second Circuit Rejects Plan’s Claim For Reimbursement From Another Plan
By Aaron Feuer on
Where an ERISA plan specifically sets forth in the plan document its rights to reimbursement/subrogation vis-à-vis a plan participant then there is no requirement that recovery be conditioned on the plan being able to trace the recovered monies to the original benefit payment. Under such circumstances, the plan is considered to have an equitable lien…
District Courts Continue to Reject the Ninth Circuit’s Limitation on Surcharge
By Aaron Feuer on
We previously reported (here) that the Ninth Circuit stands alone in expressly limiting the availability of surcharge to cases involving loss to, or unjust enrichment at the expense of, the plan (as opposed to being available to a participant claiming personal loss flowing from a fiduciary breach). See Gabriel v. Alaska Electrical Pension…
Sixth Circuit Expands Availability of Remedies Under ERISA
By Brian Neulander on
The Sixth Circuit recently concluded that a disability plan participant was entitled to relief consisting of benefits under the plan and disgorgement of defendant’s profits for delaying payment. In so ruling, the Court found that this case presented a “a logical extension” of its precedent allowing a plaintiff to pursue in limited circumstances both a…
Express Plan Terms Allow Self-Insured Plan to Recover Medical Benefits Paid to Employee Post-McCutchen
By Anthony Cacace on
In Quest Diagnostics v. Bomani, et al., 11-CV-00951 (D. Conn., June 19, 2013), the court granted Quest Diagnostic’s (“Quest”) motion for summary judgment, ruling that Quest, as the fiduciary to its self-insured medical plan, could recover medical benefits paid to its employee after the employee was injured in an accident and recovered a…