Montanile — Supreme Court Victory

Client
Brian S. King
Type of Engagement
Appeal
Subject Matter
ERISA
Forum
U.S. Supreme Court
Eleventh Circuit

The Challenge

Persuading the Supreme Court to resolve an important circuit split on the reach of equitable remedies under ERISA.

The Engagement

On numerous occasions (and frequently with our attorneys appearing), the Supreme Court has grappled with the proper scope of the remedies provided under ERISA, the federal statute that covers most Americans’ health insurance. The most recent case on the remedies question involved an unlucky defendant named Robert Montanile, who was hit by a drunk driver and suffered severe injuries. While Mr. Montanile settled with the driver who injured him, those monies were insufficient to cover his medical bills and other necessary expenses. Nonetheless, Mr. Montanile’s health plan sued him, demanding that he personally reimburse it for the six figures in medical bills it had paid. The circuit courts of appeal were split on whether ERISA allowed a plan to obtain reimbursement in those and similar circumstances. We were retained by the defendant’s trial counsel to handle the case before the Eleventh Circuit, and then to obtain certiorari and argue the matter before the Supreme Court. After obtaining certiorari, we argued that neither ERISA nor the practices of historical equity permitted a plaintiff to reach the general assets of a subrogor. The United States Government intervened on our side.

The Result

The Supreme Court issued an 8-1 decision in favor of Mr. Montanile. The constraints it articulated on the recovery of monies from needy beneficiaries will help to protect the limited resources of millions of sick, disabled, and retired people.

Key Case Materials

U.S. Supreme Court

Opinion (January 20, 2016)

Oral Argument (November 9, 2015)

Reply Brief for Petitioner (October 26, 2015)

Board of Trustees’ Opposition Brief (September 25, 2015)

Brief for Petitioner (July 6, 2015)

Petition for a Writ of Certiorari (December 16, 2014)

 

Eleventh Circuit

Opinion (November 25, 2014)

Our Reply Brief (July 17, 2014)

Board of Trustees’ Opposition Brief (June 30, 2014)

Our Opening Brief (May 27, 2014)

Media Coverage

Even if you win an injury lawsuit, you may not get your money (The Washington Post, April 28, 2016)

High Court Ruling May Hinder Plans’ Efforts To Recoup Consumers’ Legal Awards (Kaiser Health News, April 26, 2016)

Justices Say ERISA Plan Can't Chase Spent Settlement Funds (Law360, January 20, 2016) (subscription required)

Insurers lose, injured beneficiaries win in Supreme Court decision (Modern Healthcare, January 20, 2016) (subscription required)

Supreme Court Reversal in Accident-Payout Case (Courthouse News Service, January 20, 2016)

High Court Grills Health Plan Over Settlement in ERISA Suit (Law360, November 10, 2015) (subscription required)

High Court Will Address Tracing Requirement In Case Involving ERISA Benefit Overpayment (Daily Labor Report, March 31, 2015)

Supreme Court to hear case on insurer reimbursements (Modern Healthcare, March 30, 2015)