Supreme Court: ERISA Plan’s Equitable Lien Cannot Be Enforced Against Plan Participant’s Separate Assets
In an 8 to 1 decision, the U.S. Supreme Court held that a subrogation lien set forth in the benefit plan cannot be enforced in equity under section 502(a)(3) of ERISA against a plan participant’s separate assets—those funds that exist outside a specified fund. Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan, No. 14-723, 2016 WL 228344 (S. Ct. Jan. 20, 2016). Instead, the plan’s claim for satisfaction of the lien out of funds other than those he received separately in a third-party automobile accident, constitute “legal” not equitable relief. As a result, the plan cannot bring such a claim under ERISA, which permits a fiduciary to sue only for “appropriate equitable relief.” This principle applies even where a participant, as Mr. Montanile did, spent some or all of these settlement fund expenditures that could not be traced. The implication of the Court’s opinion is that it’s not enough for a plan to have in place a standard binding reimbursement clause. Rather, the claim administrator should act quickly to enforce the lien. The Court noted as much, that if the Board had objected to Mr. Montanile’s attorney’s notice that he intended to disburse the settlement funds to his client and the Board also filed suit to enforce the lien’s application to the settlement fund, then the Board would have been able to recover the medical payments under the “equitable relief” clause in ERISA.