Hollaway v. UNUM Life Insurance Co. of America

2003 OK 90, 89 P.3d 1022, 2003 WL 22439659
CourtSupreme Court of Oklahoma
DecidedOctober 31, 2003
Docket98,120
StatusPublished
Cited by37 cases

This text of 2003 OK 90 (Hollaway v. UNUM Life Insurance Co. of America) is published on Counsel Stack Legal Research, covering Supreme Court of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hollaway v. UNUM Life Insurance Co. of America, 2003 OK 90, 89 P.3d 1022, 2003 WL 22439659 (Okla. 2003).

Opinions

KAUGER, J.:

¶ 1 As originally certified, the question certified provides:

Does Oklahoma’s cause of action for breach of the implied covenant of good faith and fair dealing allowing for recovery of consequential and (when appropriate) punitive damages, as adopted in Christian v. American Home Assurance Co., 1977 OK 141, 577 P.2d 899, apply only to contracts of insurance such that it can be said to “regulate insurance” as that term is used in Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41 [107 S.Ct. 1549, 95 L.Ed.2d 39] (1987) and Unum Life Ins. Co. of America v. Ward, 527 [526] U.S. 358 [119 S.Ct. 1380, 143 L.Ed.2d 462] (1999) (requiring that to “regulate insurance” a regulation must, as a matter of common sense, “home [ ] in on the insurance industry and [ ] not just have an impact on that industry”). If Oklahoma’s cause of action for the breach of the implied obligation of good faith and fair dealing “regulates insurance,” it avoids preemption pursuant to ERISA’s saving clause under UNUM and Lewis v. Aetna U.S. Healthcare, Inc., 78 F.Supp.2d 1202 (N.D.Okla.1999). If it does not “regulate insurance,” the cause of action is no longer available in the ERISA context and Lewis is no longer good law.

¶ 2 In Kentucky Ass’n of Health Plans, Inc. v. Miller, 538 U.S. 329, 123 S.Ct. 1471, 155 L.Ed.2d 468 (2003), the United States Supreme Court set forth a new and different test for determining when a law regulates insurance under 29 U.S.C. § 1144(b)(2)1 to avoid federal preemption. Because the Miller opinion alters the test in causes previously considered by the Tenth Circuit and because pursuant to 20 O.S.2001 § 1602,2 this Court has authority to answer any question which may be determinative of an issue in the cause, we answer a single question, as reformulated:3

whether Oklahoma’s cause of action for breach of the implied covenant of good faith and fair dealing is a “law which regulates insurance” within the mean of 29 U.S.C. § 1144(b)(2)(A) and as that term is defined by Kentucky Ass’n of Health Plans, Inc. v. Miller, 538 U.S. 329, 123 S.Ct. 1471, 155 L.Ed.2d 468 (2003)?

¶ 3 Pursuant to Miller, a law which substantially affects the risk pooling arrange[1025]*1025ment between the insurer and the insured and which is specifically directed toward the insurance industry avoids the general rule of preemption under the Employee Retirement Income Security Act of 1974 (ERISA).4 Because Oklahoma’s cause of action for bad faith breach of an insurance contract does not substantially affect the risk-pooling arrangement between insurers and insureds,5 it does not meet the test established in Kentucky Ass’n of Health Plans, Inc. v. Miller, 538 U.S. 329, 123 S.Ct. 1471, 155 L.Ed.2d 468 (2003) as a law which regulates insurance under 29 U.S.C. § 1144(b)(2).6

FACTS

¶ 4 The plaintiff, Rod Hollaway, M.D. (Hollaway/insured), filed suit in the . District Court of Tulsa to recover benefits funded through a group long term disability insurance policy issued by the defendant, UNUM Life Insurance Company of America (UNUM/insurer), to Hollaway’s former employer. Hollaway also asserted a claim for bad faith breach of the implied covenant of good faith and fair dealing seeking consequential and punitive damages. Subsequently, the cause was removed to federal court.

¶ 5 It is undisputed that the insurance benefits arise out of and are related to an employee welfare benefit plan governed exclusively by ERISA. It is also agreed that any claim for benefits is preempted by ERISA and is governed by federal law. Nevertheless, Hollaway claims that Oklahoma’s common law cause of action for bad faith breach of an insurance contract is exempted from ERISA preemption as a state law which “regulates insurance” under 29 U.S.C. § 1144(b)(2).7.

¶ 6 Recognizing that state law is determinative of the preemption issue on the bad [1026]*1026faith cause of action and that this Court has not addressed the precise issue presented, the federal court certified the question to this Court pursuant to the Uniform Certification of Questions of Law Act, 20 O.S.2001 § 1601 et seq. on August 9, 2002. We set a briefing cycle which was completed on October 21, 2002.

¶ 7 On February -25th and 28th, 2003, respectively, Hollaway and UNUM filed a notice and response to recent authority following the Tenth Circuit’s decision in Conover v. Aetna U.S. Health Care, Inc., 320 F.3d 1076, 1080 (10th Cir.2003). In Conover, the federal court held that Oklahoma’s bad faith law did not “regulate insurance” within the meaning of ERISA’s savings clause and was thus preempted both because it related to an ERISA employment benefit plan and because it conflicted with the federal statute’s civil enforcement scheme. On April 2, 2003, the United States Supreme Court decided Kentucky Ass’n of Health Plans, Inc. v. Miller, 638 U.S. 329, 123 S.Ct. 1471, 155 L.Ed.2d 468 (2003), in which it established a new test for determining whether a state law “regulates insurance” and whether it is removed from the general rule of ERISA preemption under the savings clause; 29 U.S.C. § 1144(b)(2).8 Hollaway and UNUM addressed the Miller opinion in filings on April 10th and April 14th, 2003, respectively.

I.

¶ 8 THE TEST FOR ERISA PREEMPTION ALTERED WITH THE SUPREME COURT’S DECISION IN Kentucky Ass’n of Health Plans, Inc. v. Miller, MAKING ANY PREVIOUSLY PROMULGATED TENTH CIRCUIT DECISIONS OF LITTLE ASSISTANCE. UNDER THE AUTHORITY OF 20 O.S.2001 § 1602, WE ANSWER A QUESTION WHICH MAY BE DETERMINATIVE OF AN ISSUE IN THE CAUSE.

¶ 9 The federal court recognized that Oklahoma law would govern the preemption issue. It certified the preemption question over the objections of the insurer. UNUM urges us to refrain from answering the certified question. The insurer opposed certification in the federal court on grounds that federal case law. was determinative of the preemption issue and that any resolution we might provide to the dispute would not be determinative of a material issue in the cause. Although the answer to the question certified may not resolve the cause, we answer because no Oklahoma law exists on a determinative issue and because tests applied by the Tenth Circuit have been altered by a recent Supreme Court decision.

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Cite This Page — Counsel Stack

Bluebook (online)
2003 OK 90, 89 P.3d 1022, 2003 WL 22439659, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hollaway-v-unum-life-insurance-co-of-america-okla-2003.