Federal Circuits, 11th Cir. (March 11, 1991)
Docket number: 90-7011
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US Code - Title 29: Labor - 29 USC 1132 - Sec. 1132. Civil enforcement
U.S. Supreme Court - Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41 (1987)
U.S. Supreme Court - Massachusetts Mut. Life Ins. Co. v. Russell, 473 U.S. 134 (1985)
U.S. Court of Appeals for the 6th Cir. - Albert R. Varhola; Joseph Bradshaw; Curtis Darnell; Carlos E. Elrod; Frank P. Iovino; E. Jack Maynard; Curtis W. Phipps; Teresa Price, Executrix of the Estate of Earl Price, Deceased; Stephen E. Sexton; William Vanderpool; Leslie L. Wilson; Claude Wright, Plaintiffs- Appellees, Cross-Appellants, v. John Doe, Et Al., Defendants, Cyclops Corporation; Pension Plan for Salaried Employees of Cyclops Corporation; William D. Dickey; Robert A. Kushner; Donald E. Mitchell; Program of Hospital Medical Benefits for Eligible Pensioners and Surviving Spouses of Cyclops Corporation--Salaried Employees, Defendants-Appellants, Cross-Appellees., 820 F.2d 809 (6th Cir. 1987) Executrix of the Estate of Earl Price, Deceased; Stephen E. Sexton; William Vanderpool; Leslie L. Wilson; Claude Wright, Plaintiffs- Appellees, Cross-Appellants, v. John Doe, Et Al., Defendants, Cyclops Corporation; Pension Plan for Salaried Employees of Cyclops Corporation; William D. Dickey; Robert A. Kushner; Donald E. Mitchell; Program of Hospital Medical Benefits for Eligible Pensioners and Surviving Spouses of Cyclops Corporation--Salaried Employees, Defendants-Appellants, Cross-Appellees.
John C. Falkenberry, Birmingham, Ala., for defendant-appellant.
J. Burruss Riis, Hand, Arendall, Bedsole, Greaves & Johnston, Mobile, Ala., for plaintiffs-appellees.Appeal from the United States District Court for the Southern District of Alabama.Before EDMONDSON and COX, Circuit Judges and WISDOM*, Senior Circuit Judge.WISDOM, Senior Circuit Judge:This case raises an important question, under the Employee Retirement Income Security Act, ERISA:1 May a plaintiff recover extra-contractual damages under ERISA Sec. 502(a)(3), 29 U.S.C. Sec . 1132(a)(3).2Vivion McRae and his wife Paulette were insured beneficiaries of a multi-employer employee benefit insurance plan known as Seafarer's Welfare Plan ["the Plan"]. The McRaes filed suit to compel the Plan to pay certain medical expenses incurred by the McRaes as a result of Mrs. McRae obtaining a tubal reanastomosis.3 The McRaes also sued for compensatory and consequential damages for emotional distress, embarrassment, humiliation, and damages to their financial reputation.The district court entered a judgment directing the Plan to pay the McRaes' medical bills and awarded the McRaes $50,000 in extra-contractual damages. 726 F.Supp. 817. The Plan has not appealed the judgment insofar as it requires payment of the medical bills; the Plan does challenge the award of extra-contractual relief.4When there is a question as to whether the district court is mistaken on a controlling principle of law, this Court does not apply the clearly erroneous standard of Fed.R.Civ.P. 52(a) in reviewing its factual determinations. See First Alabama Bank, N.A. v. First State Ins. Co., 899 F.2d 1045, 1057 n. 6 (11th Cir.1990); Henson v. City of Dundee, 682 F.2d 897, 906 (11th Cir.1982). The weight of authority in both the Eleventh Circuit and other courts indicates that extra-contractual damages are not available as a form of relief under ERISA Sec. 502(a)(3). We follow this authoritative precedent and REVERSE the district court's award of extra-contractual damages.I. STATEMENT OF FACTSIn 1986, Paulette McRae consulted Dr. William Urquhart about obtaining a tubal reanastomosis. In the presence of the McRaes, Dr. Urquhart's insurance clerk called the toll free number of the Seafarer's Plan to inquire whether such an operation would be covered and was informed that the plan would pay 80% of the cost of such operation. In reliance on this assertion, the operation was performed, and several bills were submitted to and paid by the Plan.After a team of medical auditors reviewed these payments, they determined that a tubal reanastomosis was not covered by the Plan, on the theory that it constitutes elective surgery which is denied coverage within the Plan document. The Plan requested reimbursement from the hospital and the anesthesia provider whom it had already paid, and the Plan refused to pay Dr. Urquhart's final bill.The total amount of bills for which the McRae's became liable because of the Plan's determination of lack of coverage was $6,340.69. The McRaes were unable to pay these bills, and, as a result, they were denied credit and subjected to pressure from collection agencies.The McRaes claim that this is an appropriate case for the award of extra-contractual damages to an ERISA Plan beneficiary under ERISA Sec. 502(a)(3), 29 U.S.C. Sec . 1132(a)(3).5II. DISCUSSIONWe hold that extra-contractual damages are not available under ERISA Sec. 502(a)(3), 29 U.S.C. Sec . 1132(a)(3).6ERISA Sec. 502(a)(3), 29 U.S.C. Sec . 1132(a)(3) provides: (a) ... A civil action may be brought-- ... (3) by a participant, beneficiary, or fiduciary ... (B) to obtain other appropriate equitable relief (i) to redress such violations or (ii) to enforce any provisions of this subchapter or the terms of the plan; ... (emphasis added).Although the United States Supreme Court has not conclusively spoken on the issue of whether ERISA Sec. 502(a)(3) encompasses extra-contractual or punitive damages, it has provided the framework and the guidelines for us to use in making this decision.7 In Massachusetts Mutual Life Ins. Co. v. Russell, 473 U.S. 134, 105 S.Ct. 3085, 87 L.Ed.2d 96 (1985), the Court held that ERISA Sec. 409(a) did not authorize extra-contractual or punitive damages. Section 409(a) provides that a fiduciary who breaches any of his responsibilities "shall be subject to such other equitable or remedial relief as the court may deem appropriate...." Although this language is almost identical to the remedial language provided in ERISA Sec. 502(a)(3), because the respondent "relie[d] entirely on Sec. 409(a), and expressly disclaim[ed] reliance on Sec. 502(a)(3)," the Court said that it had "no occasion to consider whether any other provision of ERISA authorizes recovery of extra-contractual damages." Russell, 473 U.S. at 139 n. 5, 105 S.Ct. at 3088 n. 5. In dictum, however, the Court seemed to extend its reasoning to the civil enforcement system of ERISA Sec. 502 stating: "[t]he six carefully integrated civil enforcement provisions found in Sec. 502(a) ... provide strong evidence that Congress did not intend to authorize other remedies that it simply forgot to incorporate expressly." Id. at 146, 105 S.Ct. at 3092.8The Eleventh Circuit has extended the Supreme Court's reasoning in Russell, holding that the statutory limitation of remedies available under ERISA Sec. 502(a)(3) to those of an equitable nature precludes extra-contractual remedies, which are legal in nature. See Bishop v. Osborn Transp., Inc., 838 F.2d 1173, 1174 (11th Cir.1988), cert. denied,