Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan

Whether in a lawsuit under the Employee Retirement and Income Security Act of 1974, a fiduciary can recover an overpayment if the fiduciary did not identify a particular fund for the payment.

Petitioner was injured in a car accident caused by a drunk driver in 2008.

Respondent fiduciary, Board of Trustees of the National Elevator Industry Health Benefit Plan, paid the Petitioner’s medical expenses in the amount of $121,044.02. Petitioner brought suit against the drunk driver and obtained $500,000 in settlement. Of this, he paid his attorney $263,788.48 in legal fees and other expenses. Respondent asserts that it has a right to be reimbursed under the Employee Retirement and Income Security Act (ERISA) for the Petitioner’s medical expenses in the amount of $121,044.02.

ERISA allows plan participants and beneficiaries to “recover benefits due” under 29 USC 1132. In addition, the statute allows beneficiaries, participants, and fiduciaries to “seek appropriate equitable relief” to enforce plan terms. 1132(a)(3)(B).

The district court found that the Respondent was entitled to be reimbursed for the Petitioner’s medical expenses, and the appellate court affirmed.

The issue is whether the Respondent fiduciary is entitled to be reimbursed under the ERISA to recover for Petitioner’s previously covered medical expenses if the Respondent did not identify a particular fund for payment.