Kathleen Denise Shirley v. Maxicare Texas, Inc.

921 F.2d 565, 1991 U.S. App. LEXIS 101, 1991 WL 428
CourtCourt of Appeals for the Fifth Circuit
DecidedJanuary 7, 1991
Docket90-2190
StatusPublished
Cited by39 cases

This text of 921 F.2d 565 (Kathleen Denise Shirley v. Maxicare Texas, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kathleen Denise Shirley v. Maxicare Texas, Inc., 921 F.2d 565, 1991 U.S. App. LEXIS 101, 1991 WL 428 (5th Cir. 1991).

Opinion

PER CURIAM:

Plaintiff-appellant Kathleen Denise Shirley (Shirley) appeals a district court ruling ordering arbitration of her dispute and a subsequent ruling confirming the arbitration judgment. She contends that the district court lacked jurisdiction to order the parties to arbitrate their dispute and lacked jurisdiction to subsequently confirm the arbitration judgment.

Shirley originally filed suit in Texas state court, arguing that defendant-appellee Maxicare Texas, Inc. (Maxicare) wrongfully applied a change in its health insurance policy retroactively to her. Under its original policy, Maxicare offered coverage for organ transplants. Shirley had been diagnosed as needing a liver transplant and was awaiting a donor, when Maxicare ceased to offer transplant coverage. Under the amended terms of the policy, Maxicare refused to cover the cost of a transplant for Shirley after September 1, 1988.

In August, 1988, Shirley filed suit in Texas state court seeking a declaration that Maxicare was obliged to pay for her transplant when a suitable donor could be found. She also sought compensatory and punitive damages.

In September, 1988, Maxicare removed the case to federal district court, on the basis that Shirley’s claim was governed by ERISA. Shirley then filed a motion to remand. While her motion was pending, Maxicare filed a motion to abate the proceedings and to order arbitration, which the district court granted. Shirley filed a motion to reconsider, contesting the district court’s authority to order arbitration without subject matter jurisdiction. The district court denied the motion, stating that when a dispute is subject to arbitration, a court cannot rule on an issue of whether state or federal court is the proper forum. The court reaffirmed its directive that the parties arbitrate, and Shirley submitted to arbitration under protest, arguing that the district court’s order was void because it issued from a court without jurisdiction.

The arbitrator ruled that Maxicare was obliged to provide coverage for Shirley’s transplant, but that the obligation persisted only for a reasonable time, that is, through September 1, 1991. The arbitrator also awarded Shirley $25,000 in attorneys’ fees in connection with the arbitration. Shirley accepted the check for attorneys’ fees which she endorsed over to her law firm and which the law firm subsequently cashed. Maxicare then took the arbitral award to the district court and filed a motion seeking confirmation of the award as the court’s final judgment. Shirley opposed the motion on jurisdictional grounds and Maxicare countered that by accepting *567 the benefits of the award, Shirley was es-topped to challenge its validity. The court granted the order confirming the arbitral award.

We find that ERISA does not apply to this case and that the district court lacked jurisdiction over the case, including jurisdiction to order arbitration. We find, moreover, that Shirley was not estopped from challenging the validity of the proceedings below. For the foregoing reasons, we order that the judgment be vacated, that the payment for attorneys’ fees accordingly be returned, with interest, and that the case be remanded to state court.

I.

We first consider whether the district court had subject matter jurisdiction over this case. In its petition for removal, Maxicare cited the federal Employee Retirement and Income Security Act of 1974 (ERISA) as its only basis for federal subject matter jurisdiction. Under 29 U.S.C. § 1003(b), however, ERISA shall not apply to any employee benefit plan if such plan is a governmental plan. The term “governmental plan,” under ERISA, refers to plans “established or maintained for its employees by the Government of the United States, by the government of any State or political subdivision thereof, or by any agency or instrumentality of any of the foregoing.” 29 U.S.C. § 1002(32). The question before us is whether the employer in this case—the Aldine Independent School District (AISD)—represents a political subdivision, agency or instrumentality of the state.

Shirley cites several cases which support the proposition that Congress intended for plans established or maintained by public school districts to be exempt from ERISA. In Roy v. Teachers Ins. and Annuity Ass’n, 878 F.2d 47 (2d Cir.1989), although the court did not specifically hold that the public school (the State University of New York) was a “governmental entity” for the purpose of exemption under ERISA, the court recognized, as a matter of fact, the University’s “governmental status.” Id. at 50. Similarly, in Feinstein v. Lewis, 477 F.Supp. 1256 (S.D.N.Y.1979), the court found as an undisputed fact that the employees of two public school districts were employees of “ ‘the government of [a] State or political subdivision thereof, or [of an] agency or instrumentality of any of the foregoing.’ ” Id. at 1259 (quoting 29 U.S.C. § 1003(b)).

In Brown v. Northwestern Nat’l Life Ins. Co., the District Court for the Eastern District of Louisiana held that the plan at issue, which was held by a parish school board for its employees and insured dependents, was a “governmental plan.” No. 9585, 1987 WL 18813 (E.D.La. Oct. 22, 1987) (LEXIS, Genfed library, Dist file) (following Feinstein).

Maxicare cites Krupp v. Lincoln Univ., 663 F.Supp. 289 (E.D.Pa.1987), in order to demonstrate that the issue remains open. Krupp, which held that a university’s health care plan was not within the “governmental plan” exception to ERISA, however, can easily be distinguished from the case at bar. Unlike the instant case, Krupp concerned a private non-profit corporation chartered for educational purposes, as opposed to a public school district. Moreover, as this court stated in B., Inc. v. Miller Brewing Co., 663 F.2d 545 (5th Cir.1981), “we have consistently held that it is the party who urges jurisdiction upon the court who must always bear the burden of demonstrating that the case is one which is properly before the federal tribunal.” Id. at 549. We do not believe that Maxicare has met this burden. 1

II.

Maxicare goes on to argue that even if the district court lacked subject matter jurisdiction, it was nevertheless legally permitted to order the parties to arbitrate the *568 dispute. They argue that in disputes governed by contractual arbitration clauses, a lack of subject matter jurisdiction does not preclude the district courts from ordering the parties to arbitrate. We disagree. In Giannakos v. M/V Bravo Trader, 762 F.2d 1295

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Bluebook (online)
921 F.2d 565, 1991 U.S. App. LEXIS 101, 1991 WL 428, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kathleen-denise-shirley-v-maxicare-texas-inc-ca5-1991.