A federal district court in Kansas concluded that attaching a statement of ERISA rights, i.e., a two page document listing and explaining the rights and protections provided by ERISA to plan participants, to a life insurance policy did not convert the policy into an ERISA plan. Wichita Firemen’s Relief Ass’n v. Kansas City Life Ins. Co., 2014 WL 588064 (D. Kan. Feb. 14, 2014).
Plaintiff Wichita Firemen’s Relief Association, an association with the purpose of receiving and disbursing funds for the benefit of its members, entered into an ERISA-exempt group policy insurance contract with Defendant Kansas City Life Insurance. The decedent was a firefighter who died from a heart attack suffered while fighting a fire. The Association filed a claim on his behalf for accidental death and dismemberment benefits. The insurance company denied the claim on the ground that the decedent’s death did not result directly and independently from accidental injury, as his underlying heart condition and circumstances surrounding his heart surgery also contributed to his death.
The Association subsequently filed suit and argued that by attaching a statement of ERISA rights to the policy, the insurance company voluntarily incorporated ERISA’s legal procedures and principles into the policy. The court granted summary judgment in favor of the insurer, reasoning that parties “may not opt-in to coverage under ERISA, regardless of [their] intentions” and doubted that the parties even intended the statement, a two page document about which the Association was unaware prior to the litigation, to create additional rights and obligations under the policy. Furthermore, even assuming that the statement created ERISA rights, the court observed that the statement only provided that participants were entitled to a “full and fair review” on appeal and the insurance company conducted such a review.