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Sereboff v. Mid Atlantic Medical Services, Inc.

Docket No.: 05-260
Certiorari Granted: Nov 28 2005
Argued: March 28, 2006
Decided: May 15, 2006


Economic Activity

PartyNames: Joel Sereboff, et ux. v. Mid Atlantic Medical Services, Inc.
Petitioner: Joel Sereboff, et ux.
Respondent: Mid Atlantic Medical Services, Inc.

Court Below: United States Court of Appeals for the Fourth Circuit

Joel Sereboff, et ux.
Mid Atlantic Medical Services, Inc.
547 U.S. 356 (2006)

As the Court of Appeals recognized below, this case squarely presents a question that is the subject of a four-to-two circuit conflict and that was addressed but left open by this Court in Great-West Life & Annuity Ins. Co. v. Knudson, 534 U.S. 204 (2002). As the federal government has noted, the question is of extreme national importance and likely affects over §1 billion annually.

Question Presented:

The Question Presented is: Can a plan fiduciary bring a civil action against a plan participant to obtain "appropriate equitable relief' under Section 502(a)(3) of the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1132(a)(3), where a term of the plan requires the participant to reimburse medical expenses advanced by the plan if the participant recovers money from a third-party tortfeasor and possesses such payments in an identifiable fund?


Is a health insurance plan that requires the beneficiary to reimburse the insurer for its expenses when the beneficiary recovers damages from a third party that is responsible for the injury "equitable" under section 502(a)(3) of ERISA?

Holding: adjudged to be affirmed in rel
Vote: 9-0
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