McCravy v. Metropolitan Life Insurance Company

Court of Appeals for the Fourth Circuit·Decided May 16, 2011·No. 10-1074·Published

Opinion

Rehearing granted, August 31, 2011

PUBLISHED

UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT

DEBBIE MCCRAVY,  Plaintiff-Appellant, v.

METROPOLITAN LIFE INSURANCE 

COMPANY, No. 10-1074

Defendant-Appellee.

SECRETARY OF THE UNITED STATES DEPARTMENT OF LABOR, Amicus Supporting Appellant.

DEBBIE MCCRAVY,  Plaintiff-Appellee, v.

METROPOLITAN LIFE INSURANCE 

COMPANY, No. 10-1131

Defendant-Appellant.

SECRETARY OF THE UNITED STATES DEPARTMENT OF LABOR, Amicus Supporting Appellee.

2 MCCRAVY v. METROPOLITAN LIFE INSURANCE Appeals from the United States District Court for the District of South Carolina, at Charleston.

Patrick Michael Duffy, Senior District Judge.

(2:08-cv-01933-PMD)

Argued: January 27, 2011

Decided: May 16, 2011

Before TRAXLER, Chief Judge, and KING and WYNN, Circuit Judges.

Affirmed by published opinion. Judge Wynn wrote the opinion , in which Chief Judge Traxler and Judge King joined.

COUNSEL

ARGUED: Robert Edward Hoskins, FOSTER LAW FIRM, LLP, Greenville, South Carolina, for Debbie McCravy. Elizabeth Hopkins, UNITED STATES DEPARTMENT OF LABOR, Washington, D.C., for Secretary of the United States Department of Labor. Ian Seth Linker, METROPOLITAN LIFE INSURANCE COMPANY, New York, New York, for Metropolitan Life Insurance Company. ON BRIEF: Peter Stris, STRIS & MAHER, LLP, Dallas, Texas, for Debbie McCravy. J.D. Quattlebaum, HAYNSWORTH, SINKLER & BOYD, PA, Greenville, South Carolina, for Metropolitan Life Insurance Company. M. Patricia Smith, Solicitor of Labor, Timothy D. Hauser, Associate Solicitor, Plan Benefits Security Division, James L. Craig, Jr., Senior Regulations Attorney, UNITED STATES DEPARTMENT OF LABOR, Washington , D.C., for Secretary of the United States Department of Labor.

MCCRAVY v. METROPOLITAN LIFE INSURANCE 3 OPINION

WYNN, Circuit Judge:

Plaintiff Debbie McCravy sued Defendant Metropolitan Life Insurance Company ("MetLife"), alleging, among other things, breach of fiduciary duty, and seeking damages under the "other appropriate equitable relief" provision of the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1132(a)(3). The district court granted McCravy summary judgment, but limited her damages to the return of her premiums. Both parties appealed. We now affirm.

I.

McCravy works for Bank of America. As a full-time employee, she participated in Bank of America’s life insurance and accidental death and dismemberment ("AD&D") plan, which was issued and administered by MetLife. The plan provided that an insured could purchase accidental death and dismemberment coverage for "eligible dependent children ." Under the plan, McCravy elected to obtain such insurance coverage for her daughter Leslie McCravy and paid premiums, which were accepted and retained by MetLife.

In 2007, while named as a covered dependent on McCravy’s insurance plan, Leslie was murdered at the age of 25. McCravy, who was the beneficiary of the policy insuring her daughter, filed a claim for benefits. MetLife denied McCravy’s claim on the grounds that Leslie did not qualify for coverage under the plan’s "eligible dependent children" provision.

The plan defines "eligible dependent children" as children of the insured who are unmarried, dependent upon the insured for financial support, and either (a) under the age of 19 or (b) under the age of 24 if enrolled full-time in school. According to MetLife, because Leslie was 25 at the time of her death, 4 MCCRAVY v. METROPOLITAN LIFE INSURANCE she no longer fit the definition of "eligible dependent children ." As a result, MetLife denied McCravy’s claim and attempted to refund the premiums retained to provide coverage for Leslie. McCravy, however, refused to accept the refund check.

