QUALCHOICE, Inc.,
Plaintiff-Appellant, v. ROBIN ROWLAND, Defendant-Appellee. No. 02-3614 UNITED STATES COURT OF
APPEALS FOR THE SIXTH CIRCUIT 367 F.3d 638; 2004
U.S. App. LEXIS 9160; 2004 FED App. 0134P (6th Cir.); 32 Employee Benefits Cas.
(BNA) 2601 December 3, 2003,
Argued May 11, 2004, Decided May 11, 2004, Filed SUBSEQUENT HISTORY:
Rehearing,
en banc, denied by Qualchoice, Inc. v. Rowland, 2004 U.S. App. LEXIS 19282 (6th
Cir., Sept. 10, 2004) US Supreme Court certiorari denied by, Motion granted by
Qualchoice, Inc. v. Rowland, 2005 U.S. LEXIS 2693 (U.S., Mar. 21, 2005) PRIOR HISTORY: [*1]
Appeal from the United States District Court for the Northern District
of Ohio at Cleveland. No. 01-02605. Kathleen McDonald OMalley, District
Judge. COUNSEL:
ARGUED: Daran P. Kiefer, KREINER & PETERS CO., Cleveland, Ohio, for
Appellant. Donald Cybulski, LOWE, EKLUND, WAKEFIELD & MULVIHILL,
Cleveland, Ohio, for Appellee. ON BRIEF: Daran P. Kiefer, Ted M. Traut, KREINER & PETERS CO.,
Cleveland, Ohio, for Appellant. Donald Cybulski, LOWE, EKLUND, WAKEFIELD & MULVIHILL,
Cleveland, Ohio, for Appellee. JUDGES: Before:
MARTIN and MOORE, Circuit Judges; McKEAGUE, District Judge. * * The Honorable David W. McKeague, United States District Judge
for the Western District of Michigan, sitting by designation. OPINIONBY: KAREN NELSON MOORE OPINION: KAREN NELSON MOORE, Circuit Judge. Plaintiff-Appellant QualChoice,
Inc. (QualChoice), a fiduciary and administrator of an
employee benefits plan governed by the Employee Retirement Income Security Act
of 1974 (ERISA), appeals from the district courts
dismissal, for lack of subject matter jurisdiction, of its action to obtain
reimbursement under the terms of that plan from Defendant-Appellee Robin
Rowland (Rowland), a
[*2] plan participant.
QualChoice raises three claims of error on appeal. First, QualChoice argues
that the district court had jurisdiction pursuant to 28 U.S.C. § 1331,
as federal common law provides federal question jurisdiction for ERISA
reimbursement actions. Second, QualChoice argues that the district court had
jurisdiction pursuant to 29 U.S.C. § 1132(e)(1), as QualChoice prayed
for equitable relief within the meaning of 29 U.S.C. § 1132(a)(3).
Third, QualChoice argues that the district court erred in granting
Rowlands motion to dismiss for lack of subject matter jurisdiction
before allowing QualChoice sufficient time to gather evidence. For the following reasons, we AFFIRM the district courts
dismissal for lack of subject matter jurisdiction. I. BACKGROUND On November 16, 2001, QualChoice filed a complaint against Rowland
alleging that QualChoice was a plan administrator and fiduciary for an employee
benefit plan governed by ERISA, and that Rowland was a participant in that
plan. QualChoice further alleged that it had advanced $ 80,763.58 to Rowland
under the plan to cover medical
[*3] expenses arising from
an accident, that Rowland had settled a claim with the third-party tortfeasor,
and that under the terms of the plan Rowland was obligated to reimburse
QualChoice from the money she received in that settlement. QualChoice prayed
for specific performance of the reimbursement provision of the plan and
restitution of the money it had advanced under the plan. On January 11, 2002,
Rowland filed a Rule 12(b)(1) motion to dismiss QualChoices complaint
for lack of subject matter jurisdiction because QualChoice sought only legal
remedies for which ERISA does not provide federal question subject matter
jurisdiction. On January 21, 2001, QualChoice filed a motion for leave to file
an amended complaint that requested equitable relief in order to avoid
dismissal for lack of federal question subject matter jurisdiction. On February 27, 2002, the district court held a case management
conference during which it granted QualChoices motion for leave to
file an amended complaint, but specified that Rowlands motion to
dismiss for lack of subject matter jurisdiction would apply to the amended
complaint. On February 28, 2002, QualChoice filed an amended complaint that
made many [*4] of the same factual allegations as its
original complaint but newly alleged that it had advanced $ 101,440.54 to
Rowland and prayed for equitable restitution, imposition of a constructive
trust or equitable lien, an order declaring that QualChoice has a
right to the equitable remedy of subrogation to obtain reimbursement . . .[and]
any other equitable relief. Joint Appendix (J.A.)
