A self insured ERISA health plan has been sued in state
court as part of a personal injury lawsuit. One count of
the complaint is essentially a claim for payment of benefits
that as of today have not been paid. (The member has
refused to sign the subro agreement as clearly required
by the terms of the plan.)
Prior to the QualChoice case which came out earlier this
month in the 6th Circuit, I would have simply removed the
case and gone through the constructive trust/equitable
lien hoops. However, QualChoice effectively killed these
options within the 6th Circuit. Therefore, if I remove the
case, the federal court is likely to give us a quick boot.
I am tenatively planning to discuss this matter with the
P.I. attorney and have his client sign the subro agreement.
This will allow us to pay the bills and participate in the
state court action under a true subrogation theory
(plan v. tortfeasor).
Questions...
1. What are your thoughts on this approach?
2. Does the state court have subject matter jurisdiction over
an action brought by the ERISA plan against the 3rd party
tortfeasor?
3. Any issues or options I am missing?