Karkare v. Int'l Ass'n of Bridge, Structural, Ornamental & Reinforcing

140 F.4th 60
CourtCourt of Appeals for the Second Circuit
DecidedJune 9, 2025
Docket22-2874
StatusPublished
Cited by2 cases

This text of 140 F.4th 60 (Karkare v. Int'l Ass'n of Bridge, Structural, Ornamental & Reinforcing) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Karkare v. Int'l Ass'n of Bridge, Structural, Ornamental & Reinforcing, 140 F.4th 60 (2d Cir. 2025).

Opinion

22-2874 Karkare v. Int’l Ass’n of Bridge, Structural, Ornamental & Reinforcing Iron Workers Loc. 580

United States Court of Appeals For the Second Circuit

August Term 2022

Argued: June 9, 2023 Decided: June 9, 2025

No. 22-2874

NAKUL KARKARE, M.D., Attorney in Fact on behalf of Patient JN,

Plaintiff-Appellant,

v.

INTERNATIONAL ASSOCIATION OF BRIDGE, STRUCTURAL, ORNAMENTAL & REINFORCING IRON WORKERS LOCAL 580,

Defendant-Appellee.

Appeal from the United States District Court for the Eastern District of New York No. 22-cv-5988, Gary R. Brown, Judge.

Before: SULLIVAN, ROBINSON, and KAHN, Circuit Judges.

Nakul Karkare, a surgeon affiliated with AA Medical, P.C. (“AA Medical”) who holds a power of attorney on behalf of Patient JN, brought this action against the International Association of Bridge, Structural, Ornamental & Reinforcing Iron Workers Local 580 (the “Union”), seeking to recover unpaid benefits pursuant to section 502(a)(1)(B) of the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1132(a)(1)(B). According to Karkare, the Union failed to fully reimburse AA Medical for payments related to its provision of surgical services to Patient JN, a beneficiary under the Union’s self- funded insurance plan (the “Local 580 Insurance Fund”). The district court (Brown, J.) dismissed the complaint sua sponte after concluding that a power of attorney, as distinct from an assignment of claim, did not permit Karkare to maintain his ERISA cause of action on behalf of Patient JN.

On appeal, we conclude that Karkare lacks standing under Article III of the United States Constitution to bring this cause of action because, notwithstanding the power of attorney, the allegations in the complaint indicate that Karkare is suing in his own name and not on behalf of Patient JN. Nevertheless, we remand the case to the district court to consider whether Patient JN should be permitted to be substituted into the action pursuant to Federal Rule of Civil Procedure 17.

AFFIRMED IN PART, VACATED IN PART, AND REMANDED.

ROBERT J. AXELROD, Axelrod LLP, New York, NY, for Plaintiff-Appellant.

THOMAS P. KEANE, Colleran O’Hara & Mills LLP, Woodbury, NY, for Defendant- Appellee.

RICHARD J. SULLIVAN, Circuit Judge:

Nakul Karkare, a surgeon affiliated with AA Medical, P.C. (“AA

Medical”) who holds a power of attorney on behalf of Patient JN, brought this

action against the International Association of Bridge, Structural, Ornamental &

Reinforcing Iron Workers Local 580 (the “Union”), seeking to recover unpaid

2 benefits pursuant to section 502(a)(1)(B) of the Employee Retirement Income

Security Act of 1974 (“ERISA”), 29 U.S.C. § 1132(a)(1)(B). According to Karkare,

the Union failed to fully reimburse AA Medical for payments related to its

provision of surgical services to Patient JN, a beneficiary under the Union’s self-

funded insurance plan (the “Local 580 Insurance Fund”). The district court

(Brown, J.) dismissed the complaint sua sponte after concluding that a power of

attorney, as distinct from an assignment of claim, did not permit Karkare to

maintain his ERISA cause of action on behalf of Patient JN.

On appeal, we conclude that Karkare lacks standing under Article III of

the United States Constitution to bring this cause of action because,

notwithstanding the power of attorney, the allegations in the complaint indicate

that Karkare is suing in his own name and not on behalf of Patient JN.

Nevertheless, we remand the case to the district court to consider whether

Patient JN should be permitted to be substituted into the action pursuant to

Federal Rule of Civil Procedure 17.

I. BACKGROUND

In 2022, Dr. Vedant Vaksha, a surgeon affiliated with AA Medical,

performed surgery on Patient JN to repair a meniscus root tear in his right knee.

At the time of the surgery, Patient JN was a plan beneficiary of the Local 580

3 Insurance Fund, under which AA Medical was an out-of-network provider.

After Patient JN’s surgery, AA Medical submitted an invoice to the Union’s

claims administrator, Empire Blue Cross Blue Shield (“Empire”), for a total

amount of $153,579.94. Of this, the Union paid only $1,095.92 pursuant to its

plan’s Summary Plan Description, which provided for reimbursement to out-

of-network providers like AA Medical “based on . . . the customary charge or

the average market charge in [the patient’s] geographical area for a similar

service.” App’x at 7. AA Medical appealed the reimbursement to Empire,

which responded that the claim had been “paid at the maximum amount

available.” Id. (internal quotation marks omitted).

Karkare, also a surgeon practicing with AA Medical, obtained a power of

attorney from Patient JN and brought the instant litigation, asserting that the

Union violated its obligations under section 502(a)(1)(B) of ERISA, 29 U.S.C.

§ 1132(a)(1)(B), when it limited AA Medical’s reimbursement for Patient JN’s

surgery to $1,095.92. 1 The district court sua sponte ordered Karkare to show

1The Union argues that it is not a proper defendant for a section 502(a)(1)(B) claim, since it is neither the plan nor the plan’s administrator, trustee, or sponsor. See Union Br. at 26–28 (citing, inter alia, Leonelli v. Pennwalt Corp., 887 F.2d 1195, 1199 (2d Cir. 1989); N.Y. State Psychiatric Ass’n, Inc. v. UnitedHealth Grp., 798 F.3d 125, 132 (2d Cir. 2015)). Because this issue was not raised before the district court, and we conclude that a remand is appropriate for the reasons set forth below, we leave this argument for the district court to address in the first instance as necessary.

4 cause why, in light of the “requirement that a physician must demonstrate a

valid assignment of a claim from a beneficiary to maintain a cause of action for

unpaid benefits under ERISA, . . . th[e] matter should not be dismissed for

failure to plausibly allege a valid assignment.” App’x at 2. In response, Karkare

did not submit proof of a valid assignment, but instead argued that no

assignment was necessary because the power of attorney was sufficient to allow

Karkare to maintain a cause of action under ERISA on behalf of Patient JN. 2 The

district court disagreed, dismissing the complaint and later denying Karkare’s

motion for reconsideration. This appeal followed. 3

II. DISCUSSION

On appeal, the parties dispute whether Karkare, as attorney-in-fact who

purportedly received a power of attorney from a plan member, has “standing”

2Patient JN’s insurance plan is not included in the record on appeal, and neither party’s brief indicates whether the plan permitted or prohibited an assignment of claims. At oral argument, the parties took contrary positions on this matter: Counsel for Karkare conveyed his understanding that the plan contained an express “anti-assignment” provision, see Oral Arg. Tr.

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140 F.4th 60, Counsel Stack Legal Research, https://law.counselstack.com/opinion/karkare-v-intl-assn-of-bridge-structural-ornamental-reinforcing-ca2-2025.