at 11-12 (First Am. Compl. PP 10, 13, 14). The amended complaint claimed that
federal jurisdiction was proper under 29 U.S.C. § 1132(e) and 28
U.S.C. § 1331. On April 29, 2002, the district court entered an order
explaining its obligation to ascertain whether federal question subject matter
jurisdiction existed and its power to conduct an evidentiary investigation in
furtherance of that goal, and requesting that the parties supply the following
information to the Court as soon as possible. J.A. at 65-67
(District Ct. Order, 4/29/02) (emphasis added). . The
time and nature of defendant Rowlands accident, as referred to in P 8
of the amended complaint. . The
details of how Rowland received a fund in settlement of her
claims [*5] from the above accident, id.
at P 11 (e.g., whom she sued, what the settlement amount was, and when and to
whom settlement amounts were or will be paid). . Where
the monies making up the fund in settlement are now. J.A. at 66-67. (District Ct. Order). One day later, on April 30,
2002, Rowland filed an affidavit sworn by Attorney Claudia R. Eklund
(Attorney Eklund) in response to the district
courts order. Attorney Eklunds affidavit provided the following
information. On the evening of November 23, 1994, when a Wheeling & Lake
Erie Railroad (W & LE) train was crossing an
unguarded, unlit track, Rowland drove her car into one of the
railcars. J.A. at 68 (Eklund Aff. PP 2, 3). Rowland was severely injured in the
accident and required several hospitalizations, surgical procedures, and
eventually a below-the-knee amputation. Rowland incurred medical bills totaling
$ 203,000 as a result of the accident. Attorney Eklund represented Robin and Robert Rowland in their
lawsuit against W & LE for personal injuries and damages arising out of the
collision. W & LE was an uninsured entity and verified by counsel
to be an entity functioning on the verge of [*6]
bankruptcy. J.A. at 69 (Aff. P 5). [A] settlement
was proposed under which [W & LE] agreed to pay a total of $ 147,668.00
over the course of forty-four (44) months. J.A. at 69 (Aff. P 6). W
& LE agreed to pay an additional $ 37,500 over the same forty-four months,
contingent upon W & LE obtaining certain concessions from the
Surface Transportation Board at a hearing to be held in June, 1998.
J.A. at 69 (Aff. P 7). According to Attorney Eklund, QualChoice agreed to waive
any subrogated interest it may have had in the proposed settlement agreement.
On December 3, 1997, W & LE and Rowland consummated the settlement
agreement. The Surface Transportation Board, however, did not grant the
concessions upon which the contingent payment of $ 37,500 was based; therefore,
that amount did not become payable. On December 3, 1997, upon signing the agreement, W & LE paid a
lump sum of $ 25,000 to Rowland. On May 1, 1998, W & LE paid an additional
lump sum of $ 8,000 to Rowland. Commencing with June 1, 1998, monthly
payments of $ 2,322.00 for the next 44 months were paid by [W & LE], the
last of which was received on January 1, 2002. J.A. at 69-70 (Aff. P
12). From the initial payments,
[*7] the sum of $ 13,168
was used to pay litigation expenses. J.A. at 69 (Aff. P 11). From
each monthly check, an amount was deducted to pay the $ 27,308 attorney fee
balance. Robin and Robert Rowland received a net recovery of $
107,192. J.A. at 69 (Aff. P 11). According to Attorney Eklund, at this time [April 30,
2002], no settlement fund exists, as the money has been
disbursed over the last 44 months on a monthly basis. J.A. at 70
(Aff. P 13). On April 30, 2002, which was the day after the district court
requested that the parties supply additional information and the same day that
Rowland filed Attorney Eklunds affidavit, the district court entered
an order granting Rowlands motion to dismiss for lack of subject
matter jurisdiction. QualChoice timely appealed the district courts
order dismissing this action for lack of subject matter jurisdiction. II. ANALYSIS A. Standard of Review We review de novo a district courts decision
to grant a motion to dismiss for lack of subject matter jurisdiction.
