Pilot Life Insurance v. Dedeaux

481 U.S. 41, 107 S. Ct. 1549, 95 L. Ed. 2d 39, 1987 U.S. LEXIS 1512, 55 U.S.L.W. 4471, 8 Employee Benefits Cas. (BNA) 1409
CourtSupreme Court of the United States
DecidedApril 6, 1987
Docket85-1043
StatusPublished
Cited by3,445 cases

This text of 481 U.S. 41 (Pilot Life Insurance v. Dedeaux) is published on Counsel Stack Legal Research, covering Supreme Court of the United States primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pilot Life Insurance v. Dedeaux, 481 U.S. 41, 107 S. Ct. 1549, 95 L. Ed. 2d 39, 1987 U.S. LEXIS 1512, 55 U.S.L.W. 4471, 8 Employee Benefits Cas. (BNA) 1409 (1987).

Opinion

*43 Justice O’Connor

delivered the opinion of the Court.

This case presents the question whether the Employee Retirement Income Security Act of 1974 (ERISA), 88 Stat. 829, as amended, 29 U. S. C. § 1001 et seq., pre-empts state common law tort and contract actions asserting improper processing of a claim for benefits under an insured employee benefit plan.

I

In March 1975, in Gulfport, Mississippi, respondent Everate W. Dedeaux injured his back in an accident related to his employment for Entex, Inc. (Entex). Entex had at this time a long term disability employee benefit plan established by purchasing a group insurance policy from petitioner, Pilot Life Insurance Co. (Pilot Life). Entex collected and matched its employees’ contributions to the plan and forwarded those funds to Pilot Life; the employer also provided forms to its employees for processing disability claims, and forwarded completed forms to Pilot Life. Pilot Life bore the responsibility of determining who would receive disability benefits. Although Dedeaux sought permanent disability benefits following the 1975 accident, Pilot Life terminated his benefits after two years. During the following three years Dedeaux’s benefits were reinstated and terminated by Pilot Life several times.

In 1980, Dedeaux instituted a diversity action against Pilot Life in the United States District Court for the Southern District of Mississippi. Dedeaux’s complaint contained three counts: “Tortious Breach of Contract”; “Breach of Fiduciary Duties”; and “Fraud in the Inducement.” App. 18-23. Dedeaux sought “[djamages for failure to provide benefits under the insurance policy in a sum to be determined at the time of trial,” “[gjeneral damages for mental and emotional distress and other incidental damages in the sum of $250,000.00,” and “[pjunitive and exemplary damages in the *44 sum of $500,000.00.” Id., at 23-24. Dedeaux did not assert any of the several causes of action available to him under ERISA, see infra, at 53.

At the close of discovery, Pilot Life moved for summary judgment, arguing that ERISA pre-empted Dedeaux’s common law claim for failure to pay benefits on the group insurance policy. The District Court granted Pilot Life summary judgment, finding all Dedeaux’s claims pre-empted. App. to Pet. Cert. 16a.

The Court of Appeals for the Fifth Circuit reversed, primarily on the basis of this Court’s decision in Metropolitan Life Ins. Co. v. Massachusetts, 471 U. S. 724 (1985). See 770 F. 2d 1311 (1985). We granted certiorari, 478 U. S. 1004 (1986), and now reverse.

II

In ERISA, Congress set out 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 the Federal courts.” §2, as set forth in 29 U. S. C. § 1001(b).

ERISA comprehensively regulates, among other things, employee welfare benefit plans that, “through the purchase of insurance or otherwise,” provide medical, surgical, or hospital care, or benefits in the event of sickness, accident, disability, or death. § 3(1), 29 U. S. C. § 1002(1).

Congress capped off the massive undertaking of ERISA with three provisions relating to the pre-emptive effect of the federal legislation:

“Except as provided in subsection (b) of this section [the saving clause], the provisions of this subchapter and *45 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 . . . .” § 514(a), as set forth in 29 U. S. C. § 1144(a) (pre-emption clause).
“Except as provided in subparagraph (B) [the deemer clause], nothing in this subchapter shall be construed to exempt or relieve any person from any law of any State which regulates insurance, banking, or securities.” § 514(b)(2)(A), as set forth in 29 U. S. C. § 1144(b)(2)(A) (saving clause).
“Neither an employee benefit plan . . . nor any trust established under such a plan, shall be deemed to be an insurance company or other insurer, bank, trust company, or investment company or to be engaged in the business of insurance or banking for purposes of any law of any State purporting to regulate insurance companies, insurance contracts, banks, trust companies, or investment companies.” § 514(b)(2)(B), 29 U. S. C. § 1144(b) (2)(B) (deemer clause).

To summarize the pure mechanics of the provisions quoted above: If a state law “relate[s] to . . . employee benefit plan[s],” it is pre-empted. § 514(a). The saving clause excepts from the pre-emption clause laws that “regulat[e] insurance.” § 514(b)(2)(A). The deemer clause makes clear that a state law that “purport[s] to regulate insurance” cannot deem an employee benefit plan to be an insurance company. § 514(b)(2)(B).

“[T]he question whether a certain state action is preempted by federal law is one of congressional intent. ‘ “The purpose of Congress is the ultimate touchstone.”’” Allis-Chalmers Corp. v. Lueck, 471 U. S. 202, 208 (1985), quoting Malone v. White Motor Corp., 435 U. S. 497, 504 (1978), quoting Retail Clerks v. Schermerhorn, 375 U. S. 96, 103 (1963). We have observed in the past that the express pre *46 emption provisions of ERISA are deliberately expansive, and designed to “establish pension plan regulation as exclusively a federal concern.” Alessi v. Raybestos-Manhattan, Inc., 451 U. S. 504, 523 (1981). As we explained in Shaw v. Delta Air Lines, Inc., 463 U. S. 85, 98 (1983):

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481 U.S. 41, 107 S. Ct. 1549, 95 L. Ed. 2d 39, 1987 U.S. LEXIS 1512, 55 U.S.L.W. 4471, 8 Employee Benefits Cas. (BNA) 1409, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pilot-life-insurance-v-dedeaux-scotus-1987.