The Longaberger Company v. Jeffrey Kolt

CourtCourt of Appeals for the Sixth Circuit
DecidedNovember 16, 2009
Docket08-4432
StatusPublished

This text of The Longaberger Company v. Jeffrey Kolt (The Longaberger Company v. Jeffrey Kolt) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
The Longaberger Company v. Jeffrey Kolt, (6th Cir. 2009).

Opinion

RECOMMENDED FOR FULL-TEXT PUBLICATION Pursuant to Sixth Circuit Rule 206 File Name: 09a0399p.06

UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT _________________

X - THE LONGABERGER COMPANY, as - Administrator of the Longaberger Family of Companies Group Medical Plan, - Plaintiff-Appellee, - No. 08-4432

, > - - v. - - JEFFREY A. KOLT, Defendant-Appellant. - N Appeal from the United States District Court for the Northern District of Ohio at Cleveland. No. 05-00197—Lesley Brooks Wells, District Judge. Argued: October 14, 2009 Decided and Filed: November 16, 2009 Before: BATCHELDER, Chief Judge; GRIFFIN, Circuit Judge; TARNOW, * District Judge. _________________ COUNSEL ARGUED: George H. Carr, GALLAGHER SHARP, Cleveland, Ohio, for Appellant. Daran Paul Kiefer, KREINER & PETERS CO. L.P.A., Cleveland, Ohio, for Appellee. ON BRIEF: George H. Carr, Timothy John Fitzgerald, GALLAGHER SHARP, Cleveland, Ohio, for Appellant. Daran Paul Kiefer, KREINER & PETERS CO. L.P.A., Cleveland, Ohio, for Appellee. _________________

OPINION _________________

GRIFFIN, Circuit Judge. Defendant Jeffrey A. Kolt appeals the district court’s denial of his motion for summary judgment and its grant of summary judgment for

* The Honorable Arthur J. Tarnow, United States District Judge for the Eastern District of Michigan, sitting by designation.

1 No. 08-4432 The Longaberger Co. v. Kolt Page 2

plaintiff The Longaberger Company (“Longaberger”), an Employee Retirement Income Security Act (“ERISA”) governed, self-funded employee welfare benefit plan, which sought to enforce the terms of the Plan’s reimbursement provisions against attorney Kolt and his client Samuel Billiter.1 Kolt argues that Longaberger’s claims for monetary relief were barred by ERISA and principles of judicial estoppel, and were premised on an invalid lien which was subordinate to Kolt’s lien. We disagree and affirm. In doing so, we hold that the district court correctly granted Longaberger equitable restitution as authorized by § 502(a)(3) of ERISA.

I.

On June 15, 2003, Samuel Billiter was involved in an automobile accident in which he was seriously injured. Longaberger’s self-funded plan covered Samuel Billiter (as the dependent child of Longaberger employee Theresa Billiter), paying his medical bills in the sum of $113,668.31.

Kolt, an Ohio attorney, represented Samuel and Theresa Billiter in civil tort actions against the negligent drivers involved in the June 15, 2003, accident. In July 2004, Kolt reached settlements with the insurance companies of the two negligent drivers, receiving $35,000 from one carrier and $100,000 from the other carrier. Kolt deposited the $135,000 from the two separate settlements into his Interest on Lawyer’s Trust Account (“IOLTA”). He also sent an August 4, 2004, letter to Longaberger notifying it of the settlements, and stating: “Mr. Billiter would like to try to amicabl[y] satisfy his subrogation obligation to you . . . .”2

On December 8 and 9, 2004, Kolt disbursed the majority of the settlement funds from his IOLTA. Kolt kept $45,000 for himself as an attorney fee, disbursed $1,750 to attorney Jerry Alan Goodwin as compensation for his representation of Samuel Billiter