Nichols v. Muskingum College, 318 F.3d 674, 677 (6th Cir. 2003). Although
Rowland makes both facial and factual challenges to QualChoices [*8] assertion of federal question subject matter jurisdiction,
we only reach the facial challenge, and thus we must view the facts in the
light most favorable to QualChoice, the non-moving party. See Ohio
Natl Life Ins. Co. v. United States, 922 F.2d 320, 325-26 (6th Cir. 1990). B. 28 U.S.C. § 1331 QualChoice argues that the district court had federal question
subject matter jurisdiction pursuant to 28 U.S.C. § 1331 because
QualChoice sought reimbursement under the terms of an ERISA plan, which we have
held may be obtained under federal common law. To support this argument,
QualChoice relies upon Walbro Corp. v. Amerisure Cos., 133 F.3d 961,
965-66 (6th Cir. 1998), in which we held that a plan fiduciarys
action for reimbursement is cognizable under federal common law doctrines
building on the enforcement provisions of ERISA, and thus falls within the
district courts federal question jurisdiction. Subsequent to our decision in Walbro, however, the Supreme
Court decided Great-West Life & Annuity Insurance Co. v. Knudson, 534 U.S. 204, 209,
151 L. Ed. 2d 635, 122 S. Ct. 708 (2002), in which [*9] the Court
reemphasized its view that ERISA is a comprehensive and
reticulated statute, the product of a decade of congressional study
of the Nations private employee benefit system. (citations
omitted). The Court further stated that, because of the comprehensive nature of
the statute, it has been especially reluctant to tamper
with [the] enforcement scheme embodied in the statute by extending
remedies not specifically authorized by its text. Id. (quoting Massachusetts
Mut. Life Ins. Co. v. Russell, 473 U.S. 134, 147, 87 L. Ed. 2d 96, 105 S.
Ct. 3085 (1985)). Obeying the Courts direction in Knudson, we
explicitly held in Community Health Plan of Ohio v. Mosser, 347 F.3d 619, 624
(6th Cir. 2003), that federal question jurisdiction does not exist under 28
U.S.C. § 1331 in an action by a plan fiduciary seeking civil
enforcement of the terms of an ERISA plan that does not implicate any ERISA
provision. In Mosser, we held that 29 U.S.C. § 1132(e)(1) did not
provide federal question subject matter jurisdiction over the plan
fiduciarys action because the relief sought was not equitable
within [*10] the meaning of 29 U.S.C. §
1132(a)(3). Id. at 623-24. We further held that no other ERISA provision
permitted the action; therefore, federal question jurisdiction does
not exist under 28 U.S.C. § 1331 [because] ERISA does not authorize
the suit. Id. at 624. Thus in Mosser, we abandoned our
position in Walbro and held explicitly that there is no federal question subject
matter jurisdiction in an action by a plan fiduciary seeking civil enforcement
of the terms of an ERISA plan, unless ERISA specifically authorizes the suit. Therefore,
QualChoices action to enforce the reimbursement provision is not
cognizable under federal common law, and QualChoice cannot rely upon federal
common law to supply jurisdiction over its claim pursuant to 28 U.S.C.
§ 1331. C. 29 U.S.C. § 1132 QualChoice alternatively argues that the district court had
subject matter jurisdiction pursuant to 29 U.S.C. § 1132(e)(1) because
QualChoice sought equitable remedies within the meaning of 29 U.S.C. §
1132(a)(3). In [*11] its amended complaint, QualChoice
prayed for restitution, imposition of a constructive trust or equitable lien,
subrogation to obtain reimbursement, or any other equitable
relief that the district court deemed proper. J.A. at 12. QualChoice argues that
the settlement money that Rowland recovered from W & LE rightfully belongs
to QualChoice; therefore, equity requires imposition of a constructive trust or
an equitable lien to prevent unjust enrichment. QualChoice acknowledges that in
Knudson, the Supreme Court held that if a plan fiduciary seeks
restitution from a plan beneficiary, who recovered from another, and the plan
beneficiary does not possess the recovered funds, then the action is merely a
legal action under the terms of the contract. QualChoice argues, however, that
the instant action is distinguishable from Knudson because the evidence
demonstrates that Rowland possesses the recovered funds. n1 QualChoice further
argues that the Supreme Court expressly limited its holding in Knudson to
situations where the plan participant or beneficiary did not possess the
recovered funds, thereby indicating that the result would have been different
if the plan participant [*12] or beneficiary did possess the
recovered funds. The district court rejected this argument, noting that
regardless of Rowlands possession of an identifiable fund, QualChoice
is still seeking damages for breach of contract, and concluding in any case
that the beneficiary in Knudson did actually possess the fund, as the
beneficiarys settlement recovery there was placed in a Special Needs
Trust and a client trust account. - - - - - - - - - - - - - - Footnotes - - - - - - - - - - - - - -
- n1 QualChoice argues that Attorney Eklunds affidavit
confirms that Rowland took possession of [a] settlement
fund in the amount of $ 107,192.00.
