Plan Can’t Sue to Recover Benefits Paid When Disputed Bills Were for a Non-beneficiary
cmonfils | November 18, 2011
Employer’s Guide to Self-Insuring Health Benefits October 2011 | Vol. 19, No. 1
A federal appeals court lined up with two lower court rulings in deciding that a hospital and a physician practice were not liable under ERISA to return money to a plan that mistakenly paid claims for a plan member’s ineligible daughter.
The 7th U.S. Circuit Court of Appeals said because the child was never enrolled in the plan, the plan’s suit to enforce ERISA rights or duties could not work, in Kolbe & Kolbe Health and Welfare Ben. Plan v. Medical College of Wisconsin, Inc., 2011 WL 3873773 (7th Cir., Sept. 2, 2011). (more…)
