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ERISA Preemption, 29 U.S.C. § 1001, et seq.

Hendrix v. United Healthcare Ins. Co. of the River Valley, [Ms. 1190107, Sept. 18, 2020] ___ So. 3d ___ (Ala. 2020). The Court (Sellers, J.; Bolin and Mendheim, JJ., concur; Shaw and Bryan, JJ., concur in the result; Parker, C.J., and Wise and Stewart, JJ., dissent; Mitchell, J., recuses) issues a plurality opinion affirming a judgment of the Etowah Circuit Court dismissing Hendrix’s medical-malpractice wrongful-death claim against United Healthcare on the basis of preemption by the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001, et seq. (“ERISA”).

Mr. Hendrix was injured in an automobile accident, admitted to Gadsden Regional Medical Center for treatment and then ordered by his treating physician to be admitted for further care to an inpatient-rehabilitation facility. Ms. *4. However, efforts by Mr. Hendrix and his representatives to have United authorize payment for inpatient rehabilitation were rejected. Ms. *5. The complaint alleged that United Healthcare made medical treatment decisions that Mr. Hendrix should instead be discharged to his home where he received a lower quality of care than had been ordered by his physicians, therapists and nurses. Id. Plaintiff alleged that Mr. Hendrix thereafter died from pulmonary thromboembolism which would not have occurred had United Healthcare approved inpatient rehabilitation. Ibid. The personal representative then sued the estate of the other driver involved in the automobile accident, that driver’s employer and United Healthcare alleging wrongful death pursuant to § 6-5-410, Ala. Code 1975. Plaintiff alleged that United Healthcare voluntarily assumed duties of medical care which were breached and thereby proximately caused Mr. Hendrix’s death.

United Healthcare removed the action to the Northern District of Alabama asserting federal question jurisdiction under 28 U.S.C. § 1331 in that, according to United Healthcare, the complaint should be treated as seeking relief under the civil-enforcement provisions of ERISA and therefore was completely preempted by ERISA. Ms. *8. The district court rejected this contention, reasoning that Alabama’s wrongful-death statute creates a new right which arises after the decedent’s death, allows for the recovery of punitive damages only and does not compensate the insured such that the claims could not be treated as seeking ERISA benefits. Id.

Upon remand, United Healthcare moved the Etowah Circuit Court to dismiss plaintiff’s complaint based upon defensive preemption, 29 U.S.C. § 1144(a). United Healthcare argued that plaintiff’s medical-malpractice wrongful-death claim “relate[s] to” the ERISA-governed health-benefit plan and is therefore defensively preempted. The circuit court agreed, granted United Healthcare’s motion to dismiss and certified its judgment as final. Ms. *10.

The plurality holds that plaintiff’s wrongful death claim is defensively preempted by ERISA. Ms. **16-29. The plurality rejects the holdings of Pegram v. Herdrich, 530 U.S. 2011 (2000), Land v. Signa Healthcare of Florida, 339 F.3d 1286 (11th Cir. 2003), and HealthAmerica v. Menton, 551 So. 2d 235 (Ala. 1989) which found no preemption for claims which do not “relate to” an employee benefit plan. The plurality rejects the line of cases holding that § 1144(a) does not preempt a third-party claim against an insurer where the claim does not seek benefits under the policy.

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