Sereboff v. Mid Atlantic Medical Services, Inc.

547 U.S. 356 (2006)

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Nature of the Case

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Facts

The Sereboffs (D) were involved in an automobile accident in California and suffered injuries. D's employer sponsors a health insurance plan administered by respondent P and covered by ERISA. Pursuant to the plan's coverage provisions, the plan paid D's medical expenses. D then filed a tort action in state court against several third parties, seeking compensatory damages for injuries suffered as a result of the accident. P then sent D's attorney a letter asserting a lien on the anticipated proceeds from the suit, for the medical expenses paid on D's behalf. D's suit settled for $750,000. P did not get any monies from them and sued for $74,869.37. The District Court found in P's favor and ordered Ds to pay Mid Atlantic the $74,869.37, plus interest, with a deduction for P's share of the attorney's fees and court costs Ds had incurred in state court. D appealed, and the Fourth Circuit affirmed. A fiduciary may bring a civil action under § 502(a)(3) of ERISA '(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.' 29 U. S. C. § 1132(a)(3).