A Georgia United States District Court decision was affirmed August 24, 2006 by the 11th Circuit Court. The Court consolidated the Carrillo and Parrott cases pending before it.
The style of the case: DEBORAH PARROTT, Defendant-Appellee; BLUECROSS BLUESHIELD OF SOUTH CAROLINA, Plaintiff-Appellant, v. JOSUE CARILLO, VINCENTE CARILLO, Defendants-Appellees.
Pertinent Case #: No. 05-10235 D.C. Docket No. 04-00889-CV-JOF-1 No. 05-13344 D.C. Docket No. 05-00044-CV-HLM-4
The conclusion reads: Popowski and the Commerce Group appeal the dismissal by the district court of their claim under § 1132(a)(3) seeking reimbursement out of the third-party recovery made by Parrott for benefits paid by the United Distributors Plan on her behalf. Because, as required by Sereboff, Popowski and the Commerce Group seek relief from an identifiable fund and have specified the portion of that fund over which they assert a claim, we find that they have stated a claim for appropriate equitable relief under this provision of ERISA. Accordingly, we REVERSE the dismissal, VACATE the denial of the motions for TRO, preliminary injunction, and the addition of Parrott as party-defendant, and REMAND case number 05-10235 for proceedings consistent with this opinion.
BCBS appeals the dismissal by the district court of its claim under § 1132(a)(3) seeking reimbursement for medical expenses paid on behalf of the Carillos by the Mohawk Plan. Because the Mohawk Plan makes the beneficiaries' recovery from a third party only a trigger for reimbursement and sets no limit upon the reimbursement thereby initiated, we find that BCBS has failed to state a claim for appropriate equitable relief according to the requirements outlined in Sereboff. Accordingly we AFFIRM as to case number 05-1334.
http://www.ca11.uscourts.gov/opinions/ops/200510235.pdf
