Trustees of the Central States, Southeast & Southwest Areas Health & Welfare Fund v. State Farm Mutual Automobile Insurance

17 F.3d 1081
CourtCourt of Appeals for the Seventh Circuit
DecidedMarch 7, 1994
DocketNos. 93-1453, 93-1516
StatusPublished
Cited by5 cases

This text of 17 F.3d 1081 (Trustees of the Central States, Southeast & Southwest Areas Health & Welfare Fund v. State Farm Mutual Automobile Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Trustees of the Central States, Southeast & Southwest Areas Health & Welfare Fund v. State Farm Mutual Automobile Insurance, 17 F.3d 1081 (7th Cir. 1994).

Opinion

COFFEY, Circuit Judge.

The Trustees of the Central States, Southeast and Southwest Areas Health and Welfare Fund appeal the grant of summary judgment in favor of State Farm Mutual Automobile Insurance Company, State Farm Fire and Casualty, and State Farm General Insurance Company (“State Farm”). State Farm cross-appeals the denial of its motion for leave to file a third-party complaint. We affirm the grant of summary judgment and dismiss the cross-appeal.

FACTS AND PROCEDURAL BACKGROUND

The Trustees administer a Welfare Fund, a self-funded employee welfare benefit plan within the meaning of ERISA. The Fund provides medical and other benefits to participating employees and their dependents residing in 37 states (the “covered individuals”). The Fund offers several plans, each of which provides benefits pursuant to written documents known as plans. Each plan provides that upon payment of benefits to a covered individual, the Welfare Fund becomes “subrogated to” certain rights of recovery that the covered individual may have against any responsible person or entity.

The Trustees’ amended complaint alleged that in a number of instances in which covered individuals suffered accidental injuries, the Fund paid the covered individuals’ medical expenses, notified State Farm of its sub-rogation rights, and that nevertheless, State Farm settled claims with the covered individuals and refused to pay to the Fund the value of the Fund’s subrogation rights.1 The Trustees’ complaint requested an injunction seeking to require State Farm to settle the Welfare Fund’s subrogation rights prior to or at the same time (simultaneously) State Farm settled with the Fund’s covered individuals and the imposition of a constructive trust for the amount of the Fund’s subrogation interest.2 State Farm admitted executing settlements and releases with the covered individuals after receiving notice of the Fund’s subrogation interest, but claimed that because it was not a party to the Fund’s subrogation agreement it was not under an obligation to settle claims with the Fund. State Farm filed a third-party complaint against three designated covered individuals for indemnification in the event that it was ordered to pay damages to the Welfare Fund.

Each party filed a motion for summary judgment. The district court granted the motion of State Farm and denied the Trustees’ motion, finding that nothing in the plan document or ERISA required State Farm to settle the Welfare Fund’s subrogation claims and the claims of covered individuals simultaneously, and therefore refused to enjoin State Farm from its practice of independent settlement with covered individuals. The district judge also found no authority to support the Trustees’ claim that they were entitled to a constructive trust. Finally, the court dismissed State Farm’s third-party complaint after finding that it was without in personam jurisdiction over the third-party defendants.

[1083]*1083 ISSUE

State Farm has admitted that it settled with the covered individuals despite receiving notice of the Fund’s subrogation interest. The sole issue is whether the district judge correctly determined that State Farm did not violate the plan’s terms or ERISA by refusing to settle with the Fund prior to or at the same time State Farm settled with the covered individuals.

Standard of Review

Initially we address the Trustees’ contention that the usual de novo standard of review in summary judgment cases is inapplicable because the arbitrary and capricious standard is used when reviewing Trustees’ interpretations of Welfare Funds’ plan terms. While we agree with the Trustees that “[tjrust principles make a deferential standard of review appropriate when a trustee exercises discretionary powers,” Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 111, 109 S.Ct. 948, 954, 103 L.Ed.2d 80 (1989), the United States Supreme Court was careful to observe in Firestone that “[a]s they do with contractual provisions, courts construe terms in trust agreements without deferring to either party’s interpretation.” Id. at 112, 109 S.Ct. at 955. The Court continued:

“The extent of the duties and powers of a trustee is determined by rules of law that are applicable to the situation, and not the rules that the trustee or his attorney believes to be applicable, and the terms of the trust as the court may interpret them, and not as they may be interpreted by the trustee or by his attorney.”

Id. (quoting 3 W. Fratcher, Scott on Trusts § 201, at 221 (4th ed. 1988)) (Supreme Court’s emphasis).

Deferential review is appropriate only when the trust instrument allows the trustee to interpret the instrument and when the trustee has in fact interpreted the instrument. See Firestone, 489 U.S. at 111, 109 S.Ct. at 954-55. The Trustees have failed to cite any authority for their novel proposition, nor have we discovered any, that Firestone requires deferential review when the Trustees’ actions implicate the rights of third parties like State Farm who are not parties to the Fund’s agreement with its covered individuals. Thus we reject the Trustees’ argument that their interpretation of the plan’s subrogation terms must be reviewed under a deferential standard. Rather, in review of summary judgments, we adhere to Fed. R.Civ.P. 56 and this circuit’s case law:

Summary judgment is appropriate ‘if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law.’ Fed. R.Civ.P. 56(c). This court reviews ‘issues decided on summary judgment de novo, and ... resolve[s] all reasonable inferences in favor of the nonmoving party,’ Kennedy v. United States, 965 F.2d 413, 417 (7th Cir.1992)[.] ... Rule 56(c) requires entry of summary judgment if the non-moving party fails to come forth with evidence to refute the allegations of the moving party in the motion for summary judgment. Celotex Corp. v. Catrett, 477 U.S. 317, 322-24, 106 S.Ct. 2548, 2552-53, 91 L.Ed.2d 265 (1986).

Hickey v. A.E. Staley Manufacturing, 995 F.2d 1385, 1388 (7th Cir.1993).

DISCUSSION

The Trustees argue that the plan’s terms require that the Fund’s subrogation rights be settled prior to or at the time of any settlement with covered individuals. Advancing this argument the Trustees contend that State Farm is required to settle claims with covered individuals as well as the Fund simultaneously, so long as State Farm has received the notice of the Fund’s subrogation rights. We disagree.

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17 F.3d 1081, Counsel Stack Legal Research, https://law.counselstack.com/opinion/trustees-of-the-central-states-southeast-southwest-areas-health-ca7-1994.