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Because the ERISA statute
lacks a statute of limitations, courts have
had difficulty in determining both the
applicable limitations period and affixing a
date upon which the limitation period
accrues. Wise v. Verizon Communications,
Inc., 2010 U.S.App.LEXIS 7244 (9th Cir.
April 8, 2010) promotes certainty on these
issues.
In Wise, the
plaintiff, Nancy Wise, was diagnosed with
multiple sclerosis while working for GTE in
1997. Shortly thereafter, she became
employed by Qwest and was covered by that
organization's long-term disability plan. In
1999, though, Wise was recruited to return
to GTE. Because of her concern that she
would be without long-term disability
insurance coverage due to the MS being
deemed a pre-existing condition, she
negotiated an assurance that her benefits
would be "bridged" back to her initial start
date with GTE in 1995. Shortly after Wise
returned to GTE, that organization became
part of Verizon Communications due to a
merger.
In 2000, Wise was
diagnosed with breast cancer; and on account
of both that condition and the MS, she
applied for long-term disability benefits.
The benefits were approved by MetLife, the
plan's administrator and continued until
2001. Despite receiving a report from Wise's
neurologist that Wise's MS symptoms had
worsened, MetLife terminated her benefit
payments. MetLife also advised Wise that it
considered her MS a pre-existing condition
and therefore not covered by the Verizon
long-term disability plan. After exhausting
appeals, Wise filed suit in 2008. However,
the suit was dismissed on statute of
limitations grounds. The district court held
the claim was governed by Washington's
three-year limitations period applicable to
partly oral contracts.
The court began by noting
that the ERISA statute itself, like many
federal statutes, is devoid of an explicit
statute of limitations for benefit claims.
In such cases, the settled practice is to
"borrow" the most analogous state law
limitations period applicable to such a
claim. However, the practice is to select
only one limitations period per state for
any given claim. The court referenced
Wilson v. Garcia, 471 U.S. 261, 266-67,
105 S. Ct. 1938, 85 L. Ed. 2d 254 (1985),
superseded by statute on other grounds,
Pub. L. No. 101-650, 104 Stat. 5089, 5114-15
(1990), which dealt with the limitations
period for a civil rights claim under 42
U.S.C. § 1983.
In Wilson, in
order to avoid the possibility that several
limitations periods would be borrowed for
any given claim, the court chose the option
of requiring a "simple, broad
characterization" of § 1983 claims for
limitations purposes: a personal injury tort
action for damages. Id. at 272,
276. One year later, in Owens v. Okure,
488 U.S. 235, 109 S. Ct. 573, 102 L. Ed. 2d
594 (1989), the court addressed another
conflict in choosing a statute of
limitations applicable to a § 1983 claim —
the intentional-tort statute of limitations
or the state's residual limitations period
for torts. The court selected the residual
period alone in order to avoid "chaos and
uncertainty" (Id. at 243, 249-50)
and advance the goal of "predictability."
Id. at 240.
The 9th Circuit
determined the same rationale applies to
ERISA. Looking at prior precedent,
Wetzel v. Lou Ehlers Cadillac Group Long
Term Disability Ins. Program, 222 F.3d
643 (9th Cir. 2000) (en banc), the court
determined the proper limitations period is
the one applicable to written contracts. The
court noted the 6th Circuit had acted
similarly in Laborers' Pension Trust
Fund v. Sidney Weinberger Homes, Inc.,
872 F.2d 702 (6th Cir. 1988) (per curiam),
to resolve a dispute about whether a
six-year limitations period based on a
written contract would apply to an ERISA
benefit claim.
The court acknowledged an
argument that if Congress had desired a
uniform statute of limitations it could have
enacted one, and pointed out that Congress
has enacted a 4-year statute of limitations
for civil actions arising under federal
statutes enacted subsequent to Dec. 1, 1990.
28 U.S.C. § 1658. However, since ERISA was
enacted in 1974, and its remedial provisions
have not been amended since 1990, that
provision is inapplicable. Thus, the court
ruled it needed to choose a single
applicable limitations period to Wise's
claim.
In examining the choices,
the court found the appropriate limitations
period applicable to an ERISA benefit claim
brought pursuant to 29 U.S.C. §
1132(a)(1)(B) was Washington's 6-year
statute of limitations for written contract
claims. The court then next examined when
the claim accrued. Under prior precedent,
an ERISA claim "accrues either at the
time benefits are actually denied, or when
the insured has reason to know that the
claim has been denied." Wetzel, 222
F.3d at 649 (internal citation omitted).
"Reason to know" occurs when the plan
communicates a "clear and continuing
repudiation of a claimant's rights under a
plan such that the claimant could not have
reasonably believed but that his [or her]
benefits had been finally denied." Chuck
v. Hewlett Packard Co., 455 F.3d 1026,
1031 (9th Cir. 2006) (internal quotation
marks and citation omitted). The record
showed Wise received four letters
communicating the decision with respect to
her benefits. The first three letters
advised that she could seek further internal
review, while the fourth letter notified
Wise that "all decisions of the [Verizon
Claims Review Committee] are final." The
letter also, for the first time, advised her
of her right to bring a civil enforcement
action. Hence, the court determined it was
the fourth letter that triggered the accrual
of the limitations period. Because Wise
filed suit within six years of that date,
her action was timely and the district
court's dismissal was overturned.
The court then turned to
Wise's other claims, which the district
court had also dismissed. In addition to her
benefit claim, Wise alleged a breach of
fiduciary duty. The court easily disposed of
those claims as either duplicative of the
benefit claim or barred by the ERISA
statute.
There have been several
recent cases involving the accrual of
limitations periods in ERISA benefit claims,
most of which relate to contractual
limitations periods contained in the plans
themselves. White v. Sun Life Assur.Co.
of Canada, 488 F.3d 240 (4th Cir. 2007)
held that an ERISA limitations period
accrues when the initial benefit
determination is communicated to the
beneficiary, but the period is tolled during
mandatory pre-suit appeals. However, in
Abena v. Metropolitan Life Ins.Co., 544
F.3d 880 (7th Cir. 2008), the court did not
toll the limitations period during the
pre-litigation appeal. Abena did
note, though, that if the limitations period
expired during the mandatory appeal, it
could be equitably extended.
Other cases holding that
the limitations period accrues when the
initial benefit decision is communicated to
the insured include Rice v. Jefferson
Pilot Financial Ins.Co., 578 F.3d 450
(6th Cir. 2009), Burke v.
PricewaterhouseCoopers LLP Long Term
Disability Plan, 572 F.3d 76 (2nd Cir.
2009), and Salisbury v. Hartford Life
and Accid.Ins.Co., 583 F.3d 1245 (10th
Cir. 2009). Also, in Abdel v.
U.S.Bancorp, 457 F.3d 877 (8th Cir.
2006), the 8th Circuit ruled that the
limitations period accrued when an insurer
notified the insured that a mental
impairment limitation applied to the claim
and not when the pre-suit appeals were
exhausted.
The approach taken here,
though, promotes the goal the 9th Circuit
deemed paramount — the avoidance of
uncertainty and chaos. By advancing a rule
that commences accrual of the ERISA
limitations period when the claimant is
advised of her right to bring a civil
enforcement action, there can be no doubt as
to the accrual of a limitations period and
certainty in resolving a defense of
untimeliness.
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