Sample v. Monsanto Co., 79-1462C (4).
| Decision Date | 12 March 1980 |
| Docket Number | No. 79-1462C (4).,79-1462C (4). |
| Court | U.S. District Court — Eastern District of Missouri |
| Parties | Denver SAMPLE, Plaintiff, v. MONSANTO COMPANY, Defendant. |
Lawrence O. Willbrand, St. Louis, Mo., for plaintiff.
Arthur L. Smith, Robert L. Kelley, St. Louis, Mo., for defendant.
This matter is before the Court on defendant's motion for summary judgment or, in the alternative, for an order compelling arbitration and for a stay pending arbitration. For the reasons stated below, defendant's motion for summary judgment will be granted.
On or about November 6, 1979, plaintiff filed this action in state court seeking benefits for permanent and total disability under an employee benefit plan maintained by defendant. The cause was removed to federal court with jurisdiction based on a federal question under the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001, et seq. ERISA.
Defendant admits plaintiff has claimed total and permanent disability benefits and admits it has refused to pay such benefits. However, defendant argues that plaintiff has failed to pursue his remedies as set forth in the employee benefit plan.
The plan contains a claim procedure which requires that all disputed claims for total and permanent disability benefits under the plan be submitted to medical arbitration by an independent physician selected jointly by the employee and the defendant. Nonetheless, plaintiff did not submit his disputed claim for a determination by a medical arbitrator before initiating these judicial proceedings.
Defendant now moves the Court for summary judgment based on plaintiff's failure to exhaust administrative remedies.
In his first amended complaint, plaintiff asserts that (1) medical arbitration would be futile; (2) medical arbitration is a wrongful and unreasonable delegation of defendant's fiduciary duties under the employee benefit plan; and (3) the doctrine of laches bars any defense based on medical arbitration.
However, plaintiff has failed to allege any facts that support his general allegations that recourse to the plan claims procedures would be futile and that he was denied access to those procedures.
Further, the Court finds that the medical arbitration procedures are a reasonable delegation of defendant's fiduciary duties under the plan.
The broad managerial discretion granted trustees under ERISA indicates a congressional intent that they be primarily responsible for establishing and operating claims procedures under employee benefit plans. See generally 29 U.S.C. §§ 1101-1114. The federal courts generally limit their review of disputed claims and intervene...
To continue reading
Request your trial
-
Schwartz v. Interfaith Medical Center
...Denton v. First Nat'l Bank, 765 F.2d 1295 (5th Cir.1985); Kross v. Western Elec. Co., 701 F.2d 1238 (7th Cir.1983); Sample v. Monsanto Co., 485 F.Supp. 1018 (E.D.Mo.1980). Plaintiffs do not contest a denial of benefits under a plan but the entire structure of the plan. Indeed, one of plaint......
-
Anderson v. Alpha Portland Industries, Inc.
...(9th Cir.1980); Carpenters Local No. 1846 v. Pratt-Farnsworth, Inc., 511 F.Supp. 509, 515 (E.D.La.1981); see Sample v. Monsanto Co., 485 F.Supp. 1018, 1019 (E.D.Mo. 1980). It is plaintiffs' position that they are entitled to life-long insurance coverage because such benefits were "vested" u......
-
Grossmuller v. International Union, United Auto., Aerospace and Agr. Implement Workers of America, UAW, Local 813
...for devising and implementing claims procedure. See Toland v. McCarthy, 499 F.Supp. 1183 (D.Mass.1980), and Sample v. Monsanto Co., 485 F.Supp. 1018 (E.D.Mo.1980). Thus, "full and fair review" must be construed not only to allow a pension plan's trustees to operate claims procedures without......
-
Mahan v. Reynolds Metals Co., LR-C-83-70.
...requirement in suits under ERISA, and that as a matter of sound policy they should usually do so. The case of Sample v. Monsanto Co., 485 F.Supp. 1018 (E.D.Mo.1980), is also of particular interest with respect to both the exhaustion requirement and the delegation of the fiduciary duty of th......