Appellants Br. at 24. - - - - - - - - - - - - End Footnotes- - - - - - - - - - - - - - ERISA contains a section specifying the proper procedures for
civil enforcement of the statute. Section 1132(e)(1) provides, Except
for actions under subsection (a)(1)(B) of this section, the district courts of
the United States shall have exclusive jurisdiction of civil actions under this
subchapter brought by the Secretary or by a participant, beneficiary,
fiduciary, or any person referred to in section 1021(f)(1) [*13] of this title. Thus, except for actions by a
participant or beneficiary to recover benefits under the terms of a plan, and
another exception not relevant here, § 1132(e)(1) supplies exclusive
federal subject matter jurisdiction for the civil enforcement procedures
authorized by § 1132. Title 29 U.S.C. § 1132(a)(3) is the civil enforcement
mechanism available to plan fiduciaries. Section 1132(a) provides: A civil
action may be brought -- . . . (3) by a
participant, beneficiary, or fiduciary (A) to enjoin any act or practice which
violates any provision of this subchapter or the terms of the plan, or (B) to
obtain other appropriate equitable relief (i) to redress such violations or
(ii) to enforce any provisions of this subchapter or the terms of the plan. The Supreme Court has emphasized that § 1132(a)(3) does
not authorize all relief that a court of equity might award; rather it only
authorizes those remedies traditionally awarded by courts of equity. The Court
has also made clear that regardless of how plaintiffs label their claims to
relief, courts must determine whether the relief sought is truly equitable. [*14] See Knudson, 534 U.S. at 209-10; Mertens v. Hewitt
Assocs.,
508 U.S. 248, 256-57, 124 L. Ed. 2d 161, 113 S. Ct. 2063 (1993). The district court predicated its dismissal for lack of subject
matter jurisdiction upon its conclusion that the instant case is
indistinguishable from Knudson. In Knudson, the Supreme Court held that a plan
fiduciarys action for specific performance and restitution under the
plans reimbursement provision was not authorized by §
1132(a)(3). Knudson, 534 U.S. at 210-11. After the plan beneficiary in
Knudson was injured in a car accident, the plan fiduciary advanced money to
cover the cost of medical expenses. Id. at 207. The plan beneficiary then
received money from a settlement with the tortfeasor. Id. The plan fiduciary
brought an action against the plan beneficiary seeking reimbursement under the
terms of the plan and prayed for various equitable remedies. Id. at 208. The
Supreme Court held that the plan fiduciary was not entitled to an injunction against
respondents failure to reimburse the Plan or
specific performance of the past due monetary
obligation [*15] because such remedies are not typically
available in equity. Id. at 210-11. In rejecting the plan fiduciarys
claim for restitution, the Supreme Court distinguished between legal and
equitable restitution. Id. at 212-13. The Supreme Court stated: In cases in which the plaintiff
could not assert title or right to possession of particular property
but in which nevertheless he might be able to show just grounds for recovering
money to pay for some benefit the defendant had received from him,
the plaintiff had a right to restitution at law through an action derived from
the common-law writ of assumpsit. In such cases, the plaintiffs claim
was considered legal because he sought to obtain a judgment imposing
a merely personal liability upon the defendant to pay a sum of money.
Such claims were viewed essentially as actions at law for breach of contract
(whether the contract was actual or implied). In
contrast, a plaintiff could seek restitution in equity, ordinarily in the form
of a constructive trust or an equitable lien, where money or property
identified as belonging in good conscience to the plaintiff could clearly be
traced [*16] to particular funds or property in the
defendants possession. A court of equity could then order a defendant
to transfer title (in the case of the constructive trust) or to give a security
interest (in the case of the equitable lien) to a plaintiff who was, in the
eyes of equity, the true owner. But where the property [sought to be
recovered] or its proceeds have been dissipated so that no product remains,
[the plaintiffs] claim is only that of a general creditor,
and the plaintiff cannot enforce a constructive trust of or an
equitable lien upon the property of the [defendant]. Id. at 213-14 (citations omitted) (alterations in original). In
holding that the plan fiduciary in Knudson was not entitled to equitable
restitution, the majority wrote that petitioners seek, in essence, to
impose personal liability on respondents for a contractual obligation to pay
money -- relief that was not typically available in equity. A claim
for money due and owing under a contract is quintessentially an action at
law. Id. at 210 (quotation omitted). Yet, the
majority opinion also emphasized that the plan fiduciary in Knudson [*17] was not entitled to equitable restitution because the proceeds from the settlement of
respondents tort action -- are not in respondents
possession [; rather] . . . the disbursements from the settlement were paid by
two checks, one made payable to the Special Needs Trust and the other to
respondents attorney. . . . The basis for petitioners claim
is not that respondents hold particular funds that, in good conscience, belong
to petitioners, but that petitioners are contractually entitled to some funds
for benefits that they conferred. Id. at 214. Subsequent to Knudson, we held that a claim seeking restitution,
or imposition of a constructive trust or equitable lien, is a legal claim if
the plan participant or beneficiary does not possess an identifiable fund,
regardless of whether the plan participant or beneficiary possesses money
recovered from another entity. Mosser, 347 F.3d at 624. QualChoice attempts to
distinguish this case from both Knudson and Mosser by claiming that it
has alleged that Rowland possesses an identifiable fund, and further that
Attorney Eklunds affidavit proves that Rowland possesses the [*18] settlement money. Therefore, we must decide whether district
courts have jurisdiction over claims seeking restitution, or imposition of a constructive
trust or an equitable lien, if the participant or beneficiary recovered money
from another entity, and possesses that recovery in an identifiable fund. Of the circuits that have been faced with this same issue, two
have concluded that a reimbursement action by an ERISA fiduciary is equitable
if the participant or beneficiary has recovered from another entity and
possesses that recovery in an identifiable fund, but legal if the participant
or beneficiary does not possess that recovery in an identifiable fund. See,
e.g., Bombardier Aerospace Employee Welfare Benefits Plan v. Ferrer, Poirot and
Wansbrough, 354 F.3d 348 (5th Cir. 2003); Admin. Comm. of the Wal-Mart
Stores, Inc. Assocs. Health and Welfare Plan v. Varco, 338 F.3d 680 (7th
Cir. 2003), petition for cert. filed, 72 U.S.L.W. 3452 (Dec. 23, 2003) (No.
