Filed Under:Health Insurance, Individual Health

Supremes back enrollee in 5-4 ERISA attorney's fee case

(AP photo/J. Scott Applewhite)
(AP photo/J. Scott Applewhite)

The U.S. Supreme Court today decided 5-4 that a federal court can use equitable law principles when a group health plan contract governed by the Employee Retirement Income Security Act (ERISA) is silent about a legal issue.

James McCutchen, the plan enrollee in the case, U.S. Airways Inc. vs. McCutchen (11-1285), was badly hurt in an automobile collision caused by another motorist. He was working for US Airways, and his employer's plan paid $66,866 in medical expenses.

Normally, federal courts are not supposed to use "equitable law" doctrines — efforts to use traditional standards of fairness to do what seems right, rather than sticking rigidly to the letter of a law or document — when dealing with ERISA plan matters, Kagan said.

Kagan said equity cannot override the plain terms of an ERISA plan contract.

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Nichole Morford

Nichole Morford
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