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because the appellants’ wrongful death action directly related to the administration and disbursement of ERISA plan benefits, it impinged on the functioning of an ERISA plan.
The Spains’ wrongful death action also could not be salvaged under ERISA’s saving clause, which is an exception created by Congress for “any law of any [s]tate which regulates insurance, banking, or securities.”207 The wrongful death cause of action is a general tort claim, and as such is not specifically tailored by the state to regulate insurance.208 Therefore, although the appellants’ wrongful death claim arose under insurance law, specifically the improper withholding of necessary treatment that should have been covered by the insurance company, the action of withholding benefits was a tort, which is not exempt from ERISA preemption.
ERISA specifically states the limited types of recovery that an individual claimant is entitled to bring in an enforcement action against
an insurance company.209
An individual may bring a civil claim
rights under the terms of benefits under the terms of
plan, or plan.”210
to clarify his rights to future Therefore, any other types of
damages and claims arising under state law a wrongful death claim, are preempted by
Accordingly, if insurance benefits are wrongly withheld, and
an insurance beneficiary is injured as a result, a claim can be brought to enforce the administration of the benefits, and to ensure that the benefits are continued in the future, but the insurance company cannot be sued for punitive damages or any other damages arising under state law causes of action.
ERISA Preemption of Damages for Medical Malpractice
Although the courts have held that the recovery of damages for withholding or delaying benefits is preempted, in recent years they have begun to distinguish these cases from those brought for medical
29 U.S.C.A. § 1144(b)(2)(A) (2002) (amendment to original).
Spain, 11 F.3d at 132.
See Employee Retirement Income Security Act § 502(a)(1)(A)-(B), 29 U.S.C. §
§ 1132 (a)(1)(B).
See, e.g., Corcoran v. United Healthcare, Inc., 965 F.2d 1321, 1324, 1332 (5th Cir. 1992)
(construing ERISA to preempt the state law claim of wrongful death).