03-959). Several of these circuit cases focus largely upon the language
throughout Knudson emphasizing that the plan beneficiary did not possess the
settlement [*19] money, and the admonishment near the
end of Knudson stating that the majority was not foreclosing the possibility
that a plan fiduciary might be able to bring an equitable action against the
Special Needs Trust or the client trust account. See, e.g., Varco, 338 F.3d at 687-88
(concluding that the action sought equitable relief because the plan
participant possessed an identifiable fund); Primax Recoveries, Inc. v.
Sevilla,
324 F.3d 544, 547-48 (7th Cir. 2003) (concluding that the action sought legal
relief because the plan participant possessed only an uncashed check from an
insurer and the money remained with the insurer; therefore, the participant did
not possess an identifiable fund); Bauhaus USA, Inc. v. Copeland, 292 F.3d 439, 445
(5th Cir. 2002) (concluding that the action sought legal relief because the
settlement money had been paid into the registry of the Mississippi Chancery
Court; therefore, the beneficiary did not possess an identifiable fund).
Additionally, in a malpractice suit by ERISA trustees against an actuary hired
to evaluate a plan, the Second Circuit took a similar position regarding the
distinction between [*20] equitable and legal relief. Gerosa
v. Savasta & Co., 329 F.3d 317, 321-22 (2d Cir. 2003), cert. denied, 157 L. Ed. 2d
312, 124 S. Ct. 435 (Oct. 20, 2003), and cert. denied, 157 L. Ed. 2d 744, 124
S. Ct. 929 (Dec. 8, 2003). n2 The Gerosa court concluded that the trustees
sought legal relief because they sued for damages for the actuarys
misconduct, rather than to recover a specific fund from the actuary. Id. We
find the analysis in these opinions to be unavailing on this issue because the
majority in Knudson left open the question of whether the plan
participants or beneficiarys possession of an identifiable
fund would have allowed the fiduciary to seek equitable relief, and because
this analysis ignores the Knudson majoritys repeated emphasis that a
breach of contract claim seeking money damages is a legal action. - - - - - - - - - - - - - - Footnotes - - - - - - - - - - - - - -
- n2 Notably, in both Primax Recoveries and Bauhaus, the plan participant
or beneficiary never possessed the settlement money, much less maintained it in
an identifiable fund. See Primax Recoveries, Inc. v. Sevilla, 324 F.3d 544, 548
(7th Cir. 2003); Bauhaus USA, Inc. v. Copeland, 292 F.3d 439, 445
(5th Cir. 2002). - - - - - - - - - - - - End Footnotes- - - - - - - - - - - - -
- [*21] Recently, however, the Fifth Circuit issued an opinion providing a
more thorough analysis supporting its view of the distinction between legal and
equitable relief. Bombardier, 354 F.3d 348. Extrapolating from Knudson,
Bombardier creates the following three-part test for determining whether an
action by a plan fiduciary seeks equitable relief: Does the Plan seek
to recover funds (1) that are specifically identifiable, (2) that belong in
good conscience to the Plan, and (3) that are within the possession and control
of the defendant beneficiary? Id. at 356. The first prong of this test
asks whether the plan fiduciary sought to recover funds [that they
had paid out previously as benefits] from a specifically identifiable corpus of
money. Id. The second prong of the test asks whether the
plans terms contained an express, unambiguous reimbursement provision
which made the disputed funds belong in good conscience to the
plan. Id. The third prong of the test asks whether the plan
participant or beneficiary had actual or constructive possession or control over
the funds. Id. According to the Fifth Circuit, the plan [*22] beneficiary in Knudson did not have actual or constructive
possession over the funds because the settlement money had been
placed in a Special Needs Trust, as mandated by California law, but
the plan participant in Bombardier did have possession because the funds were
held in a bank account in the name of the participants
attorneys, which gave him constructive control, as the attorneys were
his agents. Id. Finding that the plan fiduciary in Bombardier met all of the
requirements of the three-part test, the Fifth Circuit concluded that the
fiduciary sought to recoup the amount it had paid to the participant in
benefits, rather than to impose personal liability on the participant, and
therefore, that the fiduciary sought equitable relief. Id. at 358. The Ninth Circuit has taken the opposite view and held that an
action by an ERISA fiduciary to enforce a plan reimbursement provision is
legal, regardless of whether the plan participant possesses an identifiable
fund. Westaff (USA) Inc. v. Arce, 298 F.3d 1164, 1167 (9th Cir. 2002), cert.
