You already know that an ERISA plan recipient may recover attorney fees when prevailing in an action to enforce rights under the plan.
But to win attorney fees, the claimant must show:
- "[success] on [a] significant issue of litigation which achieves some of the benefit...sought in bringing the suit...'"
- something more than "'trivial success on the merits' or a 'purely procedural victory....'"
SO... what IS "trivial success on the merits" or a "purely procedural victory"?
This new decision explains when courts deny attorney fee motions by claimants, when cases are remanded. Woolsey v. Aetna Life Ins. Co., Cause No. CV-18-00578-PHX-SMB (D. AZ. August 4, 2020)(Court denied plaintiff's motion for fees after remanding the case for "procedural irregularities.")
FACTS: Plaintiff Woolsey initially obtained ERISA-governed short term disability benefits. Aetna later discontinued those benefits, and denied long term disability benefits. Plaintiff sued, seeking benefits, and moved for summary judgment.
The District Court, concluding that Aetna's claim denial was "generally on solid ground," denied Plaintiff's motion for summary judgment but "remanded the case to Aetna to remedy" a "few [procedural] irregularities".
The "procedural irregularities" found by the Court were:
- Aetna's assessment of the claim "was made without a specialist's initial consultation clinical notes";
- Aetna failed to address Plaintiff's specific vocational requirements;
- Aetna failed to communicate in sufficient detail how Plaintiff could perfect his appeal;
- Aetna's reviewers failed to consider the cumulative effects of his claimed conditions." Op. at 2.
Plaintiff moved for an award of attorney fees, claiming Woolsey had succeeded on a "significant issue of litigation which achiev[ed] some of the benefit sought in bringing the lawsuit."
ISSUE: Whether Plaintiff was entitled to attorney fees when the District Court remanded the claim to Aetna to "remedy" a "few procedural irregularities"?
DISTRICT COURT HELD: NO — Attorney Fees DENIED.
1. "A[n] [ERISA] plan recipient who prevails in an action to enforce rights under the plan is ordinarily entitled to a reasonable attorney's fee if the participant 'succeed[s] on any significant issue of litigation which achieves some of the benefit...sought in bringing the suit...'". Op. at 3.
2. "A claimant does not satisfy that requirement by achieving 'trivial success on the merits' or a 'purely procedural victory....'" Op. at 3. (Emph. added).
3. "[G]iven the particular circumstances here, Plaintiff's claim constitutes no more than "purely procedural victory" that falls short of what Hardt requires." Op. at 3.
4. "Plaintiff's claim here [does] not compel the conclusion that Plaintiff achieved "some success on the merits." Op. at 4.
Have a great Labor Day Weekend!
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