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BUSCHING-KAPOCHUNAS FINAL

2/4/2009 1:59:19 AM

628

HOFSTRA LABOR & EMPLOYMENT LAW JOURNAL

[Vol. 25:601

found that the law could not be saved from preemption as being directed at the insurance business.196 Several federal courts have since applied this reasoning in cases to “prohibit damages suits by health plan enrollees injured by health plan coverage denials and delays.” 197

In Spain v. Aetna Life Insurance Co.,198 the courts applied the holding of the court from Pilot Life, and ruled that the claimant’s suit for recovery of wrongful death benefits was preempted by ERISA because they arose from the mishandling of a claim under an employee benefits plan.199 In Spain, the decedent, Steven Spain, received approval from his insurance company for a three part surgical procedure to treat his cancer diagnosis.200 The insurance company later withdrew approval for the third stage of the procedure, and as a result, Steven died.201 His wife and daughter sued the insurance company for wrongful death recovery. 202

The Spain Court reasoned that Steven’s wife and daughter were pre-empted from wrongful death recovery; they stated that “ERISA preempts [a]ppellants’ wrongful death action because the state law in its application directly ‘relates to’ the administration and disbursement of ERISA plan benefits.”203 ERISA’s preemption clause “is deliberately expansive”204 and “contains one of the broadest preemption clauses ever

enacted

by

Congress.”205

Thus,

a

state

cause

of

action,

such

as

a

wrongful death claim, “relates to an ERISA benefit plan when of the law impinges on the functioning of an ERISA plan.”206

operation In Spain,

    • 196.

      Id.

    • 197.

      Id.; see, e.g., Andrews-Clarke v. Travelers Ins. Co., 984 F. Supp. 49, 53-55 (D. Mass.

  • 1997)

    ; Corcoran v. United Healthcare, Inc., 965 F.2d 1321, 1328-29, 39 (5th Cir. 1992); Danca v.

Private Healthcare Sys., Inc., 185 F.3d 1, 7 (1st Cir. 1999); Hull v. Fallon, 188 F.3d 939, 943 (8th Cir. 1999); Kuhl v. Lincoln Nat’l Health Plan of Kansas City, Inc., 999 F.2d 298, 302 (8th Cir. 1992); Nealy v. U.S. Healthcare HMO, 844 F. Supp. 966, 971 (S.D.N.Y. 1994); Spain v. Aetna Life Ins. Co., 11 F.3d 129, 131 (9th Cir. 1993); Tolton v. Am. Biodyne, Inc., 48 F.3d 937, 941-42 (6th Cir. 1995); Turner v. Fallon Cmty. Health Plan Inc., 127 F.3d 196, 199 (1st Cir. 1997) (citations omitted).

  • 198.

    Spain, 11 F.3d 129.

  • 199.

    Id. at 131.

  • 200.

    Id.

  • 201.

    Id. After withdrawing approval for the third part of the surgical procedure, the insurance

company admitted its mistake and regranted the approval. Id. However, the window of opportunity to successfully complete the procedure had passed. Id.

  • 202.

    Id.

  • 203.

    Id.

  • 204.

    Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 45-46 (1987).

  • 205.

    Greany v. W. Farm Bureau Life Ins. Co., 973 F.2d 812, 817 (9th Cir. 1992) (quoting PM

Group Life Ins. Co. v. W. Growers Assurance Trust, 953 F.2d 543, 545 (9th Cir. 1992)). 206. Spain, 11 F.3d at 131 (citing Metro. Life Ins. Co. v. Mass., 471 U.S. 724, 739 (1985)).

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