Singletary v. State Farm Fire & Cas. Co.

982 So. 2d 216, 7 La.App. 3 Cir. 1347, 2008 La. App. LEXIS 578, 2008 WL 1808800
CourtLouisiana Court of Appeal
DecidedApril 23, 2008
DocketCA 2007-1347
StatusPublished
Cited by1 cases

This text of 982 So. 2d 216 (Singletary v. State Farm Fire & Cas. Co.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Singletary v. State Farm Fire & Cas. Co., 982 So. 2d 216, 7 La.App. 3 Cir. 1347, 2008 La. App. LEXIS 578, 2008 WL 1808800 (La. Ct. App. 2008).

Opinion

982 So.2d 216 (2008)

Keith SINGLETARY, et al.
v.
STATE FARM FIRE & CASUALTY CO., et al.

No. CA 2007-1347.

Court of Appeal of Louisiana, Third Circuit.

April 23, 2008.
Rehearing Denied June 5, 2008.

*218 William Preston Crews, Jr., Attorney at Law, Natchitoches, LA, for Defendant/Appellant, Conagra Poultry Company.

Craig Alan Davis, Attorney at Law, Lafayette, LA, for Plaintiffs/Appellees, Keith Singletary, Belinda Singletary.

Court composed of ULYSSES GENE THIBODEAUX, Chief Judge, JOHN D. SAUNDERS, and GLENN B. GREMILLION, Judges.

SAUNDERS, Judge.

FACTS AND PROCEDURAL HISTORY:

On May 4, 2001, then fifteen-year-old Mary Peterson (hereinafter "Ms. Peterson") was involved in an automobile accident from which she sustained severe bodily injury. Ms. Peterson was transported by MedExpress ambulance to Natchitoches Parish Hospital, and then flown by Life Air Rescue helicopter to LSU Health Sciences Center in Shreveport (hereinafter "LSUS"), where she remained in intensive care for over a month. Due to the severity of Ms. Peterson's injuries, the medical bills she incurred totaled nearly $250,000.00.

At the time of the accident, Ms. Peterson's father, Mr. Keith Singletary (hereinafter "Mr. Singletary"), was employed by defendant ConAgra Poultry Company (later acquired by Pilgrims Pride Corporation, both hereinafter referred to as "ConAgra"). As part of its employee benefits package, ConAgra provided health insurance coverage in the form of the ConAgra Employee Benefit Plan (hereinafter "Benefit Plan"), which was administered by Blue Cross Blue Shield of Nebraska (hereinafter "BCBSN"). Stemming in part from ConAgra's alleged failure to timely repay medical bills under the Benefit Plan, Mr. Singletary and his wife, Ms. Belinda Singletary (hereinafter collectively "plaintiffs") *219 brought suit on May 3, 2002, in the Eleventh Judicial District Court, in Sabine Parish, Louisiana. Plaintiffs sought payment of bills as well as attorney's fees.

After years of litigation, plaintiffs and ConAgra finally participated in a one-day bench trial before Judge Stephen Beasley (hereinafter "Judge Beasley") in July 2007, with the only issue being the plaintiffs' claim against ConAgra for payment of medical bills. At trial, Mr. Singletary testified that although the majority of the $59,112.76 in medical bills owed to LSUS were incurred during the months of May and June 2001, they were not paid under the Benefit Plan until March 2003. Plaintiffs argued that they were thus entitled to statutory penalties and attorney's fees under La.R.S. 22:657(A), the enforcement provision of the Louisiana Insurance Code. As an affirmative defense, ConAgra argued that La.R.S. 22:657(A) was preempted by the federal Employee Retirement Income Security Act of 1964 (hereinafter "ERISA"). 29 U.S.C. § 1001, et seq.