Instead, McCravy filed suit in federal court in May 2008, alleging that MetLife’s actions constituted a breach of fiduciary duty under ERISA, 29 U.S.C. § 1104, and seeking recovery under 29 U.S.C. § 1132(a)(2) or (a)(3). McCravy also alleged various claims under state law, including negligence , promissory estoppel, and breach of contract. In September 2008, MetLife filed a "Memorandum in Support of Preemption." With the parties’ agreement, the district court treated the filing as a motion to dismiss.

On June 12, 2009, the district court ruled that McCravy’s state law claims were preempted by ERISA. Regarding McCravy’s breach of fiduciary duty claim, the district court ruled that McCravy could not recover under § 1132(a)(2). McCravy does not challenge the district court’s ruling on the preemption of her state law claims or the disposition of her § 1132(a)(2) claim.

As for McCravy’s claim under § 1132(a)(3), the district court ruled that, although McCravy was not entitled to recover full benefits under this provision, McCravy could recover the premiums withheld by MetLife for coverage that she never actually had on the life of her daughter. The district court therefore denied MetLife’s motion to dismiss McCravy’s § 1132(a)(3) claim and invited the parties to conduct further discovery.

On June 22, 2009, McCravy moved for summary judgment regarding the improperly withheld premiums, and reserved the right to appeal the district court’s limitation of her recovery under § 1132(a)(3). On January 14, 2010, the district court entered a final order and judgment awarding McCravy the

MCCRAVY v. METROPOLITAN LIFE INSURANCE 5 improperly withheld premiums.1 McCravy appealed, and MetLife cross-appealed.

II.

McCravy first argues that 29 U.S.C. § 1132(a)(3) allows the remedy of surcharge, which would permit recovery of the life insurance proceeds lost by McCravy because of MetLife’s breach of fiduciary duty. 29 U.S.C. § 1132(a)(3) provides that a civil action may be brought:

by a participant, beneficiary, or fiduciary (A) to enjoin any act or practice which violates any provision of this subchapter or 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 this subchapter or the terms of the plan ....

29 U.S.C. § 1132(a)(3). This case concerns the scope of the "equitable relief" provision.2 1 The district court founded its decision on the parties’ agreement that McCravy was entitled to a refund of the wrongfully withheld premiums. The district court did not explicitly address whether MetLife’s actions constituted a breach of fiduciary duty under ERISA. Accordingly, we assume without deciding that MetLife breached its fiduciary duty under ERISA for the purpose of examining the scope of remedies available under 29 U.S.C. § 1132(a)(3).

2 MetLife argues that 29 U.S.C. § 1132(a)(1) (allowing a plan participant to bring a civil action to recover benefits due under the terms of the plan) is McCravy’s exclusive avenue of relief. See Korotynska v. Metro. Life Ins. Co., 474 F.3d 101, 107 (4th Cir. 2006) (holding that a plaintiff may not seek recovery under § 1132(a)(3) when § 1132(a)(1) provides adequate relief). Insofar as McCravy does not have a claim for benefits under the plan, her claim is not precluded by Korotynska. See Varity Corp. v. Howe, 516 U.S. 489, 515 (1996) (allowing action under § 1132(a)(3) when plaintiffs could not proceed under § 1132(a)(1) because they were no longer members of the plan).

6 MCCRAVY v. METROPOLITAN LIFE INSURANCE Surcharge is defined as "[t]he amount that a court may charge a fiduciary that has breached its duty." Black’s Law Dictionary 1579 (9th ed. 2009). McCravy alleges that surcharge encompasses the remedies provided by section 205 of the Restatement of Trusts, including charging a trustee with "(a) any loss or depreciation in value of the trust estate resulting from the breach of trust; or (b) any profit made by him through the breach of trust; or (c) any profit which would have accrued to the trust estate if there had been no breach of trust." Restatement of Trusts § 205 (1935). McCravy portrays surcharge as having a distinctly restitutionary focus and functioning as a sanction.

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