Where Untimely Death Occurred Outside Coverage Grant, Claimant's Recovery Under ERISA Section 502(a)(3) Was Limited to Reimbursement of Premiums

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U.S. Court of Appeals for the Fourth Circuit

In McCravy v. Metropolitan Life Ins. Co., __ F.3d __, 2011 WL 1833873 (4th Cir. (S.C.) May 16, 2011), the Fourth Circuit Court of Appeals held that a claim for breach of fiduciary duty under ERISA section 502(a)(3) necessarily sought legal, not equitable, relief, and therefore benefits under an accidental death and dismemberment (AD&D) plan were not recoverable as a remedy for a claimed violation of that section.

Debbie McCravy was enrolled in an AD&D plan issued by her employer. McCravy also obtained coverage for her daughter, who at the time was an “eligible dependent child.” The plan defined “eligible dependent child” as a dependent child of the insured who was unmarried and either younger than 19 years old, or younger than 24 years old and also enrolled in school full-time. After the death of McCravy’s daughter, McCravy submitted a claim to MetLife for AD&D benefits. MetLife denied the claim because her daughter was 25 years old when she died, and was therefore no longer an eligible dependent child. McCravy sued MetLife under ERISA Sections 502(a)(2) and (a)(3). The district court held that McCravy could not recover under section (a)(2) (a determination that McCravy did not dispute on appeal) and that, under section (a)(3), McCravy’s recovery was limited to reimbursement of the premiums she had paid after her daughter no longer was eligible for coverage. McCravy appealed.

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