denied, 537 U.S. 1111, 154 L. Ed. 2d 784, 123 S. Ct. 901 (2003). n3 In Westaff, the plan
fiduciary [*23] brought an action seeking a
declaratory judgment that the funds in escrow belonged to it and seeking
specific performance of [the participants] obligation to reimburse
[it]. Id. at 1166. Noting that the Supreme Court has instructed
courts to look at the substance of the remedy sought . . .
rather than the label placed on that remedy, the Ninth
Circuit concluded that the plan fiduciary in Westaff sought to
enforce a contractual obligation for the payment of money, a classic action at law
and not an equitable claim. Id. In Westaff, the Ninth Circuit
expressly took the position that the participants possession of an
identifiable fund did not alter the nature of the action. Id. - - - - - - - - - - - - - - Footnotes - - - - - - - - - - - - - -
- n3 Recently in Honolulu Joint Apprenticeship and Training
Committee of United Assn Local Union No. 675 v. Foster, 332 F.3d 1234, 1237
(9th Cir. 2003), the Ninth Circuit characterized Knudson as holding that the
distinction between legal and equitable restitution turns upon the existence of
an identifiable fund. Foster, however, involved a very different scenario than
that involved in Westaff (USA) Inc. v. Arce, 298 F.3d 1164 (9th
Cir. 2002), cert. denied, 537 U.S. 1111, 154 L. Ed. 2d 784, 123 S. Ct. 901
(2003), and in this case, in that the ERISA administrator sought to recoup
money that it had spent training the defendant apprentice after the apprentice
broke the parties contract by working for a non-union employer
without repaying the cost of training. Foster, 332 F.3d at 1236. We
do not view Foster as an indication that the Ninth Circuit has retreated from
its holding in Westaff. - - - - - - - - - - - - End Footnotes- - - - - - - - - - - - -
- [*24] The Third and Fourth Circuits have also applied Knudson to
determine whether the relief the plaintiff sought was legal or equitable, but
have done so only in unpublished opinions involving obscure factual scenarios.
See Sackman v. Teaneck Nursing Ctr., 86 Fed. Appx. 483, 2003 WL 23173649 (3d
Cir. 2003); Local 109 Ret. Fund v. First Union Natl Bank, 57 Fed. Appx. 139,
2003 WL 152851 (4th Cir. 2003). While these cases do not answer the exact
question we face, they do reflect an adherence to Knudsons admonition
to look beyond the label the plaintiff puts on the relief sought. Since Knudson was decided, we have dismissed for lack of subject
matter jurisdiction several actions brought by plan fiduciaries seeking
reimbursement. See, e.g., Mosser, 347 F.3d 619; Caffey v. Unum Life Ins.
Co.,
302 F.3d 576 (6th Cir. 2002); Cmty. Ins. Co. v. Morgan, 54 Fed. Appx. 828,
2002 WL 31870325 (6th Cir. 2002); Unicare Life & Health Ins. Co. v. Saiter,
37 Fed. Appx. 171, 2002 WL 1301574 (2002); Sheet Metal Local # 24 v. Newman, 35 Fed. Appx. 204, 2002
WL 1033739 (2002). In each of these cases, we simply held that the plan
fiduciary sought legal relief for breach of contract. None of them, however,
forecloses jurisdiction over the ostensibly equitable relief QualChoice seeks. In Mosser, the plan had paid for the participants medical
expenses arising out of an accident with a negligent police officer. Mosser, 347 F.3d at 621.
