Scarangella & Sons, Inc. v. Group Health, Inc.

731 F.3d 146, 2013 WL 4792466
CourtCourt of Appeals for the Second Circuit
DecidedSeptember 10, 2013
DocketDocket 12-2750-cv
StatusPublished
Cited by39 cases

This text of 731 F.3d 146 (Scarangella & Sons, Inc. v. Group Health, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Scarangella & Sons, Inc. v. Group Health, Inc., 731 F.3d 146, 2013 WL 4792466 (2d Cir. 2013).

Opinion

RESTANI, Judge:

Appellant Village Fuel appeals the district court’s denial of attorney’s fees in this ERISA action. The district court held that Village Fuel was ineligible for attorney’s fees because it “was not the ‘prevailing party,’ and ... it did not obtain any success on the merits.” Although the district court appeared to rely upon the Supreme Court’s standard for determining eligibility for an award of attorney’s fees, as set out in Hardt v. Reliance Std. Life Ins. Co., 560 U.S. 242, 130 S.Ct. 2149, 176 L.Ed.2d 998 (2010), it erred in interpreting that standard and applying it in this case. As a result, we vacate the court’s decision and remand for the district court to apply the appropriate standard and to exercise its discretion in determining to what extent, if any, Village Fuel is entitled to an award of reasonable attorney’s fees.

BACKGROUND

This long, contentious litigation stems from a benefits dispute under an employee benefits plan (the “Plan”) insured by Defendant^Counter ClaimanL-Cross Defendant-Appellee Group Health Insurance, Inc. (“GHI”) and administered by Village Fuel. Plaintiff Nicholas Scarangella (“Scar-angella”) was provided insurance under the Plan as an employee of Village Fuel. The Plan provided family coverage, which applied to Scarangella’s wife. After Scar-angella’s wife incurred substantial medical expenses, GHI initiated an investigation into whether Scarangella was an eligible employee under the Plan. 1 Based on its investigation, GHI determined that Scar-angella was not an eligible employee. 2 As a result, GHI purported to retroactively rescind the entire insurance policy issued to Village Fuel and denied reimbursement for medical expenses claimed by Scaran-gella’s wife. GHI then brought suit in New York state court seeking rescission and restitution from Village Fuel under state-law-based contract claims. Prior to trial, Village Fuel removed the case to federal court, claiming GHI’s causes of *149 action were preempted under ERISA. GHI moved to remand the case to state court, but while the motion was pending, Searangella filed an action against GHI and Village Fuel under ERISA, alleging that his wife was wrongfully denied benefits under the terms of the Plan. The parties eventually agreed to voluntarily dismiss the state action and instead assert cross-claims as defendants in Scarangella’s federal action.

In response to Searangella’s complaint, GHI asserted three counterclaims seeking rescission and/or reformation of the Plan so as to exclude Searangella and his dependents from coverage in addition to restitution of previously conferred benefits. GHI also cross-claimed against Village Fuel for rescission/reformation of its policy to exclude Searangella from the Plan as well as restitution for previously conferred benefits. 3 Finally, Village Fuel cross-claimed against GHI for restitution in the event that Village Fuel was required to pay any damages to Searangella. 4 Both GHI and Village Fuel filed cross-motions for summary judgment. In a detailed opinion, the district court dismissed both GHI’s and Village Fuel’s claims for restitution, holding that the money damages sought were not equitable remedies and therefore not permitted under ERISA. It also noted concern with some of GHI’s remaining claims to the extent that they sought the same relief of money damages, a form of relief the district court found likely not permitted under ERISA, even when equitable rescission or reformation might be allowed. In particular, the district court found that no court within the Southern District of New York had equitably reformed an insurance plan contract so that an insurance company could then recover benefits via restitution, calling GHI’s claim to recover benefits paid to providers “even more dubious.” It also noted, with respect to GHI’s rescission claim, that courts rarely permit equitable rescission where the court cannot easily restore the pre-agreement status quo. Because the court found that material facts related to GHI’s rescission and reformation claims remained in dispute, 5 however, it denied Village Fuel’s motion for summary judgment as to these claims.

Following summary judgment, GHI continued settlement negotiations with Scar-angella. After briefing and a hearing addressing which remaining issues would be tried, GHI and Searangella settled them respective claims. The settlement paid a confidential sum to resolve the claims brought by Searangella in his complaint. As a result, GHI and Searangella voluntarily dismissed with prejudice their remaining claims against each other, and Searangella dismissed its outstanding claims against Village Fuel. GHI also dismissed its remaining claims against Village Fuel, and the district court entered an order dismissing the action with prejudice but without costs. Subsequently, Village Fuel moved for attorney’s fees, and the *150 matter was assigned to a magistrate judge for a report and recommendation.

In its application for attorney’s fees from GHI, Village Fuel contended that it was entitled to fees as a “prevailing party,” although it claimed that a lower standard applied in ERISA cases. GHI contended that Village Fuel was not a prevailing party, both because Village Fuel had lost its own cross-claim on summary judgment and also because Village Fuel could not claim success based on the settlement between GHI and Scaran-gella, to which Village Fuel was not a party. The magistrate judge found that under Hardt, 6 Village Fuel had achieved some degree of success on the merits, and applying the factors set out in Chambless, 7 recommended a partial award of attorney’s fees. 8 Both parties objected to aspects of the magistrate judge’s report and recommendation. Upon review, the district court determined that Village Fuel was ineligible for attorney’s fees under ERISA. 9 First, the district court held that Village Fuel could not claim the dismissal of GHI’s restitution claim as success on the merits, because the dismissal was procedural in nature and both parties had failed on their respective restitution claims. Second, the district court found that the voluntary dismissal of the remaining claims lacked the judicial imprimatur necessary to qualify as litigation success, emphasizing that neither party won on summary judgment. As a result, without reaching the magistrate judge’s discussion of the Chambless factors, the district court found Village Fuel statutorily ineligible for an award of attorney’s fees and denied its application.

Village Fuel appealed, contending that the district court erred in its interpretation of the appropriate standard for an award of attorney’s fees in ERISA cases. It urges us to reverse the district court and award it attorney’s fees, and to adopt the analysis of the Chambless factors as set forth in the report and recommendation of the magistrate judge.

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731 F.3d 146, 2013 WL 4792466, Counsel Stack Legal Research, https://law.counselstack.com/opinion/scarangella-sons-inc-v-group-health-inc-ca2-2013.