Blogging Employee Benefits

May 16, 2006

Subrogation Reimbursement Approved by High Court

Filed under: Litigation — Fuguerre @ 6:30 am

An ERISA plan's action seeking reimbursement under the plan's subrogation agreement constitutes "equitable relief" under ERISA §502(a)(3), according to a unanimous decision of the U.S. Supreme Court, resolving disagreement among the appellate courts. [Sereboff v. Mid Atlantic Medical Services, Inc., No. 05-260]

The court distinguished the case from its previous adverse ruling in Great-West Life & Annuity Ins. Co. v. Knudson insofar as recovery of paid medical expense benefits is being sought through an equitable lien from specifically identified funds remaining in the possession of the individual from a suit against third parties, whereas in Knudon those funds had been placed in trust under state law. The basis for the plan's claim was found equitable since its subrogation provision specifically identified a particular fund as the source of the claimed recovery distinct from the individual's general assets. Tracing requirements are inapplicable, nor is identification of the funds required at the time the contract between the plan and the individual is effectively made under the plan's terms.

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