From Casetext: Smarter Legal Research

Berge v. Local 701

United States District Court, N.D. Illinois
Nov 7, 2003
03 C 50264 (N.D. Ill. Nov. 7, 2003)

Opinion

03 C 50264

November 7, 2003


(Reserved for use by the Court)


MEMORANDUM OPINION AND ORDER

Plaintiff, Lori Berge, individually and as mother and next friend of Rachel Berge, a minor, filed this action in state court against, defendant, Automobile Mechanics Local 701 Union and Industry Welfare Fund seeking reimbursement for medical expenses incurred in treating Rachel, Defendant removed this action to this court based on federal question jurisdiction. 28 U.S.C. § 1331, 1441(a). Defendant premises federal jurisdiction on the complete preemption of state contract claims relating to an employee welfare plan by the civil enforcement provision (section 502(a)) of the Employee Retirement Income Security Act ("ERISA"). 29 U.S.C. § 1132 (a). Plaintiff moves to remand asserting the action is merely a state law contract claim.

Rachel was struck by an automobile and injured. Defendant paid benefits. Plaintiff reached a settlement with the driver and negotiated a resolution of defendant's subrogation rights under the plan. After the settlement, Rachel required surgery to remove certain plates and screws from her fractured leg which had been inserted in the surgery required due to the accident injuries. Defendant refused to pay for this surgery relying on language in the plan which provides additional bills cannot be submitted for the same injury after a settlement has been effectuated.

A state law claim is properly recharacterized as an ERISA claim, making it removable to federal court, when the following factors are present: 1) the plaintiff is eligible to bring an action under § 502(a); 2) the plaintiff's cause of action falls within the scope of an ERISA provision plaintiff can enforce via § 502(a); and 3) the plaintiff's state law claim cannot be resolved without interpreting the contract governed by ERISA. Jass v. Prudential Health Care Plan. Inc., 88 F.3d 1482, 1487 (7th Cir. 1996). Here, plaintiff is a beneficiary and, therefore, eligible to bring an action under § 502(a). 29 U.S.C. § 1132 (a) (1) (a civil action may be brought by a participant or beneficiary). Plaintiff's claim is to recover benefits due under the terms of the plan and, therefore, is within the scope of an ERISA provision enforceable via § 502(a)(1)(B). See Moran v. Rush Prudential HMO, Inc., 230 F.3d 959, 967 (7th Cir. 2000), aff'd, 536 U.S. 355 (2002). Plaintiff claims that the terms of the plan, particularly the meaning of "same injury", are ambiguous and should be interpreted to allow her claim. Thus, the third Jass factor, a requirement that the ERISA contract be interpreted, is also met.

Because all of the Jass factors are met, plaintiff's state law claim falls within the complete preemption doctrine and the action was properly removed to this court. Plaintiffs motion to remand is denied.


Summaries of

Berge v. Local 701

United States District Court, N.D. Illinois
Nov 7, 2003
03 C 50264 (N.D. Ill. Nov. 7, 2003)
Case details for

Berge v. Local 701

Case Details

Full title:BERGE vs. LOCAL 701

Court:United States District Court, N.D. Illinois

Date published: Nov 7, 2003

Citations

03 C 50264 (N.D. Ill. Nov. 7, 2003)