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Second Circuit: Group Health Plan Has No Claim for Reimbursement of Benefits from Individual Policy Where Both Claim to Provide Secondary Coverage (PDF)
U.S. Court of Appeals for the Second Circuit Nov. 16, 2014
"After it paid the claims, Central States sought reimbursement from Gerber, whom it considered the primary insurance provider. Gerber refused to pay, taking the position that ... its policies provided only excess, secondary coverage.... [We] are not free to fill in unwritten gaps in ERISA's civil remedies by reading into the statute additional causes of action derived from federal common law.... [A]lthough Central States might well be left without an appropriate remedy as a result of this decision, and that in the future its beneficiaries may be put in the unfortunate position of having to sue their insurance companies to receive benefits to which they are indisputably entitled, the claims raised by Central States are legal, not equitable, and therefore may not be brought under Section 502(a)(3)." [Cent. States, Se. & Sw. Areas Health & Welfare Fund v. Gerber Life Ins. Co., No. 13-4834 (2d Cir. Nov. 14, 2014)]
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