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Noetzel v. Hawaii Medical Service Association

United States District Court, D. Hawaii

December 27, 2016

ELIZABETH NOETZEL, Plaintiff,
v.
HAWAII MEDICAL SERVICE ASSOCIATION, Defendant. HAWAII MEDICAL SERVICE ASSOCIATION, Plaintiff,
v.
ELIZABETH NOETZEL, Defendant.

          ORDER GRANTING DEFENDANT HAWAII MEDICAL SERVICE ASSOCIATION'S MOTION FOR PARTIAL SUMMARY JUDGMENT

         Before this court is a motion for partial summary judgment brought by Defendant Hawaii Medical Service Association. HMSA requests a judicial determination that the Employee Retirement Income Security Act of 1974, 29 U.S.C. §§ 1001 et seq., preempts the state statutes relied on by Plaintiff Elizabeth Noetzel. See HMSA's Motion for Partial Summary Judgment, ECF No. 41, PageID # 704. Relying heavily on its reasoning in declining to remand this removed case, this court grants HMSA's motion for partial summary judgment.

         I. BACKGROUND.

         Pursuant to an ERISA plan, HMSA provided Noetzel with health insurance coverage for injuries she suffered in a car accident. See HMSA Concise Statement of Facts, ECF No. 42, PageID #s 736-37; see also Noetzel's Petition for Determination of Claim, Exhibit A to HMSA's Notice of Removal, ECF No. 1-2, PageID #s 12-13. Noetzel filed a motor vehicle tort action in Hawaii state court, which she ultimately settled. See ECF No. 42, PageID # 737; ECF No. 1-2, PageID # 13.

         Upon learning of the settlement, HMSA notified Noetzel that it intended to seek reimbursement from the settlement proceeds for the health benefits provided to her, pursuant to the reimbursement terms of its ERISA plan. See ECF No. 42, PageID # 738; ECF No. 1-2, PageID # 13-14. The plan's “Guide to Benefits” gave HMSA the following:

a right to be reimbursed for any benefits we provide, from any recovery received from or on behalf of any third party or other source of recovery in connection with the injury or illness, including, but not limited to, proceeds from any:
Settlement, judgment, or award;
. . . .
We shall have a first lien on such recovery proceeds, up to the amount of total benefits we pay or have paid related to the injury or illness. You must reimburse us for any benefits paid, even if the recovery proceeds obtained (by settlement, judgment, award, insurance proceeds, or other payment):
Do not specifically include medical expenses;
Are stated to be for general damages only;
Are for less than the actual loss or alleged loss suffered by you due to the injury or illness;
Are obtained on your behalf by any person or entity, including your estate, legal representative, parent, or attorney;
Are without any admission of liability, fault, or causation by the third party or payor.
Our lien will attach to and follow such recovery proceeds even if you distribute or allow the proceeds to be distributed to another person or entity. Our lien may be filed with the court, any third party or other source of recovered money, or any entity ...

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