Leah Bilyeu filed a claim with First Unum Life Insurance Co. under her long-term disability plan with her employer Morgan Stanley. Unum approved a claim for 24-months of benefits, subject to a mental-illness limitation. Bilyeu brought an action against Unum and alleged that her benefits were wrongfully terminated because her disability was caused by an autoimmune condition. Unum counterclaimed for reimbursement of $36,000 in Social Security benefits Bilyeu received.
By reversing the trial court's judgment in favor of Unum, the Ninth Circuit split with five other circuit courts. Specifically, the court ruled that Unum could seek only equitable relief and could not sue for breach of contract under the Employee Retirement Income Security Act (ERISA). Moreover, Unum could not obtain reimbursement by imposing an "equitable lien by agreement" against the proceeds of Bilyeu's Social Security benefits by targeting money in her possession as a fund for recovery. The court found that this would "circumvent the congressional prohibition on assignment and attachment of Social Security benefits...."
This case may have implications for bankruptcy debtors and trustees. In particular, it is likely to impact the priority and treatment of insurers' claims for reimbursement against bankruptcy estates.
Also seen on Legal By the Bay, the Bar Association of San Francisco's blog.
Also seen on Legal By the Bay, the Bar Association of San Francisco's blog.