IBEW-NECA Southwestern Health & Benefit Fund v. Douthitt

211 F. Supp. 2d 812, 2002 U.S. Dist. LEXIS 11430
CourtDistrict Court, N.D. Texas
DecidedJune 25, 2002
Docket3:01-cv-01730
StatusPublished
Cited by8 cases

This text of 211 F. Supp. 2d 812 (IBEW-NECA Southwestern Health & Benefit Fund v. Douthitt) is published on Counsel Stack Legal Research, covering District Court, N.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
IBEW-NECA Southwestern Health & Benefit Fund v. Douthitt, 211 F. Supp. 2d 812, 2002 U.S. Dist. LEXIS 11430 (N.D. Tex. 2002).

Opinion

MEMORANDUM OPINION AND ORDER

LINDSAY, District Judge.

Before the court is Defendant’s Motion to Dismiss; No Subject Matter Jurisdiction (hereinafter “Motion to Dismiss for Lack of Subject Matter Jurisdiction”), filed December 3, 2001. After 'having considered the motion, the parties’ briefs, the evidence submitted, and the applicable law, the court denies Defendant’s Motion to Dismiss for Lhck of Subject Matter Jurisdiction.

I. Background

Plaintiffs IBEW-NECA Southwestern Health and Benefit Fund (the “Plan”) and its Board of Trustees (the “Trustees,” collectively “Plaintiffs”) filed this action against Jessie Douthitt (“Douthitt”) pursuant to the Employment Retirement Income Security Act of 1974 (“ERISA”), as amended, ■ § 502(a)(3), 29 ■ U.S.C. § 1132(a)(3). Plaintiffs seek' declaratory and injunctive relief, specific performance, restitution, reimbursement, and/or recovery of certain amounts allegedly owed by the Defendant under the terms of the Plan and a reimbursement agreement signed by the Defendant.

On September 18, 1999, Douthitt was injured in an automobile apcident and incurred substantial medical bills as a result of his subsequent treatment. The Plan advanced to Douthitt approximately $30,752 to pay for his medical 'bills in *814 exchange for his agreement to repay the Plan in full from any judgment or settlement he received from a third party. The parties memorialized their agreement in a written Reimbursement Agreement. The Reimbursement Agreement expressly assigned to the Plan the right to a recovery against a third person or an insurance company.

Douthitt brought a claim against the third-party tortfeasor and settled for approximately $20,000. The Plan agreed to accept two-thirds of that settlement in partial satisfaction of its lien, and allowed the remaining settlement funds to be apportioned between the Defendant and his attorney. Douthitt subsequently recovered an additional $25,000 from his uninsured/underinsured motorist coverage, but refused to reimburse the Plan for the approximately $17,500 he allegedly owes under the Reimbursement Agreement. The Plan filed the present action to recover these funds.

II. Analysis

Douthitt contends the court lacks subject matter jurisdiction in light of the Supreme Court’s recent decision in Great-West Life & Annuity Ins. Co. v. Knudson, 534 U.S. 204, 122 S.Ct. 708, 151 L.Ed.2d 635 (2002), and the Fifth Circuit’s subsequent decision in Bauhaus USA Inc. v. Copeland, 292 F.3d 439 (5th Cir.2002). Plaintiffs contend the holdings of these cases do not apply because the Plan and its Trustees seek only “equitable relief’ under 29 U.S.C. § 1132(a)(3).

Section 502(a)(3) authorizes a civil action:

by a participant, beneficiary, or fiduciary (A) to enjoin any act or practice which violates ... the terms of the plan, or (B) to obtain other appropriate equitable relief (i) to redress such violations or (ii) to enforce any provisions of ... the terms of the plan.

29 U.S.C. § 1132(a)(3). The term “equitable relief’ in § 502(a)(3) refers only to “those categories of relief that were typically available in equity.” Mertens v. Hewitt Assocs., 508 U.S. 248, 256, 113 S.Ct. 2063, 124 L.Ed.2d 161 (1993). In Great-West Life, the Supreme Court directly addressed whether an action to recover money pursuant to a reimbursement provision of an ERISA plan qualifies as “equitable relief’ under § 502(a)(3). 122 S.Ct. at 711.

The facts of Great-West Life are as follows. Janette Knudson, a beneficiary under an ERISA-governed employee welfare benefit plan, was injured in a car accident and, as a result of her injuries, incurred significant medical expenses. Id. Greab-West Life paid Knudson’s medical expenses pursuant to a reimbursement provision which provided that Great-West Life shall have “the right to recover from [the beneficiary] any payment for benefits” paid by the plan that the beneficiary is entitled to recover from a third party. Id. Specifically, the reimbursement provision stated that the plan had “a first lien upon any recovery, whether by settlement, judgment, or otherwise,” that the beneficiary collects from a third party up to “the amount of benefits paid [by the plan].” Id. The reimbursement agreement further provided that if the beneficiary recovered from a third party and failed to reimburse the plan, “then [the beneficiary] will be personally liable to [the Plan] ... up to the amount of the first lien.” Id.

Knudson ultimately recovered a $650,000 settlement from the Hyundai Motor Company. Id. The settlement allocated approximately $256,750 to a Special Needs Trust to provide for Knudson’s medical care; approximately $373,500 to attorney’s fees and costs; $5,000 to reim *815 burse the state medicaid program; and approximately $13,900 to 'satisfy ■ Great-West Life’s claims under the reimbursement provisions of the plan. Id. Great-West Life filed suit in federal court" seeking declarative and injunctive relief under § 502(a)(3) to enforce the reimbursement provision. Id., 122 S.Ct. at 712 Specifically, Great-West Life demanded payment of the remaining amounts owed to it under the reimbursement provisions of the plan, some $411,000. Id.

The Supreme Court held that § 502(a)(3) does not authorize an action to impose personal liability on a beneficiary of an insurance plan to recover payments by a third party. Id., 122 S.Ct. at 719. Great-West Life argued that their suit was authorized by ERISA because they sought restitution, which they characterized as “equitable relief.” Id., 122 S.Ct. at 714. The Supreme Court distinguished restitution in equity from restitution at law, stating

[A] plaintiff could seek restitution in equity, ordinarily, in the form of a constructive trust or an equitable lien, where money or property identified as belonging in good conscience to the plaintiff could clearly be traced to particular funds or property in the defendant’s possession.

Id. Restitution in equity is not available, however, where “the property [sought to be recovered] or its proceeds have been dissipated so that no product remains.” Id. In such eases, “ ‘[the plaintiffs] claim is only that of a general creditor,’ and the plaintiff ‘cannot enforce a constructive trust of or an equitable lien upon other property of the [defendant].’ ” Id. (internal citations omitted).

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211 F. Supp. 2d 812, 2002 U.S. Dist. LEXIS 11430, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ibew-neca-southwestern-health-benefit-fund-v-douthitt-txnd-2002.