United States District Court, D. Hawaii
ORDER GRANTING DEFENDANT HAWAII MEDICAL SERVICE
ASSOCIATION'S MOTION FOR PARTIAL SUMMARY
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.
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.
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
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 ...