Midwest Security Life Insurance v. Stroup

730 N.E.2d 163, 2000 Ind. LEXIS 544, 2000 WL 764946
CourtIndiana Supreme Court
DecidedJune 13, 2000
Docket06S05-0006-CV-364
StatusPublished
Cited by25 cases

This text of 730 N.E.2d 163 (Midwest Security Life Insurance v. Stroup) is published on Counsel Stack Legal Research, covering Indiana Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Midwest Security Life Insurance v. Stroup, 730 N.E.2d 163, 2000 Ind. LEXIS 544, 2000 WL 764946 (Ind. 2000).

Opinions

[165]*165ON PETITION TO TRANSFER

SHEPARD, Chief Justice.

We grant transfer in this case to discuss whether common law claims for breach of contract and bad faith are preempted by the Employee Retirement Income Security Act of 1974 (ERISA). We hold that the claims in this case are preempted by ERISA and reverse the trial court.

Factual and Procedural Background

Patrick and Theresa Stroup received a group health insurance policy from Midwest Security Life Insurance Company as a result of Patrick’s employment with Ivy Homes. The policy was governed by ERISA. On January 12, 1993, Theresa sought predetermination of benefits for surgery to correct congenital problems with her jaw. Midwest approved the surgery and Theresa underwent orthognathic surgery on April 13, 1994. Complications arose from this surgery that required another procedure three weeks later.

About four months after Theresa’s surgeries, in August 1994, Midwest amended its plan to exclude coverage for orthog-nathic surgery. After Theresa’s second surgery, she experienced continuing jaw spasms and pain. Non-surgical treatment was unsuccessful and, in January 1995, Theresa requested predetermination for another surgery to her jaw. The procedure was not considered a continuation of a course of care, but was approved under Midwest’s Temporomandibular Joint Dysfunction (TMJ) coverage which capped benefits at 1,000 dollars per year.

To avoid the cost of another procedure, Theresa opted for continued non-surgical treatment but, in October 1995, she awoke in considerable pain to discover that her jaw had broken. One week later, Theresa underwent bone graft surgery to repair her jaw. In January 1996, Theresa was forced to undergo another surgery because of continued pain and muscle spasms in her jaw. This surgery finally corrected the problems.

The Stroups filed suit against Midwest on June 26, 1995, for injunctive relief and damages. They amended their complaint to add claims for breach of contract and the tort of bad faith and to request both compensatory and punitive damages and a jury trial. Midwest filed a motion for summary judgment, arguing that the Stroups’ claims were preempted by ERISA and moving to strike the Stroups’ request for a jury trial. The trial court held that the Stroups’ state law claims were not preempted by ERISA, their request for punitive damages was not preempted by ERISA, and the claims were triable to a jury. On interlocutory appeal, the- Court of Appeals reversed, holding that the Stroups’ state law claims were preempted by ERISA and were not preserved by the ERISA savings clause. Midwest Sec. Life Ins. Co. v. Stroup, 706 N.E.2d 201, 207 (Ind.Ct.App.1999). We granted the Stroups’ petition for transfer.

Standard of Review

Though the appealing party bears the burden of persuasion in an appeal involving summary judgment, we otherwise’ approach the question in the same way a trial court does: summary judgment is appropriate only wheré the evidence shows there is no genuine issue of material fact and the moving party is entitled to a judgment as a matter of law. See Ind. Trial Rule 56(C); Shell Oil Co. v. Lovold Co., 705 N.E.2d 981 (Ind.1998). All facts and reasonable inferences drawn from those facts are construed in favor of the non-moving party. Colonial Penn Ins. Co. v. Guzorek, 690 N.E.2d 664 (Ind.1997). The review of a summary judgment motion is limited to those materials designated to the trial court. See T.R. 56(H); see also Rosi v. Business Furniture Corp., 615 N.E.2d 431 (Ind.1993). We. review decisions on summary judgment motions carefully to ensure -that the parties were not improperly denied their day in court. Estate of Shebel ex rel. Shebel v. Yaskawa Elec. Am., Inc., 713 N.E.2d 275 (Ind.1999). In this case, the question of whether [166]*166ERISA preempts the Stroups’ state law claims is a question of law. Therefore, it is a matter that may be properly determined on a motion for summary judgment.

Preemption under ERISA

The Stroups first contend that the Court of Appeals erred in determining that the breach of contract and bad faith claims are preempted by ERISA. The stated purpose of ERISA is to “protect ... participants in employee benefit plans and their beneficiaries, by requiring the disclosure and reporting to participants and beneficiaries of financial and other information with respect thereto, by establishing standards of conduct, responsibility, and obligation for fiduciaries of employee benefit plans, and by providing for appropriate remedies, sanctions, and ready access to Federal courts.” See 29 U.S.C. § 1001(b) (1998). ERISA creates a federal statutory claim for recovery of “benefits due to [the beneficiary] under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan,” Employee Retirement Income Security Act of 1974 (ERISA) § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B) (1994 & Supp. 1997). Suits under § 1132(a)(1)(B) may be brought in either federal or state court. Id. § 1132(e)(1).

A “Relates To”

ERISA provides for broad preemption of state law claims in 29 U.S.C. § 1144(a) which reads: “[e]xeept as provided in subsection (b) of this section, the provisions of this subchapter and subchapter III of this chapter shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan.... ” The United States Supreme Court has examined the legislative history surrounding § 1144(a) to determine that “the words ‘relate to’ in [114]4(a) [were used by Congress] in their broad sense.” Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 98, 103 S.Ct. 2890, 77 L.Ed.2d 490 (1983) (quoting Representative Dent that “the crowning achievement of this legislation [is] the reservation to Federal authority [of] the sole power to regulate the field of employee benefit plans”).

The courts have focused on the “relate to” language of § 1144(a) and have held that a law “relates to” an employee benefit plan if it has a connection with1 or a reference to such a plan. Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 47, 107 S.Ct. 1549, 95 L.Ed.2d 39 (1987); accord Shaw, 463 U.S. at 96-97, 103 S.Ct. 2890; California Div. of Labor Standards Enforcement v. Dillingham Constr., N.A., Inc., 519 U.S. 316, 324, 117 S.Ct. 832, 136 L.Ed.2d 791 (1997). The preemption provision may apply even to laws that are not specifically designed to affect employee benefit plans or to laws that affect the plans only indirectly. Ingersoll-Rand Co. v. McClendon, 498 U.S. 133, 139, 111 S.Ct. 478, 112 L.Ed.2d 474 (1990).

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Bluebook (online)
730 N.E.2d 163, 2000 Ind. LEXIS 544, 2000 WL 764946, Counsel Stack Legal Research, https://law.counselstack.com/opinion/midwest-security-life-insurance-v-stroup-ind-2000.