Section 502(a)(3)(B) of ERISA permits a fiduciary to bring a civil action “to obtain equitable relief to enforce the terms of the plan”. To obtain this “equitable relief,” the basis for the fiduciary’s claim and the relief it seeks must be equitable in nature. Importantly, a fiduciary cannot seek to impose personal liability, as that would be a legal remedy. The Policy in this case required repayment of an overpayment of benefits that resulted when a claimant received benefits in the amount of $ 19,612. The Plan requested reimbursement and the beneficiary refused, stating that she no longer had any of the funds.

The Court stated that the basis for the claim was equitable in nature. Under the terms of the Policy, the beneficiary owed the Plan reimbursement for overpayment of benefits. However, the case differed from Sereboff in that the beneficiary claimed to no longer have any of the benefits in her possession. The benefits were not in an identifiable fund as the funds were in Sereboff. Therefore, imposition of liability on the beneficiary for the money was a matter of personal liability and of a legal nature, and not an equitable remedy. As a result, the Court denied summary judgment with regard to the Plan’s cross-claim for reimbursement.

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This entry was posted by Adam V. Russo on Wednesday, April 4th, 2007 at 4:38 pm and is filed under Claims Procedures, ERISA, Federal Circuits, Fiduciary Liability, Provider Reimbursement, Standings. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.