Opinion
Civil No. 1:99CV225-JAD
August 11, 2000
MEMORANDUM OPINION
Defendants have moved to dismiss or, alternatively, for summary judgment. Henry has cross-filed for summary judgment.
In 1997 Henry was employed by Falcon Products, Inc. He participated in Falcon's health insurance plan administered by Westport Benefits, LLC. On December 24, 1997, Henry sustained serious injuries in an automobile accident with an uninsured driver. His medical bills totaled over $27,500. His personal insurance policy from Mississippi Farm Bureau Mutual Insurance Company afforded him $25,000 in uninsured motorist coverage, but Farm Bureau declined to pay this amount when Westport claimed subrogation rights to those funds.
Eight months after the accident Westport asked Henry to sign an "Agreement for Reimbursement, Assignment and Lien," which made it clear that Westport was claiming subrogation rights to Henry's uninsured motorist coverage. Henry refused to sign the agreement, but in the next months offered to execute a subrogation agreement subrogating Westport to his rights against the uninsured motorist. His demands for payment of his medical bills went unanswered.
In July 1999 Henry filed suit against Falcon Products, Inc, Group Benefit Plan, Falcon Products, Inc., Plan Administrator, Westport Benefits, LLC and Group Administrators, Former and Current Claim Administrators, alleging breach of contract, damage to credit reputation and wrongful assertion of subrogation rights. He has amended his complaint to assert only breach of contract under ERISA.
One issue disposes of these motions. Defendants assert that plaintiff's claims should be dismissed because he breached a condition precedent of the contract, in that he refused to sign the subrogation agreement, which Section 13 of the plan requires prior to payment of benefits. Although the plain reading of the contractual provisions could lead one to believe that the language does not apply to Henry's uninsured motorist coverage, identical language has been interpreted by another court to include just such coverage. See, Wendy's Int'l, Inc., v. Karsko, 94 F.3d 1010 (6th Cir. 1996). This court agrees with that interpretation. Failure to comply with an ERISA Plan's provisions bars recovery. McInnis v. Provident Life and Accident Ins. Co., 853 F. Supp. 880 (M.D.N.C. 1993).
Defendants' motions for summary judgment will be granted. Plaintiff's motion for summary judgment will be denied. A final judgment in accordance with this opinion will be issued separately.