1 Although Samuel Billiter was a defendant below, he did not appeal the district court’s decision. 2 The record contains a March 25, 2004, letter addressed to Kolt from Longaberger, which indicates, pursuant to Kolt’s request, that Longaberger has provided him with a copy of the Summary Plan Description of the Longaberger Plan. The record also contains a March 5, 2004, letter from Kolt to Health Design Plus, Longaberger’s claims administrator, indicating Kolt’s willingness to “protect [its] rights” to recovery. No. 08-4432 The Longaberger Co. v. Kolt Page 3

in potential criminal proceedings, disbursed $86,082.18 to Samuel Billiter, and disbursed $1,000 to attorney Elliot Barrat in consideration for his representation of Samuel Billiter in bankruptcy proceedings. Accordingly, only $1,000 remained in the IOLTA.

The Longaberger Company Health Plan is governed by ERISA and self-funded by Longaberger employees who contribute to the Plan through payroll deductions. At the time of the June 15, 2003, automobile accident, the Plan’s provisions provided Longaberger with “RIGHTS OF REIMBURSEMENT AND SUBROGATION[.]” The Plan’s subrogation and reimbursement terms provided:

The Plan does not cover: (1) Expenses for which another party may be responsible as a result of liability for causing or contributing to the injury or illness of you or your Dependent(s); or (2) Expenses to the extent they are covered under the terms of any automobile medical, automobile no fault, uninsured or underinsured motorist, workers’ compensation, government insurance, other than Medicaid, or similar type of insurance or coverage when insurance coverage provides benefits on behalf of you or your Dependent(s). If you or your Dependent(s) incur health care expenses as described in (1) and (2) above, the Plan shall automatically have a first priority lien upon the proceeds of any recovery by you or your Dependent(s) from such party to the extent of any benefits provided to you or your Dependent(s) by the Plan. You or your Dependent(s) or their representative shall execute such documents as may be required to secure the Plan’s rights. The Plan has the right to recover from you or your Dependent(s) the lesser of: • The amount actually paid by the Plan; or • An amount actually you or your Dependent(s) received from the third party at the time that the third party’s liability is determined and satisfied; whether by full or partial settlement, judgment, arbitration or otherwise. When the Plan pays benefits to or on behalf of you or your Dependent(s), the Plan shall be subrogated, unless otherwise prohibited by law, to your and your Dependents’ claims, causes of action or rights to recovery or No. 08-4432 The Longaberger Co. v. Kolt Page 4

rights against any person who might be liable or found legally liable by a court of competent jurisdiction for the injury that necessitated the hospitalization, medical or the surgical treatment for which Plan benefits were paid. Such subrogation rights shall extend only to the recovery by the Employer of the benefits it has paid for such hospitalization, treatment or other medical care. The Plan shall have a first priority claim against any proceeds paid by or on behalf of a liable third party and shall be entitled to reimbursement or subrogation regardless of whether you or your Dependent(s) have been made whole. The Plan’s rights shall not be subject to reduction under any common fund or similar claims or theories. However, the Employer or its authorized representative may agree to a reduction from amounts recovered to pay reasonable and necessary expenditures, including attorney’s fees, incurred in obtaining the recovery of Plan benefits. This may occur when, in the judgment of Plan Administrator, it would be in the best interests of the Plan to agree to such terms. These rights of reimbursement and subrogation are reserved whether the liability of a third party arises in tort, contract or otherwise. Regardless of how proceeds are designated, the Plan’s rights shall attach to any full or partial judgment, settlement or other recovery. In the event that benefits are to be paid by the Plan for expenses resulting from an injury for which a third party is liable, you or your Dependent(s), as appropriate, shall execute a Subrogation/Right of Reimbursement Agreement, in a form prescribed by the Plan. In addition, you and your Dependent(s) shall cooperate fully in the enforcement of the Plan’s rights, and shall take all actions necessary to enable the Plan to secure such rights and in no way prejudice or diminish such rights without the Plan’s written consent.

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The Longaberger Company v. Jeffrey Kolt, Counsel Stack Legal Research, https://law.counselstack.com/opinion/the-longaberger-company-v-jeffrey-kolt-ca6-2009.