Weddle v. LINA, 2018 WL 2376358

The Plaintiff whose benefits were terminated after the insurer scheduled a number of IMEs when Plaintiff could not attend, including one when she was visiting her dying father, included a state law claim for intentional infliction of emotional distress along with her claim to reinstate ERISA benefits and for attorney’s fees.  ERISA supersedes, or ‘preempts,’ state law causes of action that ‘relate to’ an employee benefit plan.

To make this determination, courts evaluate whether a court must evaluate or interpret the terms of the ERISA-regulated plan in order to determine the outcome of the state law claim.  The court looked at two ways that the insurer’s actions could have inflicted emotional distress.  The first was that it terminated and refused to reinstate her benefits knowing it would cause her emotional distress.  To make this decision a court would have to evaluate whether the insurer had a legitimate basis for terminating benefits, which would require interpreting and applying the terms of the plan.  The court found this theory was preempted, but the other way to view the claim was that the insurer inflicted emotional distress when it scheduled the IMEs at times it knew she could not attend, including at a time her father was dying.  To determine whether this action caused emotional distress would not require any interpretation of the ERISA benefit plan.  The court therefore found it was not preempted by ERISA. 

However, the court went on to decide that this behavior by the plan, even if true, would not rise to the level of ‘extreme and outrageous conduct’ that would be ‘utterly intolerable in a civilized society,’ which is what constitutes intentional infliction of emotional distress under state law.  The magistrate judge (magistrates sometimes write decisions that are recommendations, which the judge must adopt or not) therefore recommended that the judge dismiss the state law claim for intentional infliction of emotional distress.

The Takeaway: ERISA didn't supersede state law. The court found that the Insurer didn't cause emotional distress by terminating benefits which resulted in the court dismissing the case claiming emotional distress.