After the participant recovered from the city through a settlement, he did not
reimburse the plan for the money it had paid out pursuant to the terms of the
plan. The plan fiduciary then sued the participant, bringing a breach of
contract claim requesting specific performance and
restitution for medical payments made by the plan. Id. at 622. When
dismissing the plan fiduciarys action, we noted that the plan
fiduciary did not, in its complaint, allege that it had
given certain funds to [the participant], trace those funds to the settlement
funds from [the tortfeasor], allege that [the participant] was unjustly
enriched by retaining the settlement funds, and seek the return of the
settlement funds in [the participants possession]. Rather, [the [*26] fiduciary] sought restitution from [the
participant] for all covered services. Id. at 624. Although we did not emphasize it our opinion, there was
a significant factual difference between Mosser and Knudson. In Knudson, the plan
beneficiary never possessed the money she recovered in her settlement with the
tortfeasor, as it had been paid directly into a Special Needs Trust and a
client trust account. Knudson, 534 U.S. at 234. In Mosser, however, the plan
participant apparently possessed the money she recovered from the city. Mosser, 347 F.3d at 622-23. In Saiter, a case very similar to Mosser, the plan paid $
164,000 in medical expenses after the participant was injured in a car accident
by a negligent driver. Saiter, 37 Fed. Appx. 171, 172, 2002 WL 1301574, at
*1. The participant then recovered $ 100,000 from the tortfeasor. The plan
fiduciary sued the participant, the tortfeasor, and the tortfeasors
insurance carrier, seeking reimbursement from the participant and asserting
subrogation rights against the tortfeasor and the tortfeasors
insurance carrier. When dismissing the fiduciarys action, we
stated [*27] that such actions are not
authorized claims under ERISA because they seek to enforce plan provisions
through legal remedies. Saiter, 37 Fed. Appx. at 173. In Morgan, a factually complex case, the plan paid $ 116,000 in
medical expenses after the participant was injured in a car accident by a
negligent driver. Morgan, 54 Fed. Appx. 828, 830, 2002 WL 31870325, at *1. The
participant had a $ 50,000 underinsured motorist policy with Liberty Mutual and
the tortfeasor had a $ 100,000 liability policy with State Farm. Because the
participant incurred more than $ 100,000 in medical expenses, Liberty Mutual
paid the participant $ 50,000 on his underinsured motorist claim and in order
to protect its subrogation rights, advanced him $ 100,000 on the State Farm
policy. Morgan, 54 Fed. Appx. at 830. The participant then entered into a
settlement agreement with State Farm, Liberty, and the tortfeasor in which the
participant was to recover $ 7,500 in cash and a $ 30,000 note with 6% secured
interest. Before the participant received any settlement money, the plan
fiduciary sued the participant, seeking to enforce the plans
reimbursement provision. When dismissing the fiduciarys action, we
broadly stated, The claim
[*28] of [the plan
fiduciary] against . . . the plan participant, for reimbursement under the
terms of the plan is squarely precluded by Knudson. Id. We did not
specify whether our holding was limited to situations such as that present in
Morgan, where the settlement had not yet been paid to the participant. Id. After thorough review, we believe that no clear or binding answer
emerges to the question before us: whether a claim maintained by a fiduciary
against a participant or beneficiary, who has recovered money from another and
possesses that recovery in an identifiable fund, is an equitable claim under 29
U.S.C. § 1132(a)(3). We therefore must determine ourselves how to
answer that question, left open by Knudson. To do so, we look to Dobbs on
Remedies, relied upon by the Court in Knudson. Professor Dobbs defines
restitution as a return or restoration of what the defendant has
gained in a transaction. 1 Dan B. Dobbs, Law of Remedies 551 (2d
ed.1993) [hereinafter Dobbs]. The purpose of restitution is to
prevent the defendants unjust enrichment by recapturing the gains the
defendant secured in a transaction. Id. at [*29] 552. Both restitution and damages may be appropriate
remedies for breach of contract; however, they each measure the remedy
differently. Id. Restitution measures the remedy by the
defendants gain and seeks to force disgorgement of that gain. It
differs in its goal or principle from damages, which measures the remedy by the
plaintiffs loss and seeks to provide compensation for that
loss. Id. at 555. Under this analysis, QualChoices action
could be characterized appropriately as one seeking damages for
Rowlands breach of contract, in that QualChoice seeks to recoup the
money it lost because Rowland breached the plans reimbursement
provision. QualChoices action could also be characterized
appropriately as one seeking restitution for Rowlands breach of
contract, in that QualChoice seeks to disgorge the unjust enrichment that
Rowland received via her double recovery. As Knudson points out, however, determining that QualChoice can
bring an action for restitution is only half of the analysis. To fall within
the district courts original federal question jurisdiction under
§ 1132(e)(1), QualChoices action must seek equitable rather
than legal restitution. [*30] Knudson, 534 U.S. at 214.
