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.