ASSIGNMENTS OF ERROR:

1) Did the trial court commit manifest error in finding that ConAgra did not meet its burden of proof in establishing its affirmative defense that the Benefit Plan was an "ERISA plan?"
2) Did the trial court commit manifest error in employing considerations of whether or not the Benefit Plan was funded or unfunded to determine that the Benefit Plan was not an "ERISA plan?"
3) Did the trial court commit manifest error in awarding plaintiffs statutory penalties and attorney's fees under La.R.S. 22:657?
4) Did the trial court commit manifest error in concluding that certain medical bills at issue here had not been timely processed and paid?

ASSIGNMENT OF ERROR # 1:

In its first assignment of error, ConAgra argues that the trial court erred in finding that it failed to meet its burden of proof in establishing the affirmative defense that the Benefit Plan was an "ERISA plan." More particularly, ConAgra asserts that the inclusion of its "Poultry Company Medical Plan PM23F" (hereinafter "Plan Booklet") in the record precluded the trial court from reasonably concluding that the Benefit Plan was not an "ERISA plan," thus preempting the applicability of La. R.S. 22:657(A). We agree.

The United States District Court for the Western District of Louisiana previously discussed the preemptive effect of ERISA on state laws in Rasmussen v. Metropolitan Life Insurance Co., 675 F.Supp. 1497 (W.D.La.1987). There, the court proclaimed:

The ERISA preemption clause provides that ERISA "shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan described in § 1003(a) of this title and not exempt under § 1003(b) of this title." 29 U.S.C. § 1144(a). Thus if the employee benefits do not constitute a "plan" within the meaning of ERISA, the preemption inquiry ends. Likewise, if the state law does not "relate to" an ERISA plan, preemption will not occur. The definition of an ERISA plan is codified in § 1002(1), and was summarized in Donovan v. Dillingham, 688 F.2d 1367, 1373 (11th Cir.1982), as follows:
[A] `plan, fund, or program' under ERISA is established if from the surrounding circumstances a reasonable person can ascertain the intended benefits, a class of beneficiaries, the source of financing, and procedures for receiving benefits. To be an employee *220 welfare benefit plan, the intended benefits must be health, . . . the intended beneficiaries must include union members, employees, former employees, or their beneficiaries; and an employer or employee organization, or both, and not individual employees or entrepreneural [sic] businesses, must establish or maintain the plan, fund, or program.

Id. at 1500 (footnote omitted). Thus, in order for employee benefits to qualify under ERISA, they must first satisfy the requirements for an "ERISA plan" under Donovan.

ConAgra argues that its Benefit Plan satisfies these requirements. We agree. As evidenced by the Plan Booklet — entered into the record as plaintiffs' "Exhibit 3" — the Benefit Plan was established by ConAgra for the intended purpose of providing health benefits to employees and their eligible dependents. With respect to the Benefit Plan's source of financing, the Plan Booklet clearly states: "The plan is funded by ConAgra Poultry Company and participating employees through a trust agreement with: State Street Bank and Trust Company." Moreover, the Plan Booklet outlines clearly the procedures for receiving benefits, under the section bearing the heading "How to File a Claim." In sum, the Benefit Plan satisfies all prerequisites for qualifying as an "ERISA plan" under Donovan.

In addition to meeting the substantive requirements for an "ERISA plan," we note further that the Plan Booklet contains a section entitled "Your ERISA Rights." That section begins: "The ConAgra Poultry Company Medical Plan provides rights and protections to employees under the Employee Retirement Income Security Act of 1974 (ERISA)." The section goes on to provide a mechanism for employees' free review of "all plan documents," a mailing address from which copies of "all plan documents and other information" can be ordered for a nominal per-page fee, and an assurance that a summary of the annual financial report will be provided to employees.

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982 So. 2d 216, 7 La.App. 3 Cir. 1347, 2008 La. App. LEXIS 578, 2008 WL 1808800, Counsel Stack Legal Research, https://law.counselstack.com/opinion/singletary-v-state-farm-fire-cas-co-lactapp-2008.