According to Professor Dobbs, Restitution claims for money are
usually claims at law. . . . On the other hand, restitution
claims that may require coercive intervention or some judicial action that is
historically equitable[] may be regarded as equitable
claims. Dobbs at 556 (emphasis added). The most notable
equitable procedures to enforce restitution are the constructive trust, the
equitable lien, and subrogation. These procedures give the plaintiff
restitution by giving the plaintiff title to, or a security interest in
particular property. Id. at 565. Therefore, the procedural posture of
this case gives rise to a conundrum QualChoice seeks restitution of
money, which is typically a claim at law; however, QualChoice also seeks to
obtain restitution by asking the court to impose a constructive trust or an
equitable lien upon the identifiable fund of settlement recovery that Rowland
allegedly possesses, which is typically an equitable claim. The Fifth and
Seventh Circuits hold that Knudson indicates that district courts have federal
question jurisdiction to impose a constructive trust or an equitable lien in
cases [*31] such as this where the plan
participant or beneficiary has recovered from another entity and possesses that
recovery in an identifiable fund. Bombardier, 354 F.3d 348; Varco, 338 F.3d 680. We conclude, however, that the source of the claim asserted by
QualChoice is a contract to pay money, and that the procedural mechanisms of
constructive trust and equitable lien are not proper mechanisms for enforcing
this right, as such relief would not have traditionally been awarded by a court
of equity in a breach of contract action. Historically, legal restitution was
limited by the concept of formal title. Dobbs at 586. Equitable restitution
developed to fill the void left by that limitation and allowed plaintiffs, who
lacked formal title, to bring actions for restitution. The problem of formal
title was irrelevant in cases where the plaintiff sought intangibles, such as
money; therefore, all plaintiffs could bring such actions in the courts of law.
Historically, when a plaintiff sought restitution of money for breach of
contract, he brought an action for assumpsit, which is a legal remedy. Id. at
571, 578-79 (Assumpsit was the common [*32] law form
of action by which contract claims were redressed.). Contrary to Rowlands assertions, a plaintiff is not
necessarily required to prove wrongdoing by the defendant in order to obtain
relief through imposition of a constructive trust or an equitable lien. Id. at
597-98. The constructive trust is based on property, not
wrongs. Id. at 597 (emphasis added). In the constructive
trust case the defendant has legal rights in something that in good conscience
belongs to the plaintiff. . . . The defendant is thus made to transfer title to
the plaintiff who is, in the eyes of equity, the true
owner. Id. at 587. The equitable lien
uses similar ideas to give the plaintiff a security interest in the property or
to give the plaintiff only part of the property rather than all of
it. Id. at 588. It is true that an equitable lien or a constructive
trust may be imposed on a particular bank account. See id. at 591. The fact
that a plan participant or beneficiary places the money he recovered from
another in a bank account does not, however, change the nature of the action.
The plan may have obligated Rowland to reimburse QualChoice in the event
that [*33] QualChoice paid for Rowlands
medical expenses, but it did not give QualChoice a property right in any
particular fund. n4 - - - - - - - - - - - - - - Footnotes - - - - - - - - - - - - - -
- n4 The plan states, If you receive payment, however
designated, from a third party, you are obligated to reimburse QualChoice
Health Plan, less a pro rata share of the reasonable attorneys fees
and costs you sustained in obtaining such recovery. J.A. at 28
(emphasis added). - - - - - - - - - - - - End Footnotes- - - - - - - - - - - - - - This court has explicitly held that subrogation is not available
in a situation such as this, when the plan participant or beneficiary has
already recovered, because subrogation allows a plan fiduciary only to step
into the shoes of a plan participant or beneficiary and assert the rights of
the participant or beneficiary against another; subrogation does not allow a
plan fiduciary to obtain a judgment of personal liability against a plan
beneficiary or particpant. Mosser, 347 F.3d at 623-24; see also Dobbs at 588,
604. Therefore, QualChoice may have been able to use subrogation to step
into [*34] the shoes of Rowland during the
settlement negotiations with W & LE, but QualChoice may not now use the
doctrine of subrogation to impose personal liability on Rowland. We are aware of significant scholarly criticism of Knudson for
defining the scope of relief available under ERISA by looking to historical
practice of the courts of England. See, e.g., John H. Langbein,
What ERISA Means by Equitable: The Supreme Courts
Trail of Error in Russell, Mertens, and Great-West, 103 Colum. L. Rev. 1317,
1318-20 (2003) (arguing that in drafting ERISA, Congress intended to
incorporate substantive trust law, including make-whole
relief, such as money damages). The Supreme Court, however, has twice
defined the scope of relief available under § 1132(a)(3) of ERISA in
terms of the relief typically available in equity. Mertens,
508 U.S. at 256-57 (listing injunction, mandamus, and
restitution as examples of equitable relief); see Knudson, 534 U.S.
at 213-16 (limiting restitution available under § 1132(a)(3) to
equitable restitution). Applying the Supreme Courts cases, we hold
that a plan fiduciarys action to enforce [*35] a
plan-reimbursement provision is a legal action, regardless of whether the plan
participant or beneficiary recovered from another entity and possesses that
recovery in an identifiable fund. D. Additional Discovery Because we hold that QualChoices action is a legal one
seeking to recover money for Rowlands breach of the plans
reimbursement provision, regardless of whether Rowland possess an identifiable
fund, we need not reach QualChoices argument that the district court
abused its discretion by dismissing this action without allowing sufficient
discovery and within twenty-four hours of requesting that the parties submit
additional information. III. CONCLUSION Based on the foregoing, we AFFIRM the district courts
order dismissing this action for lack of subject matter jurisdiction. |