Bd. of Trs. of the Nat'l Elevator Indus. Health Benefit Plan v. Goodspeed

377 F. Supp. 3d 471
CourtDistrict Court, E.D. Pennsylvania
DecidedMay 1, 2019
DocketCIVIL ACTION NO. 17-05133
StatusPublished
Cited by1 cases

This text of 377 F. Supp. 3d 471 (Bd. of Trs. of the Nat'l Elevator Indus. Health Benefit Plan v. Goodspeed) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bd. of Trs. of the Nat'l Elevator Indus. Health Benefit Plan v. Goodspeed, 377 F. Supp. 3d 471 (E.D. Pa. 2019).

Opinion

EDUARDO C. ROBRENO, District Judge.

Defendant Kevin Goodspeed sought medical assistance from a physician for a foot injury. Defendant was a participant covered by an employee benefit plan. Under the benefit plan, Defendant received $ 82,088.36 for his medical expenses. After the medical treatment was concluded, Defendant and his wife sued the treating physician for claims premised on medical malpractice. The case against the physician was settled, resulting in Defendant and his wife receiving a net settlement of $ 304,463.22.

The terms of the benefit plan required subrogation of any recovery from the malpractice action, up to the amount paid by the benefit plan for Defendant's medical costs. Defendant did not repay the benefit plan, but instead deposited the net settlement proceeds into his and his wife's jointly-held bank account. The couple then made various purchases from the account, including a $ 62,000 van.

As administrator of the plan, Plaintiff Board of Trustees of the National Elevator Industry Health Benefit Plan ("the Plan") brought suit under the Employee Retirement *474Income Security Act (ERISA) seeking reimbursement of the medical benefits it paid on behalf of Defendant pursuant to the benefit plan. In an action brought under the ERISA, the Plan can only obtain equitable relief. Accordingly, a necessary element of the Plan's claim is the existence of one or more specific funds against which an equitable lien could be attached (either because the fund itself is the "thing" at the heart of the equity matter, or the fund is traceable to that "thing").

The Court ordered bifurcated discovery, proceeding first on the issue of whether there is an appropriate fund for an equitable lien, assuming that Plaintiff had a meritorious claim. Discovery on this issue has now been concluded. Defendant has moved for summary judgment, arguing that the Plan has failed to identify an appropriate fund.

The Court finds that there are specific funds against which an equitable lien could be attached through traceability, and therefore will deny Defendant's Motion for Summary Judgment.1

I. BACKGROUND

A. Parties and Allegations

Defendant resides in Flushing, New York, and participated in the employee benefit plan administrated by the Plan. ECF No. 1 ¶¶ 2, 5, 8. From late-2013 to mid-2014, Defendant sought medical treatment for heel pain from Dr. Howard Rose, an orthopedist. ECF No. 27-6 ¶¶ 4-5. Defendant claims to have suffered injuries to his Achilles tendon arising from Dr. Rose's treatment. Id. ¶¶ 7-8. In connection with the injuries, and under the terms of the benefit plan, the Plan paid $ 82,088.36 in medical expenses to various medical services providers on Defendant's behalf. ECF No. 1 ¶¶ 9-10.

In September 2016, Defendant and his wife sued Dr. Rose in state court in New York, with Defendant bringing claims of medical malpractice and lack of informed consent, and his wife bringing a claim of loss of consortium. See ECF No. 27-6.2 In late 2017, they settled their claims, netting $ 304,463.22 after fees and costs were deducted, and the case was discontinued by stipulation on October 6, 2017. ECF No. 27-1 ¶ 9, Ex. B.

The Plan learned about the New York case during its pendency, and on March 3, 2017, notified the couple's attorney, George J. Calcagnini, Esq.3 of the Plan's lien on the proceeds of any settlement. ECF No. 27 Ex. F. Notwithstanding this correspondence, Mr. Calcagnini distributed to the couple the entire net settlement proceeds and did not submit or withhold any payment to the Plan. ECF No. 27-1 ¶ 9 ; see also ECF No. 27 Ex G.

The Plan filed this action on November 13, 2017. See ECF No. 1. The Plan alleges that the terms of the benefit plan required Defendant to reimburse the Plan for the medical benefits paid from the proceeds of the settlement. Id. ¶ 12. The Plan alleges that Defendant has not done so, and so it is entitled to equitable relief under § 502(a)(3) of the ERISA ( 29 U.S.C. § 1132(a)(3) ).4 Id. ¶¶ 18, 23.

*475Defendant filed motions to dismiss or transfer the case, both of which the Court denied. ECF Nos. 3, 13. Because the ERISA allows only for equitable relief, the Plan's claims can only proceed if there is a fund against which equitable relief can be attached. See infra Section II.B. The Court ordered discovery to proceed first on whether such a fund exists.5 ECF No. 12.

B. Discovery concerning the Settlement

The material facts are undisputed.

As part of the agreement to resolve their claims against Dr. Rose, Defendant and his wife signed a general release. ECF No. 27-1 ¶ 8. "At no time was there ever an allocation of the recovery between [Defendant]'s claims and his wife's claims." Id.

The gross settlement proceeds were sent to Mr. Calcagnini, Esq., a New York attorney who represented Defendant and his wife and who represents Defendant in this action. Id. ¶ 9. "After accounting for his costs of bringing the tort action and his fee for doing so, [Mr. Calcagnini] then remitted a check made payable to [Defendant and his wife] in the net sum of $ 304,463.22." Id.

On October 10, 2017, Defendant and his wife "deposited the check for the net settlement proceeds [totaling $ 304,463.22] into a jointly held bank account with rights of survivorship." Id. ¶ 10. The couple use the joint bank account "for a variety of purposes," including receiving pension payments. Id."[T]he settlement funds from the tort action against Dr. Rose were commingled with various other monies" in the account. Id.

Between October 10, 2017 and May 31, 2018, the couple "spent or [withdrew] from [the joint] account the sum of $ 359,470." Id.

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Cite This Page — Counsel Stack

Bluebook (online)
377 F. Supp. 3d 471, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bd-of-trs-of-the-natl-elevator-indus-health-benefit-plan-v-goodspeed-paed-2019.