242 F.3d 899 (9th Cir. 2001), 99-16239, Boston Mutual Ins. v. Murphree

Docket Nº:99-16239
Citation:242 F.3d 899
Party Name:BOSTON MUTUAL INSURANCE, a Massachusetts Corporation, Plaintiff-Appellant, v. ROBERT W. MURPHREE, husband, individually and as natural parent of Susan Elizabeth Murphree, a minor; GLENDYON SUE MURPHREE, wife, individually and as a natural parent of SUSAN ELIZABETH MURPHREE, a minor, Defendants-Appellees.
Case Date:March 12, 2001
Court:United States Courts of Appeals, Court of Appeals for the Ninth Circuit
 
FREE EXCERPT

Page 899

242 F.3d 899 (9th Cir. 2001)

BOSTON MUTUAL INSURANCE, a Massachusetts Corporation, Plaintiff-Appellant,

v.

ROBERT W. MURPHREE, husband, individually and as natural parent of Susan Elizabeth Murphree, a minor; GLENDYON SUE MURPHREE, wife, individually and as a natural parent of SUSAN ELIZABETH MURPHREE, a minor, Defendants-Appellees.

No. 99-16239

United States Court of Appeals, Ninth Circuit

March 12, 2001

Argued and Submitted December 12, 2000

Page 900

[Copyrighted Material Omitted]

Page 901

Frederick C. Berry, Jr. and Brendan N. Mahoney, Frederick C. Berry, Jr., P.C., Phoenix, Arizona, for the plaintiff-appellant.

Scott A. Salmon and Kerry M. Griggs, The Cavanagh Law Firm, P.A., Phoenix, Arizona, for the defendants-appellees.

Appeal from the United States District Court for the District of Arizona David Alan Ezra, District Judge, Presiding. D.C. No.CV 97-00372 PHXSMM

Before: Myron Bright,1 Stephen Reinhardt, and Barry G. Silverman, Circuit Judges.

SILVERMAN, Circuit Judge:

In this case we are asked to decide whether an employee health plan, governed by the Employee Retirement Income and Security Act of 1974 (ERISA), 29 U.S.C. SS 1001 et seq., may coordinate medical benefits with a participant's underinsured motorist (UIM) coverage. We hold that under the coordination provision at issue here, an employee health plan may not coordinate medical benefits with a participant's UIM coverage.

I. BACKGROUND

On May 7, 1996, Susan Murphree, a minor, was seriously injured in an automobile collision. She suffered compound fractures of the fibula and tibia, crushed vertebrae, and severe soft tissue damage. Murphree's injuries required extensive care, including multiple grafts and other reconstructive surgeries, resulting in medical costs of approximately $312,000.

The majority of Murphree's medical expenses were covered by her father's employee health plan--The Arizona Health Dimensions Benefit Plan. The Plan's insurer, Boston Mutual, paid approximately $307,000 of Murphree's medical costs. Her remaining medical expenses were paid by her auto insurer, Uniguard Insurance Company, whose policy contained $5,000 in first-party, "med-pay" coverage.

The Uniguard policy also provided $500,000 in UIM insurance, which covered losses exceeding the other driver's insurance limits. The parties agree that Murphree's personal injury damages, exclusive of her medical expenses, totaled approximately $1,500,000. Although these losses were only partially offset by other driver's liability coverage of $100,000, Uniguard did not tender the UIM proceeds because Boston Mutual claimed an interest in these funds.

Boston Mutual brought this declaratory action under 29 U.S.C. S 1132 (a)(3)(B) against the Murphrees and Uniguard, attempting to coordinate the Plan's medical coverage with Uniguard's UIM coverage. Relying on the Plan's coordination provision, Boston moved for summary judgment, seeking reimbursement from the UIM proceeds for the...

To continue reading

FREE SIGN UP