October 19, 2021

Volume XI, Number 292

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October 19, 2021

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October 18, 2021

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North Carolina District Court in Fourth Circuit Rejects Extension of Amara-like Remedies to Benefit Cases

The Honorable Martin Reidinger, sitting in the United States District Court for the Western District of North Carolina, declined Plaintiff’s invitation to extend the applicability of Cigna v. Amara, 131 S. Ct. 1866 (2011), to ERISA benefit cases.  In Esposito v. Wal-Mart Stores, Inc. and Hartford Life and Accident Insurance Company, Plaintiff, who was receiving LTD benefits under Wal-Mart’s employee benefit plan, filed a lawsuit after Hartford, the insurer and claims administrator, terminated further benefits.  In Plaintiff’s first two causes of action, he sought recovery of his benefits under ERISA § 502(a)(1)(B).  But Plaintiff did not stop there; he added four more causes of action, all premised upon ERISA § 502(a)(3) and sounding in equity, including reformation, equitable estoppel and restitution. These claims were based, in part, upon alleged representations by Hartford to Plaintiff during its administrative review of Plaintiff’s LTD claim.  

Relying upon the teachings of Varity v. Howe, 516 U.S. 489, 116 S. Ct. 1065 (1996), which the Fourth Circuit followed in Korotynska v. Metropolitan Life Ins. Co., 474 F. 3d 101 (4th Cir. 2006),Judge Reidinger granted both defendants’ Motions to Dismiss as to these causes of action:  “In short, Plaintiff has ‘repackaged’ his denial of benefits claim,” which, as Varity held, is not an “appropriate” use of ERISA § 502(a)(3).  Plaintiff had argued that his causes of action were supported by McCravy v. Metropolitan Life Ins.Co., 690 F. 3d 176 (4th Cir.  2012), which was the Fourth Circuit case that followed on the heels of Cigna v. Amara, applying it to find potentially available equitable remedies under ERISA § 502(a)(3) in a case involving lack of plan coverage. (See our previous post, Fourth Circuit Takes Expansive View of Equitable Relief. (July 9, 2012)).  Judge Reidinger found that Plaintiff’s reliance on McCravy was “entirely misplaced,” because here, Plaintiff was seeking recovery under the terms of the Plan, something that was unavailable to the plaintiffs in either Amara or McCravy.  

Judge Reidinger concluded with an admonition that a “straight-forward benefit case” should not be pleaded “in this manner,” a final nod to Varity’s long-standing rule (unbroken by Amara) that an ERISA § 502(a)(3) claim is not “appropriate” when a claim under ERISA § 502(a)(1)(B) claim will do the trick.  

Disclaimer: Womble Carlyle represented a defendant in this case.

Copyright © 2021 Womble Bond Dickinson (US) LLP All Rights Reserved.National Law Review, Volume IV, Number 233
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About this Author

Katherine Thompson Lange, Labor Employment Attorney, Womble Carlyle, ERISA Litigation Lawyer
Senior Counsel

Kathy’s practice has focused almost exclusively in the area of ERISA employee benefit plan litigation for over fifteen years. She has represented plans, plan administrators and plan fiduciaries in hundreds of lawsuits involving a variety of employee benefit plan issues, including benefit entitlement, COBRA compliance and statutory compliance.  Kathy has represented clients in a wide range of industries, including insurance, health care, financial and manufacturing. 

704-331-4939
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