Lillie Green v. Hotel Employees & Restaurant Employees International Welfare-Pension Funds

105 F.3d 665, 1997 U.S. App. LEXIS 4507, 1997 WL 8466
CourtCourt of Appeals for the Ninth Circuit
DecidedJanuary 7, 1997
Docket95-16314
StatusUnpublished
Cited by4 cases

This text of 105 F.3d 665 (Lillie Green v. Hotel Employees & Restaurant Employees International Welfare-Pension Funds) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lillie Green v. Hotel Employees & Restaurant Employees International Welfare-Pension Funds, 105 F.3d 665, 1997 U.S. App. LEXIS 4507, 1997 WL 8466 (9th Cir. 1997).

Opinion

105 F.3d 665

NOTICE: Ninth Circuit Rule 36-3 provides that dispositions other than opinions or orders designated for publication are not precedential and should not be cited except when relevant under the doctrines of law of the case, res judicata, or collateral estoppel.
Lillie GREEN, Plaintiff-Appellant,
v.
HOTEL EMPLOYEES & RESTAURANT EMPLOYEES INTERNATIONAL
WELFARE-PENSION FUNDS, Defendant-Appellee.

No. 95-16314.

United States Court of Appeals, Ninth Circuit.

Argued and Submitted Oct. 10, 1996.
Decided Jan. 7, 1997.

Before: WOOD, JR.,* SCHROEDER, and HALL, Circuit Judges.

MEMORANDUM**

Plaintiff-Appellant Lillie Green ("Green") is a participant in Plan 150 of defendant-appellee Hotel Employees and Restaurant Employees International Welfare-Pension Funds ("Welfare Fund"). After she was injured in an automobile accident, Welfare Fund paid her about $2,000 in benefits. She also filed a personal injury action against the driver of one of the other vehicles.

Pursuant to the written plan, Welfare Fund filed a subrogation lien on any recovery Green might obtain in her personal injury action. Eventually, Green settled that action and asked Welfare Fund to pay a pro rata share of her attorney fees by reducing its subrogation lien on the settlement proceeds. After Welfare Fund refused, she filed the instant action. Green seeks a declaration that federal common law surrounding ERISA mandates that an employee benefit plan which has subrogation and reimbursement rights in any judgment or settlement that an injured beneficiary obtains from a third party bear a pro rata share of the attorney fees that the injured beneficiary incurs.

The district court declined her invitation to adopt such a rule and granted Welfare Fund's motion for summary judgment. Because we find that such a common law rule would contradict a reasonably administered provision in Welfare Fund's written plan, we affirm.

I.

Initially, we note that we review a district court order granting summary judgment de novo. Associated Gen. Contractors, San Diego Chapter, Inc., Apprenticeship and Training Trust Fund v. Smith, 74 F.3d 926, 929 (9th Cir.1996). However, because the parties to this action agree that no genuine issue of material fact exists, we need only determine whether the district court correctly applied the substantive law. Id.

II.

In this case, the district court determined that Welfare Fund's written plan expressly contemplated full reimbursement and that the written plan also allowed the Trustees to reduce Welfare Fund's subrogation lien to account for special circumstances, including an injured participant's attorney fees. Because these provisions addressed the exact situation arising in this case, the court refused to adopt Green's proposed common law rule. Instead, finding nothing inequitable in these written provisions, the court refused "to substitute its judgment and impose a hard and fast rule that substitutes [for] the express language of the provisions of Plan 150...."

In enacting ERISA, Congress envisioned that the federal courts would formulate a nationally uniform federal common law to supplement the statute's explicit provisions. Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 110-11 (1989); Saltarelli v. Bob Baker Group Medical Trust, 35 F.3d 382, 386 (9th Cir.1994). However, such judicially created common law rules must effectuate ERISA's underlying policies. Saltarelli, 35 F.3d at 386; PM Group Life Ins. Co. v. Western Growers Assurance Trust, 953 F.2d 543, 546 (9th Cir.1992) ("We thus have the authority, indeed the obligation, to adopt a federal rule ... that best comports with the interests served by ERISA's regulatory scheme.").

One of ERISA's primary purposes is to ensure the integrity of written plans. Duggan v. Hobbs, 99 F.3d 307, 309-10 (9th Cir.1996); see Van Orman v. American Ins. Co., 680 F.2d 301, 312 (3d Cir.1982) ("The Supreme Court has emphasized the primacy of plan provisions absent a conflict with the statutory policies of ERISA."). Therefore, a court should not fashion a common law rule which would override the express terms of a private plan unless the overridden plan provision conflicts with statutory provisions or other policies underlying ERISA. Singer v. Black & Decker Corp., 964 F.2d 1449, 1452 (4th Cir.1992) ("[R]esort to federal common law generally is inappropriate when its application would ... threaten to override the explicit terms of an established ERISA benefit plan."); see, e.g., Parker v. BankAmerica Corp., 50 F.3d 757, 769 (9th Cir.1995) (a party cannot maintain a common law claim for equitable estoppel if recovery would contradict the written provisions of the plan); Davidian v. Southern Calif. Meat Cutters Union and Food Employees Benefit Fund, 859 F.2d 134, 136 (9th Cir.1988) (same).

Here, Green asks us to create a federal common law rule obligating all ERISA-regulated funds that have rights to reimbursement or subrogation in an injured participant's judgment or settlement to pay a pro rata share of the attorney fees that the injured participant incurs in prosecuting the action resulting in the judgment or settlement. However, both the written plan and the subrogation agreement, which Green signed as a condition to receiving benefits, provide that Green must reimburse Welfare Fund fully. Indeed, Article 33 of the written plan states that Welfare Fund may recover "the amount of benefits it pays" and that Welfare Fund "expects full reimbursement."

Acknowledging these provisions, Green contends that we should judicially override them because they are unreasonable. She argues that they allow Welfare Fund to obtain the benefit of her legal action without sharing in its costs. We disagree. Article 33 is not unreasonable because it also expressly provides that the Trustees may consider attorney fees as a "special circumstance" requiring the Trustees to reduce Welfare Fund's subrogation lien. This provision reasonably balances the injured participant's interest in receiving some accommodation for her legal fees with Welfare Fund's interest in ensuring that its Trustees fulfill their fiduciary duty to administer the trust at a reasonable cost, 29 U.S.C. § 1104(a)(1)(A)(ii) (1996), by allowing them to review the nature and extent of the legal services performed before agreeing to a level of compensation.

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105 F.3d 665, 1997 U.S. App. LEXIS 4507, 1997 WL 8466, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lillie-green-v-hotel-employees-restaurant-employee-ca9-1997.